How effective is mindfulness-based cognitive therapy for adults with treatment-resistant depression?
Date of publication of the randomized controlled trial: January 2016
Design
Randomized controlled trial (RCT).
Participants
173 adults (mean age: 46.2 years, male %: 23.7%) diagnosed with unipolar treatment-resistant major depressive disorder.
Intervention
Mindfulness-based cognitive therapy (MBCT) for 8 weeks.
Comparator
Comparison 1: MBCT versus Health Enhancement Program (HEP) plus treatment-as-usual (TAU) pharmacotherapy
Major Outcomes
Outcome 1: Change in depression severity measured by score of 17-item Hamilton Depression Rating Scale (HAM-D 17). Higher scores indicated worse depression severity.
Settings
This trial was performed in an outpatient setting.
Comparison    This trial was performed in an outpatient setting.
Main Results
MBCT had led to a significant reduction on depression severity (p=0.01) among patients with treatment-resistant depression.
MBCT had led to a significant reduction on depression severity (p=0.01) among patients with treatment-resistant depression.
Outcomes No. of studies (Total number of participants) % reduction in score / No. of participants Heterogeneity test (I2) MD p value Overall quality of evidence*
Intervention Comparator
1 1 (173) 36.6/ 87 25.3/ 86 Not applicable as there is only 1 study. Not reported 0.01 Moderate
Keys: MD = mean difference.
Comparison    This trial was performed in an outpatient setting.
Main Results
MBCT had led to a significant reduction on depression severity (p=0.01) among patients with treatment-resistant depression.
MBCT had led to a significant reduction on depression severity (p=0.01) among patients with treatment-resistant depression.
Outcomes 1
No. of studies (Total number of participants) 1 (173)
% reduction in score / No. of participants Intervention 36.6/ 87
Comparator 25.3/ 86
MD Not reported
p value 0.01
Overall quality of evidence* Moderate
Keys: MD = mean difference.
Conclusion
Benefits
Compared to the HEP plus TAU, MBCT is more effective in reducing depression severity among patients with treatment-resistant depression. For Outcome 1, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/26808973
The synopsis is based on the following article:
Eisendrath SJ, Gillung E, Delucchi KL, Segal ZV, Nelson JC, McInnes LA, et al. A randomized controlled trial of mindfulness-based cognitive therapy for treatment-resistant depression. Psychotherapy and Psychosomatics. 2016 Jan 26;85(2):99-110.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.