January 29, 2020
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Mindfulness-based cognitive therapy app reduces residual depressive symptoms

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Zindel V. Segal

Online mindfulness-based cognitive therapy combined with usual depression care significantly improved depression and functional outcomes among patients with residual depressive symptoms, according to results of a randomized clinical trial published in JAMA Psychiatry.

“Patients with residual symptoms face a gap in care since they are not depressed enough to warrant re-treatment but receive few resources for managing the symptom burden they still carry,” Zindel V. Segal, PhD, of University of Toronto Scarborough’s graduate department psychological clinical science, told Healio Psychiatry. “Our findings suggest that online mindfulness-based cognitive therapy is specifically effective for residual symptoms and can lower patient risk for depression returning.”

According to the researchers, residual depressive symptoms often require tailored management strategies that can be sequenced with acute-phase treatment and made widely accessible, which makes them important treatment targets. In the present study, they evaluated the effectiveness for treating these symptoms with usual depression care combined with Mindful Mood Balance (MMB) — a web-based application used to deliver mindfulness-based cognitive therapy. They randomly assigned 230 patients to receive usual depression care and 230 patients to receive MMB plus usual depression care. The MMB intervention included eight sessions delivered online across 3 months plus minimal email or phone coaching support. As the primary outcomes, they assessed residual depressive symptom severity, rates of depressive relapse and rates of remission using the Patient Health Questionnaire-9.

Segal and colleagues found that those who received MMB plus usual depression care experienced significantly greater reductions in residual depressive symptoms than those who received usual depression care only. Significantly more patients in the MMB plus usual depression care group achieved remission compared with the usual depression care only group, and they also experienced lower rates of depressive relapse. Further, those in the MMB plus usual depression care group had decreased depression-free days, decreased anxiety and improved mental functioning, but the researchers found no statistically significant difference in physical functioning.

“Based on numerous previous studies, we knew that the evidence base for in-person mindfulness-based cognitive therapy was strong but were not sure whether the same treatment delivered online would be as effective," Segal said. "We were pleased with the results because it provides these patients with an important resource for their care. Our ongoing focus is to evaluate this treatment with new or expectant mothers who have a history of depression." – by Joe Gramigna

Disclosures: Segal reports being a codeveloper of Mindfulness Based Cognitive Therapy MBCT) and receiving royalties from Guilford Press for the MBCT treatment manual and patient books; presenting keynote addresses at conferences, and MBCT clinical training workshops where he has received a fee; and revenue from online MBCT therapist training tools available on mindfulnoggin.com. Please see the study for all other authors’ relevant financial disclosures.