Skip to main content
Top
Gepubliceerd in: Mindfulness 3/2015

01-06-2015 | ORIGINAL PAPER

A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder

Auteurs: Stuart J. Eisendrath, Erin Gillung, Kevin Delucchi, Daniel H. Mathalon, Tony T. Yang, Derek D. Satre, Rebecca Rosser, Walter E. B. Sipe, Owen M. Wolkowitz

Gepubliceerd in: Mindfulness | Uitgave 3/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of mindfulness-based cognitive therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N = 23) recruited to match the gender, age, and depression severity of a depressed control group (N = 20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = 0.165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t(32) = 4.39, p < 0.0001), with the MBCT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and is a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.
Literatuur
go back to reference Avery, D., & Silverman, J. (1984). Psychomotor retardation and agitation in depression. Relationship to age, sex, and response to treatment. Journal of Affective Disorders, 7(1), 67–76.CrossRefPubMed Avery, D., & Silverman, J. (1984). Psychomotor retardation and agitation in depression. Relationship to age, sex, and response to treatment. Journal of Affective Disorders, 7(1), 67–76.CrossRefPubMed
go back to reference Barnes, P. M., et al. (2004). Complementary and alternative medicine use among adults: United States. Advance Data, 343, 1–19.PubMed Barnes, P. M., et al. (2004). Complementary and alternative medicine use among adults: United States. Advance Data, 343, 1–19.PubMed
go back to reference Chiesa, A., Mandelli, L., & Serretti, A. (2012). Mindfulness-based cognitive therapy versus psycho-education for patients with major depression who did not achieve remission following antidepressant treatment: a preliminary analysis. Journal of Alternative and Complementary Medicine, 18(8), 756–760. doi:10.1089/acm.2011.0407.CrossRef Chiesa, A., Mandelli, L., & Serretti, A. (2012). Mindfulness-based cognitive therapy versus psycho-education for patients with major depression who did not achieve remission following antidepressant treatment: a preliminary analysis. Journal of Alternative and Complementary Medicine, 18(8), 756–760. doi:10.​1089/​acm.​2011.​0407.CrossRef
go back to reference Cuijpers, P., Reynolds, C. F., 3rd, Donker, T., Li, J., Andersson, G., & Beekman, A. (2012). Personalized treatment of adult depression: medication, psychotherapy, or both? A systematic review. Depression and Anxiety, 29(10), 855–864. doi:10.1002/da.21985.CrossRefPubMed Cuijpers, P., Reynolds, C. F., 3rd, Donker, T., Li, J., Andersson, G., & Beekman, A. (2012). Personalized treatment of adult depression: medication, psychotherapy, or both? A systematic review. Depression and Anxiety, 29(10), 855–864. doi:10.​1002/​da.​21985.CrossRefPubMed
go back to reference Eisendrath, S. J., Delucchi, K., Bitner, R., Fenimore, P., Smit, M., & McLane, M. (2008). Mindfulness-based cognitive therapy for treatment-resistant depression: a pilot study. Psychotherapy and Psychosomatics, 77(5), 319–320. doi:10.1159/000142525.CrossRefPubMed Eisendrath, S. J., Delucchi, K., Bitner, R., Fenimore, P., Smit, M., & McLane, M. (2008). Mindfulness-based cognitive therapy for treatment-resistant depression: a pilot study. Psychotherapy and Psychosomatics, 77(5), 319–320. doi:10.​1159/​000142525.CrossRefPubMed
go back to reference First, M. B., Spitzer, Robert L, Gibbon Miriam, and Williams, Janet B.W. (2002). Structured clinical interview for DSM-IV-TR Axis I disorders, research version, Patient Edition. (SCID-I/P). Biometrics Research, New York State Psychiatric Institute, November First, M. B., Spitzer, Robert L, Gibbon Miriam, and Williams, Janet B.W. (2002). Structured clinical interview for DSM-IV-TR Axis I disorders, research version, Patient Edition. (SCID-I/P). Biometrics Research, New York State Psychiatric Institute, November
go back to reference Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.CrossRefPubMed Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.CrossRefPubMed
go back to reference Fresco, D. M., Moore, M. T., van Dulmen, M. H., Segal, Z. V., Ma, S. H., Teasdale, J. D., et al. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behaviour Therapy, 38(3), 234–246. doi:10.1016/j.beth.2006.08.003.CrossRef Fresco, D. M., Moore, M. T., van Dulmen, M. H., Segal, Z. V., Ma, S. H., Teasdale, J. D., et al. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behaviour Therapy, 38(3), 234–246. doi:10.​1016/​j.​beth.​2006.​08.​003.CrossRef
go back to reference Glue, P., Donovan, M. R., Kolluri, S., & Emir, B. (2010). Meta-analysis of relapse prevention antidepressant trials in depressive disorders. The Australian and New Zealand Journal of Psychiatry, 44(8), 697–705. doi:10.3109/00048671003705441.CrossRefPubMed Glue, P., Donovan, M. R., Kolluri, S., & Emir, B. (2010). Meta-analysis of relapse prevention antidepressant trials in depressive disorders. The Australian and New Zealand Journal of Psychiatry, 44(8), 697–705. doi:10.​3109/​0004867100370544​1.CrossRefPubMed
go back to reference Godfrin, K. A., & van Heeringen, C. (2010). The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: a randomized controlled study. Behaviour Research and Therapy, 48(8), 738–746. doi:10.1016/j.brat.2010.04.006.CrossRefPubMed Godfrin, K. A., & van Heeringen, C. (2010). The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: a randomized controlled study. Behaviour Research and Therapy, 48(8), 738–746. doi:10.​1016/​j.​brat.​2010.​04.​006.CrossRefPubMed
go back to reference Hamidian, S., Omidi, A., Mousavinasab, S. M., & Naziri, G. (2013). Comparison of the effect of mindfulness-based cognitive therapy accompanied by pharmacotherapy with pharmacotherapy alone in treating dysthymic patients. Iran Red Crescent Medical Journal, 15(3), 239–244. doi:10.5812/ircmj.8024. Hamidian, S., Omidi, A., Mousavinasab, S. M., & Naziri, G. (2013). Comparison of the effect of mindfulness-based cognitive therapy accompanied by pharmacotherapy with pharmacotherapy alone in treating dysthymic patients. Iran Red Crescent Medical Journal, 15(3), 239–244. doi:10.​5812/​ircmj.​8024.
go back to reference Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social & Clinical Psychology, 6(4), 278–296.CrossRef Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social & Clinical Psychology, 6(4), 278–296.CrossRef
go back to reference Kingston, J., Chadwick, P., Meron, D., & Skinner, T. C. (2007). A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. Journal of Psychosomatic Research, 62(3), 297–300. doi:10.1016/j.jpsychores.2006.10.007.CrossRefPubMed Kingston, J., Chadwick, P., Meron, D., & Skinner, T. C. (2007). A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. Journal of Psychosomatic Research, 62(3), 297–300. doi:10.​1016/​j.​jpsychores.​2006.​10.​007.CrossRefPubMed
go back to reference Koolschijn, P. C., van Haren, N. E., Lensvelt-Mulders, G. J., Hulshoff Pol, H. E., & Kahn, R. S. (2009). Brain volume abnormalities in major depressive disorder: a meta-analysis of magnetic resonance imaging studies. Human Brain Mapping, 30(11), 3719–3735. doi:10.1002/hbm.20801.CrossRefPubMed Koolschijn, P. C., van Haren, N. E., Lensvelt-Mulders, G. J., Hulshoff Pol, H. E., & Kahn, R. S. (2009). Brain volume abnormalities in major depressive disorder: a meta-analysis of magnetic resonance imaging studies. Human Brain Mapping, 30(11), 3719–3735. doi:10.​1002/​hbm.​20801.CrossRefPubMed
go back to reference Kuyken, W., Byford, S., Taylor, R. S., Watkins, E., Holden, E., White, K., et al. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76(6), 966–978.CrossRefPubMed Kuyken, W., Byford, S., Taylor, R. S., Watkins, E., Holden, E., White, K., et al. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76(6), 966–978.CrossRefPubMed
go back to reference Kuyken, W., Byford, S., Byng, R., Dalgleish, T., Lewis, G., Taylor, R., et al. (2010a). Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse/recurrence: the PREVENT trial. Trials, 11, 99. doi:10.1186/1745-6215-11-99.CrossRefPubMedCentralPubMed Kuyken, W., Byford, S., Byng, R., Dalgleish, T., Lewis, G., Taylor, R., et al. (2010a). Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse/recurrence: the PREVENT trial. Trials, 11, 99. doi:10.​1186/​1745-6215-11-99.CrossRefPubMedCentralPubMed
go back to reference Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40.CrossRefPubMed Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40.CrossRefPubMed
go back to reference MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. Ney York: Taylor & Francis Group. MacKinnon, D. P. (2008). Introduction to statistical mediation analysis. Ney York: Taylor & Francis Group.
go back to reference Mauri, M. C., Laini, V., Cerveri, G., Scalvini, M. E., Volonteri, L. S., Regispani, F., et al. (2002). Clinical outcome and tolerability of sertraline in major depression: a study with plasma levels. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 26(3), 597–601.CrossRef Mauri, M. C., Laini, V., Cerveri, G., Scalvini, M. E., Volonteri, L. S., Regispani, F., et al. (2002). Clinical outcome and tolerability of sertraline in major depression: a study with plasma levels. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 26(3), 597–601.CrossRef
go back to reference Murray, C. J., & Lopez, A. D. (1996). Evidence-based health policy–lessons from the global burden of disease study. Science, 274(5288), 740–743.CrossRefPubMed Murray, C. J., & Lopez, A. D. (1996). Evidence-based health policy–lessons from the global burden of disease study. Science, 274(5288), 740–743.CrossRefPubMed
go back to reference Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. Journal of Personal and Social Psychology, 61(1), 115–121.CrossRef Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. Journal of Personal and Social Psychology, 61(1), 115–121.CrossRef
go back to reference Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102(1), 20–28.CrossRefPubMed Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102(1), 20–28.CrossRefPubMed
go back to reference Omidi, A., Mohammadkhani, P., Mohammadi, A., & Zargar, F. (2013). Comparing mindfulness based cognitive therapy and traditional cognitive behavior therapy with treatments as usual on reduction of major depressive disorder symptoms. Iran Red Crescent Medical Journal, 15(2), 142–146. doi:10.5812/ircmj.8018.CrossRef Omidi, A., Mohammadkhani, P., Mohammadi, A., & Zargar, F. (2013). Comparing mindfulness based cognitive therapy and traditional cognitive behavior therapy with treatments as usual on reduction of major depressive disorder symptoms. Iran Red Crescent Medical Journal, 15(2), 142–146. doi:10.​5812/​ircmj.​8018.CrossRef
go back to reference Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., et al. (2003). The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biological Psychiatry, 54(5), 573–583.CrossRefPubMed Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., et al. (2003). The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biological Psychiatry, 54(5), 573–583.CrossRefPubMed
go back to reference Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Stewart, J. W., Nierenberg, A. A., Thase, M. E., et al. (2006). Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. New England Journal of Medicine, 354(12), 1231–1242. doi:10.1056/NEJMoa052963.CrossRefPubMed Rush, A. J., Trivedi, M. H., Wisniewski, S. R., Stewart, J. W., Nierenberg, A. A., Thase, M. E., et al. (2006). Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. New England Journal of Medicine, 354(12), 1231–1242. doi:10.​1056/​NEJMoa052963.CrossRefPubMed
go back to reference Segal, Z., Williams, J. M., & Teasdale, J. (2002). Mindfulness -based cognitive therapy for depression. New York: The Guilford press. Segal, Z., Williams, J. M., & Teasdale, J. (2002). Mindfulness -based cognitive therapy for depression. New York: The Guilford press.
go back to reference Shawyer, F., Meadows, G. N., Judd, F., Martin, P. R., Segal, Z., & Piterman, L. (2012). The DARE study of relapse prevention in depression: design for a phase 1/2 translational randomised controlled trial involving mindfulness-based cognitive therapy and supported self monitoring. BMC Psychiatry, 12, 3. doi:10.1186/1471-244X-12-3.CrossRefPubMedCentralPubMed Shawyer, F., Meadows, G. N., Judd, F., Martin, P. R., Segal, Z., & Piterman, L. (2012). The DARE study of relapse prevention in depression: design for a phase 1/2 translational randomised controlled trial involving mindfulness-based cognitive therapy and supported self monitoring. BMC Psychiatry, 12, 3. doi:10.​1186/​1471-244X-12-3.CrossRefPubMedCentralPubMed
go back to reference Teasdale, J. D., Segal, Z. V., Williams, J. M., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623.CrossRefPubMed Teasdale, J. D., Segal, Z. V., Williams, J. M., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623.CrossRefPubMed
go back to reference Thase, M. E., Haight, B. R., Richard, N., Rockett, C. B., Mitton, M., Modell, J. G., et al. (2005). Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: a meta-analysis of original data from 7 randomized controlled trials. Journal of Clinical Psychiatry, 66(8), 974–981.CrossRefPubMed Thase, M. E., Haight, B. R., Richard, N., Rockett, C. B., Mitton, M., Modell, J. G., et al. (2005). Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors: a meta-analysis of original data from 7 randomized controlled trials. Journal of Clinical Psychiatry, 66(8), 974–981.CrossRefPubMed
go back to reference Van Dam, N. T., Sheppard, S. C., Forsyth, J. P., & Earleywine, M. (2010). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders. doi:10.1016/j.janxdis.2010.08.011.PubMed Van Dam, N. T., Sheppard, S. C., Forsyth, J. P., & Earleywine, M. (2010). Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. Journal of Anxiety Disorders. doi:10.​1016/​j.​janxdis.​2010.​08.​011.PubMed
go back to reference WHO (2001) Burden of mental and behavioral disorders. Geneva: WHO. WHO (2001) Burden of mental and behavioral disorders. Geneva: WHO.
Metagegevens
Titel
A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder
Auteurs
Stuart J. Eisendrath
Erin Gillung
Kevin Delucchi
Daniel H. Mathalon
Tony T. Yang
Derek D. Satre
Rebecca Rosser
Walter E. B. Sipe
Owen M. Wolkowitz
Publicatiedatum
01-06-2015
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 3/2015
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-014-0280-8

Andere artikelen Uitgave 3/2015

Mindfulness 3/2015 Naar de uitgave

ORTHOGONAL ROTATION IN CONSCIOUSNESS

Why Even Bother? The Importance of Motivation