Forkmann Thomas, Wichers Marieke, Geschwind Nicole, Peeters Frenk, van Os Jim, Mainz Verena, Collip Dina
Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Pauwelsstraße 19, 52074 Aachen, Germany.
Department of Psychiatry and Psychology, Maastricht University Medical Centre, School for Mental Health and Neuroscience, The Netherlands.
Compr Psychiatry. 2014 Nov;55(8):1883-90. doi: 10.1016/j.comppsych.2014.08.043. Epub 2014 Aug 15.
The aim of the present study was to investigate the effects of mindfulness-based cognitive therapy (MBCT) on suicidal ideation in an open-label randomised controlled trial of patients with residual depressive symptoms. Furthermore, this study aimed at examining whether an effect of MBCT on suicidal ideation was dependent on a reduction in depression severity, worry and rumination, or an increase in mindfulness.
One hundred and thirty participants were randomised to a treatment arm (treatment as usual plus MBCT) or a wait list arm. Change in depression, change in worry, change in rumination and change in mindfulness were entered as covariates in a repeated measures ANOVA in order to assess to what degree MBCT-induced changes in suicidal ideation were independent from changes in these parameters.
There was a significant group×time (pre vs. post) interaction on suicidal ideation indicating a significant reduction of suicidal ideation in the MBCT group, but not in the control group. The interaction remained significant after addition of the above covariates. Change in worry was the only covariate associated with change in suicidal ideation, causing a moderate reduction in the interaction effect size.
The results suggest that MBCT may affect suicidal ideation in patients with residual depressive symptoms and that this effect may be mediated, in part, by participants' enhanced capacity to distance themselves from worrying thoughts.
本研究的目的是在一项针对残留抑郁症状患者的开放标签随机对照试验中，探究基于正念的认知疗法（MBCT）对自杀意念的影响。此外，本研究旨在检验MBCT对自杀意念的影响是否依赖于抑郁严重程度、担忧和反刍思维的减轻，或正念的增强。
130名参与者被随机分为治疗组（常规治疗加MBCT）或等待列表组。将抑郁变化、担忧变化、反刍思维变化和正念变化作为协变量纳入重复测量方差分析，以评估MBCT引起的自杀意念变化在多大程度上独立于这些参数的变化。
在自杀意念方面存在显著的组×时间（基线与随访）交互作用，表明MBCT组的自杀意念显著降低，而对照组则未降低。加入上述协变量后，该交互作用仍然显著。担忧变化是与自杀意念变化相关的唯一协变量，导致交互效应大小适度降低。
结果表明，MBCT可能会影响残留抑郁症状患者的自杀意念，且这种影响可能部分由参与者增强的与担忧性思维保持距离的能力所介导。
