Thursday, April 23, 2015

Mindfulness-based cognitive therapy, a new way to protect you from depression

There is a trend in every regions, psychotherapy as well. Cognitive Behavioral Therapy (CBT) has been the center of psychological intervention for a few decades. And recently, a new comer attracts attention: Mindfulness-based cognitive therapy. I often find the opportunity to learn about mindfulness in London.

Mindfulness is a thought originated from Zen ways of ancient Japanese Buddhism. It emphasizes the recognition and acceptance of the presence. People tend to look back to the past, imagines the horrible future, and avoid from a focus on the present self, especially in a depressive state. Mindfulness encourage you to understand the present situation including you strength and troubles you face currently, to accept them as they are.

CBT has been proven as the most promised technique in all psychotherapies in order to deal with depression. Recently, therapists began to introduce the concept of mindfulness to enhance the effectiveness of CBT. Some psychotherapists criticized CBT for underestimating the emotional and spiritual aspects of the clients. Mindfulness-based cognitive therapy can be an answer to such disputes.

The Guardian mentioned the effectiveness of mindfulness-based cognitive therapy. In this article, a randomized-controlled trial was introduced. In this study, the participants were assigned to either therapy group or medication group.

The Guardian: Mindfulness as effective as pills for treating recurrent depression - study

The primary outcome to be measured was recurrence rate of depression. As a result, the rate of recurrence in two years followup was not significantly different in two groups, although mindfulness-based cognitive therapy group looked superior at a glance of the survival curve in the original article. The researchers seem disappointed to see this result, as they had been convinced the superiority of mindfulness-based cognitive therapy.

The Lancet: Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial

This result itself is not so surprising. The effectiveness of mindfulness-based cognitive therapy has been suggested in a systematic review.

A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder.

However, my concern is different. The recurrence rate itself was 44% in the mindfulness-based cognitive therapy group and 47% in the medication group. Thus, approximately half of the participants experienced a relapse or recurrence in spite of continuous therapy. It is quite sorry for the patients.

Depression is a chronic disease easy to recurrence. The recurrence rate in a lifetime is estimated to 75%. It is the task of professionals how to reduce the rate of saving the patients.

We cannot be satisfied to see the 44% of the recurrence rate in two years. Mindfulness-based cognitive therapy may be innovative, but still have challenges in terms of clinical approval. Notwithstanding this, it is worthy to know that a series of structured mindfulness training is compatible to two-year medication. We should seek for better solution about this matter.

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