Can Mindfulness Therapy Ease Resistant Depression?
In patients with depression resistant to National Health Service (NHS) Talking Therapies, mindfulness-based cognitive therapy (MBCT) plus treatment as usual was more effective in alleviating symptoms than treatment as usual alone, a new trial found. Additionally, MBCT plus treatment as usual had a 99% probability of being cost-effective.
METHODOLOGY:
Researchers conducted a parallel, randomized, controlled, superiority trial across three sites in the United Kingdom (2021-2023).
The study included 234 patients with major depressive disorder (mean age, 42.5 years; 71% women; 86% White) who couldn't achieve remission after ≥ 12 sessions of NHS Talking Therapies.
Participants were randomly assigned to receive either treatment as usual alone (n = 116) or MBCT plus treatment as usual (n = 118), with minimization on the basis of depression severity, antidepressant use, and recruitment site.
The primary outcome was depression symptoms, measured using the Patient Health Questionnaire-9 at 34 weeks. Cost-effectiveness was assessed using the Adult Service Use Schedule.
TAKEAWAY:
Participants who received MBCT plus treatment as usual had significantly reduced depression symptoms than those who received treatment as usual alone ( P = .0006).
= .0006). MBCT plus treatment as usual resulted in lower costs and higher utility scores than treatment as usual alone during the study period.
Analysis revealed a 99% probability that MBCT plus treatment as usual was cost-effective at the £20,000 per quality-adjusted life-year threshold.
No serious adverse events related to the trial or treatment were observed.
IN PRACTICE:
"Our findings show that psychological further-line treatment for depression can bring clinical benefit at an affordable price, potentially helping to reduce the long-term disability burden and economic costs associated with difficult-to-treat depression," the authors wrote.
SOURCE:
The study was led by Thorsten Barnhofer, PhD, School of Psychology, University of Surrey, Guildford, England. It was published online in the June 2025 issue of The Lancet Psychiatry .
LIMITATIONS:
The study was limited by a short follow-up period of 6 months. The representativeness of the findings was limited by a predominance of female and White participants. The trial was not powered for subgroup analyses, preventing gender-specific analyses. Additionally, limited information was available on the type and quality of psychologic treatment patients received as treatment as usual.
DISCLOSURES:
The study was funded by the UK National Institute for Health and Care Research. One author reported writing a book on MBCT. Several authors reported having financial or professional ties with various organizations. Details are provided in the original article.
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