Mindfulness-based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta-analysis

TY - JOUR

T1 - Mindfulness-based cognitive therapy for prevention and time to depressive relapse

T2 - Systematic review and network meta-analysis

AU - McCartney, Mark

AU - Nevitt, Sarah

AU - Lloyd, Annette

AU - Hill, Ruaraidh

AU - White, Ross

AU - Duarte, Rui

N1 - © 2020 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.

PY - 2021/1/10

Y1 - 2021/1/10

N2 - OBJECTIVE: To perform a network meta-analysis (NMA) to compare the long-term effectiveness of mindfulness-based cognitive therapy (MBCT) with available strategies for prevention and time to depressive relapse.METHODS: Seven electronic databases were searched up to June 2019. Studies evaluated MBCT for the management of depression-related outcomes and follow-up assessments occurred at 12 months or longer.RESULTS: Twenty-three publications were included, 17 of which were randomised controlled trials (RCTs). Data from 14 RCTs including 2077 participants contributed to meta-analysis (MA) and NMA to assess relapse of depression and 13 RCTs with 2017 participants contributed to MA and NMA for time to relapse of depression. NMAs showed statistically significant advantages for MBCT over treatment as usual (TAU) for relapse of depression (RR = 0.73, 95% CI 0.54 to 0.98) and for MBCT over TAU and placebo for time to relapse of depression (MBCT vs TAU: HR = 0.57, 95% CI 0.37 to 0.88; MBCT vs placebo: HR = 0.23, 95% CI 0.08 to 0.67). Subgroup meta-analysis of relapse of depression by previous number of depressive episodes showed similar results between subgroups. Subgroup meta-analysis by the use or not of booster sessions suggests these may lead to improved effectiveness.CONCLUSIONS: MBCT is more effective than TAU in the long-term in preventing relapse of depression and has statistically significant advantages over TAU and placebo for time to relapse of depression. No statistically significant differences were observed between MBCT and active treatment strategies for rate of relapse or time to relapse of depression.

AB - OBJECTIVE: To perform a network meta-analysis (NMA) to compare the long-term effectiveness of mindfulness-based cognitive therapy (MBCT) with available strategies for prevention and time to depressive relapse.METHODS: Seven electronic databases were searched up to June 2019. Studies evaluated MBCT for the management of depression-related outcomes and follow-up assessments occurred at 12 months or longer.RESULTS: Twenty-three publications were included, 17 of which were randomised controlled trials (RCTs). Data from 14 RCTs including 2077 participants contributed to meta-analysis (MA) and NMA to assess relapse of depression and 13 RCTs with 2017 participants contributed to MA and NMA for time to relapse of depression. NMAs showed statistically significant advantages for MBCT over treatment as usual (TAU) for relapse of depression (RR = 0.73, 95% CI 0.54 to 0.98) and for MBCT over TAU and placebo for time to relapse of depression (MBCT vs TAU: HR = 0.57, 95% CI 0.37 to 0.88; MBCT vs placebo: HR = 0.23, 95% CI 0.08 to 0.67). Subgroup meta-analysis of relapse of depression by previous number of depressive episodes showed similar results between subgroups. Subgroup meta-analysis by the use or not of booster sessions suggests these may lead to improved effectiveness.CONCLUSIONS: MBCT is more effective than TAU in the long-term in preventing relapse of depression and has statistically significant advantages over TAU and placebo for time to relapse of depression. No statistically significant differences were observed between MBCT and active treatment strategies for rate of relapse or time to relapse of depression.

KW - Cognitive Behavioral Therapy

KW - Humans

KW - Mindfulness

KW - Network Meta-Analysis

KW - Recurrence

KW - Secondary Prevention

KW - Treatment Outcome

U2 - 10.1111/acps.13242

DO - 10.1111/acps.13242

M3 - Review article

C2 - 33035356

SN - 0001-690X

VL - 143

SP - 6

EP - 21

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

IS - 1

ER -