New York University School of Medicine.
University of California, Berkeley.
Behav Ther. 2018 Sep;49(5):836-849. doi: 10.1016/j.beth.2018.02.001. Epub 2018 Feb 8.
We conducted a 26-month follow-up of a previously reported 12-month study that compared mindfulness-based cognitive therapy (MBCT) to a rigorous active control condition (ACC) for depressive relapse/recurrence prevention and improvements in depressive symptoms and life satisfaction. Participants in remission from major depression were randomized to an 8-week MBCT group (n = 46) or the ACC (n = 46). Outcomes were assessed at baseline; postintervention; and 6, 12, and 26 months. Intention-to-treat analyses indicated no differences between groups for any outcome over the 26-month follow-up. Time to relapse results (MBCT vs. ACC) indicated a hazard ratio = .82, 95% CI [.34, 1.99]. Relapse rates were 47.8% for MBCT and 50.0% for ACC. Piecewise analyses indicated that steeper declines in depressive symptoms in the MBCT vs. the ACC group from postintervention to 12 months were not maintained after 12 months. Both groups experienced a marginally significant rebound of depressive symptoms after 12 months but were still improved at 26 months compared to baseline (b = -4.12, p <= .008). Results for life satisfaction were similar. In sum, over a 26-month follow-up, MBCT was no more effective for preventing depression relapse/recurrence, reducing depressive symptoms, or improving life satisfaction than a rigorous ACC. Based on epidemiological data and evidence from prior depression prevention trials, we discuss the possibility that both MBCT and ACC confer equal therapeutic benefit. Future studies that include treatment as usual (TAU) control conditions are needed to confirm this possibility and to rule out the potential role of time-related effects. Overall findings underscore the importance of comparing MBCT to TAU as well as to ACCs.
我们对一项为期 12 个月的研究进行了 26 个月的随访，该研究比较了正念认知疗法（MBCT）与严格的积极对照条件（ACC）在预防抑郁复发/复发和改善抑郁症状和生活满意度方面的效果。从重度抑郁症中缓解的参与者被随机分配到 8 周的 MBCT 组（n=46）或 ACC 组（n=46）。在基线、干预后以及 6、12 和 26 个月评估结果。意向治疗分析表明，在 26 个月的随访期间，两组在任何结果上均无差异。复发时间结果（MBCT 与 ACC）表明，危险比=0.82，95%置信区间[0.34,1.99]。MBCT 的复发率为 47.8%，ACC 的复发率为 50.0%。分段分析表明，从干预后到 12 个月，MBCT 组与 ACC 组相比，抑郁症状的下降更为陡峭，但在 12 个月后并未维持。两组在 12 个月后抑郁症状均略有反弹，但与基线相比仍有所改善（b=-4.12，p<=0.008）。生活满意度的结果相似。总之，在 26 个月的随访中，MBCT 在预防抑郁复发/复发、减轻抑郁症状或改善生活满意度方面并不比严格的 ACC 更有效。基于流行病学数据和先前预防抑郁试验的证据，我们讨论了 MBCT 和 ACC 可能具有同等治疗效果的可能性。需要进行包括治疗作为常规（TAU）对照条件的未来研究来证实这一可能性，并排除与时间相关的影响的潜在作用。总体研究结果强调了将 MBCT 与 TAU 以及与 ACC 进行比较的重要性。
