Patients with a preference for medication do equally well in mindfulness-based cognitive therapy for recurrent depression as those preferring mindfulness

Marloes J Huijbers; Philip Spinhoven; Digna J F van Schaik; Willem A Nolen; Anne E M Speckens

doi:10.1016/j.jad.2016.01.041

Patients with a preference for medication do equally well in mindfulness-based cognitive therapy for recurrent depression as those preferring mindfulness

J Affect Disord. 2016 May:195:32-9. doi: 10.1016/j.jad.2016.01.041. Epub 2016 Jan 28.

Authors

Marloes J Huijbers¹, Philip Spinhoven², Digna J F van Schaik³, Willem A Nolen⁴, Anne E M Speckens⁵

Affiliations

¹ Department of Psychiatry, Radboud University Medical Centre, Reinier Postlaan 10, 6525 GC Nijmegen, The Netherlands. Electronic address: marloes.huijbers@radboudumc.nl.
² Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden and Department of Psychiatry, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
³ GGZ InGeest and VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands.
⁴ University of Groningen, University Medical Center Groningen, Department of Psychiatry, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
⁵ Department of Psychiatry, Radboud University Medical Centre, Reinier Postlaan 10, 6525 GC Nijmegen, The Netherlands.

PMID: 26852095
DOI: 10.1016/j.jad.2016.01.041

Abstract

Background: Previous studies have suggested that patients' treatment preferences may influence treatment outcome. The current study investigated whether preference for either mindfulness-based cognitive therapy (MBCT) or maintenance antidepressant medication (mADM) to prevent relapse in recurrent depression was associated with patients' characteristics, treatment adherence, or treatment outcome of MBCT.

Methods: The data originated from two parallel randomised controlled trials, the first comparing the combination of MBCT and mADM to MBCT in patients preferring MBCT (n=249), the second comparing the combination to mADM alone in patients preferring mADM (n=68). Patients' characteristics were compared across the trials (n=317). Subsequently, adherence and clinical outcomes were compared for patients who all received the combination (n=154).

Results: Patients with a preference for mADM reported more previous depressive episodes and higher levels of mindfulness at baseline. Preference did not affect adherence to either MBCT or mADM. With regard to treatment outcome of MBCT added to mADM, preference was not associated with relapse/recurrence (χ(2)=0.07; p=.80), severity of (residual) depressive symptoms during the 15-month follow-up period (β=-0.08, p=.49), or quality of life.

Limitations: The group preferring mADM was relatively small. The influence of preferences on outcome may have been limited in the current study because both preference groups received both interventions.

Conclusions: The fact that patients with a preference for medication did equally well as those with a preference for mindfulness supports the applicability of MBCT for recurrent depression. Future studies of MBCT should include measures of preferences to increase knowledge in this area.

Keywords: Antidepressant medication; Depression; Mindfulness-based cognitive therapy; Relapse prevention; Treatment preference.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Aged
Antidepressive Agents / therapeutic use
Chronic Disease
Cognitive Behavioral Therapy / methods*
Depressive Disorder, Major / psychology
Depressive Disorder, Major / therapy*
Female
Humans
Male
Middle Aged
Mindfulness / methods*
Patient Preference*
Quality of Life / psychology
Recurrence
Secondary Prevention / methods*
Time Factors
Treatment Outcome

Substances

Antidepressive Agents