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Date of Award
Spring 2021
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Amanda Murphy
Abstract
Abstract Introduction: Depression is mental illness that affects approximately 7% of the United States. Of patients with depression, 33% will not find their first treatment successful in reducing the recurrence of a Major Depressive Episode (MDE). Current first line treatment includes either pharmacotherapy or psychotherapy, or a combination of the two. These therapies have had limited success in patients who suffer from multiple depressive relapse episodes. Therefore, this study looks to address the efficacy of MBCT alone or in combination with pharmacotherapy to reduce the risk of reoccurring depressive episodes in patients with MDD. Methods: A literature search was performed in November 2019 in ClinicalKey and PubMed of Arcadia University’s online library as well as Google Scholar. Of the articles researched, six randomized controlled studies were chosen that focused depressive relapse in patients who had either failed or were currently on antidepressants. The study designs of each trial were compared and analyzed for efficacy of MBCT in the treatment of MDD or Treatment Resistant Depression (TRD). Results: Significant reduction in depressive symptom severity was shown in two of the six studies when comparing MBCT to Treatment As Usual (TAU). Despite the low statistical significance of reduction in depressive symptoms, other measures, such as anxiety and quality of life were shown to improve in the MBCT treatment arms vs antidepressants in the additional four studies. Patients who received MBCT felt they could more efficiently identify negative cognitions and accept their current mental space. There were no negative health outcomes associated with this study, however dropout rates were considered. Discussion: All studies showed a reduction in some aspect of depressive symptoms or secondary outcomes. Lack of mindful training uniformity and population size were noted as barriers to the efficacy of the studies. However, it is important to consider MBCT in the treatment of MDD or TRD due to the skills learned by the patients to help control their depressive episodes. Although there was lacking evidence to determine whether or not MBCT reduces the rate of depressive relapse, MBCT can help to reduce the severity of the relapse itself. Conclusion: MBCT helps patients to identify their negative thoughts as an intention of the present mind, contrary to placing blame or identity onto the patient for having these thoughts. MBCT can also reduction of the stigma of depression and encourage home meditation practice. The six studies reviewed illustrated the benefits of MBCT and suggest that the combination of MBCT and pharmacotherapy may help to reduce both the occurrence of relapse and improve symptoms of depression within each episode. Although there is not enough evident that MBCT should be used as primary treatment for depression, future studies with a more diverse patient population are warranted to strengthen the potential efficacy MBCT and include this therapy in patients’ individualized treatment plans.
Recommended Citation
Maxted, Claire, "The efficacy of Mindfulness-Based Cognitive Therapy (MBCT) in combination with pharmacotherapy in the treatment of Major Depressive Disorder (MDD)" (2021). Capstone Showcase. 26.
https://scholarworks.arcadia.edu/showcase/2021/pa/26
The efficacy of Mindfulness-Based Cognitive Therapy (MBCT) in combination with pharmacotherapy in the treatment of Major Depressive Disorder (MDD)
Abstract Introduction: Depression is mental illness that affects approximately 7% of the United States. Of patients with depression, 33% will not find their first treatment successful in reducing the recurrence of a Major Depressive Episode (MDE). Current first line treatment includes either pharmacotherapy or psychotherapy, or a combination of the two. These therapies have had limited success in patients who suffer from multiple depressive relapse episodes. Therefore, this study looks to address the efficacy of MBCT alone or in combination with pharmacotherapy to reduce the risk of reoccurring depressive episodes in patients with MDD. Methods: A literature search was performed in November 2019 in ClinicalKey and PubMed of Arcadia University’s online library as well as Google Scholar. Of the articles researched, six randomized controlled studies were chosen that focused depressive relapse in patients who had either failed or were currently on antidepressants. The study designs of each trial were compared and analyzed for efficacy of MBCT in the treatment of MDD or Treatment Resistant Depression (TRD). Results: Significant reduction in depressive symptom severity was shown in two of the six studies when comparing MBCT to Treatment As Usual (TAU). Despite the low statistical significance of reduction in depressive symptoms, other measures, such as anxiety and quality of life were shown to improve in the MBCT treatment arms vs antidepressants in the additional four studies. Patients who received MBCT felt they could more efficiently identify negative cognitions and accept their current mental space. There were no negative health outcomes associated with this study, however dropout rates were considered. Discussion: All studies showed a reduction in some aspect of depressive symptoms or secondary outcomes. Lack of mindful training uniformity and population size were noted as barriers to the efficacy of the studies. However, it is important to consider MBCT in the treatment of MDD or TRD due to the skills learned by the patients to help control their depressive episodes. Although there was lacking evidence to determine whether or not MBCT reduces the rate of depressive relapse, MBCT can help to reduce the severity of the relapse itself. Conclusion: MBCT helps patients to identify their negative thoughts as an intention of the present mind, contrary to placing blame or identity onto the patient for having these thoughts. MBCT can also reduction of the stigma of depression and encourage home meditation practice. The six studies reviewed illustrated the benefits of MBCT and suggest that the combination of MBCT and pharmacotherapy may help to reduce both the occurrence of relapse and improve symptoms of depression within each episode. Although there is not enough evident that MBCT should be used as primary treatment for depression, future studies with a more diverse patient population are warranted to strengthen the potential efficacy MBCT and include this therapy in patients’ individualized treatment plans.