Teasdale, J. D., Segal, Z .V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by Mindfulness-Based Cognitive Therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623. https://doi.org/10.1037/0022-006X.68.4.615

Type of Study: Randomized controlled trial
Number of Participants: 145

Population:

• Age — 18–65 years
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were patients recruited from community health care facilities and media announcements.

Location/Institution: United Kingdom

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate Mindfulness-Based Cognitive Therapy (MBCT). Participants were randomly assigned to continue treatment as usual (TAU) or to receive MBCT training in addition to TAU. Measures utilized include the Hamilton Rating Scale for Depression (HRSD) and the Beck Depression Inventory (BDI). Results indicate that for patients with 3 or more previous episodes of depression (77% of the sample), MBCT significantly reduced risk of relapse/recurrence. For patients with only 2 previous episodes, MBCT did not reduce relapse/recurrence. Limitations include the design of the present study does not allow us to attribute the benefits of MBCT to the specific skills taught by the program versus nonspecific factors, such as therapeutic attention and group participation; and the present study provides no evidence of the extent to which similar prophylactic effects would be obtained by instructors who had not been actively involved in the development of the program, or in samples with different ethnic or educational backgrounds.

Length of controlled postintervention follow-up: 1 year.

Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-Based Cognitive Therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40. https://doi.org/10.1037/0022-006X.72.1.31

Type of Study: Randomized controlled trial
Number of Participants: 130

Population:

• Age — Mean=44.5 years
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were patients recruited through general practitioners and the media.

Location/Institution: United Kingdom

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate Mindfulness-Based Cognitive Therapy (MBCT). Participants were randomly assigned to receive treatment as usual (TAU) or TAU plus MBCT. Measures utilized include the Hamilton Rating Scale for Depression (HAM-D), the Beck Depression Inventory (BDI) and the Measure of Parenting Style (MOP). Results indicate that replicating previous findings, MBCT reduced relapse from 78% to 36% in 55 patients with 3 or more previous episodes; but in 18 patients with only 2 (recent) episodes corresponding figures were 20% and 50%. MBCT was most effective in preventing relapses not preceded by life events. Relapses were more often associated with significant life events in the 2-episode group. This group also reported less childhood adversity and later first depression onset than the 3-or-more-episode group, suggesting that these groups represented distinct populations. Limitations include it was not possible to examine directly the protective effects of MBCT in the face of different severities of environmental stress because the occurrence of events in those who did not relapse was not examined.

Length of controlled postintervention follow-up: 1 year.

Kuyken, W., Byford, S., Taylor, R. S., Watkins, E., Holden, E., White, K., Barrett, B., Byng, R., Evans, A., Mullan, E., & Teasdale, J. D. (2008). Mindfulness-Based Cognitive Therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76(6), 966–978. https://doi.org/10.1037/a0013786

Type of Study: Randomized controlled trial
Number of Participants: 123

Population:

• Age — Not specified
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were patients recruited through their primary care physicians.

Location/Institution: Devon, England

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to determine if, among patients with recurrent depression who are treated with antidepressant medication (ADM), Mindfulness-Based Cognitive Therapy (MBCT) is comparable to treatment with maintenance ADM (m-ADM) in (a) depressive relapse prevention, (b) key secondary outcomes, and (c) cost effectiveness. Participants were randomly assigned to receive either a maintenance dose of the ADM or an 8-week MBCT course which included support in tapering off their medication. Measures utilized include the DSM-IV Structured Clinical Interview, the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory (BDI and the World Health Organization Quality of Life instrument (WHOQOL-BREF). Results indicate that MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains. There was no difference in average annual cost between the 2 groups. Rates of ADM usage in the MBCT group was significantly reduced, and 46 patients (75%) completely discontinued their ADM. Limitations include the m-ADM group should be characterized as an enhanced care group in that the study team actively encouraged high levels of adherence at each follow-up, the question of MBCT’s generalizability for different subpopulations and different settings (e.g., referral source, primary vs. secondary care, patients with multiple comorbidities), and researcher selection bias.

Length of controlled postintervention follow-up: Approximately 7 months.

Barnhofer, T., Crane, C., Hargus, E., Amarasinghe, M., Winder, R., & Williams, J. M. G. (2009). Mindfulness-based Cognitive Therapy as a treatment for chronic depression: A preliminary study. Behavior Research and Therapy, 47(5), 366–373. https://doi.org/10.1016/j.brat.2009.01.019

Type of Study: Randomized controlled trial
Number of Participants: 28

Population:

• Age — Mean=42 years
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were recruited through local mental health practitioners and the media.

Location/Institution: United Kingdom

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT), a treatment combining mindfulness meditation and interventions taken from cognitive therapy, in patients suffering from chronic-recurrent depression. Participants were randomly assigned to receive either MBCT or treatment as usual (TAU). Measures utilized include the DSM-IV Structured Clinical Interview, the Beck Depression Inventory (BDI) and the Beck Scale for Suicide Ideation (BSS). Results indicate that self-reported symptoms of depression decreased from severe to mild levels in the MBCT group while there was no significant change in the TAU group. Similarly, numbers of patients meeting full criteria for depression decreased significantly more in the MBCT group than in the TAU group. Limitations include small sample size, the main findings regarding severity of depressive symptoms are based on self-reports which are amenable to subjective biases, and length of follow-up.

Length of controlled postintervention follow-up: 1 month or less.

Segal, Z. V., Bieling, P., Young T., MacQueen, G., Cooke, R., Martin, L., Bloch, R., & Levitan, R. D. (2010). Antidepressant monotherapy vs sequential pharmacotherapy and Mindfulness-Based Cognitive Therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Psychiatry, 67(12), 1256–1264. https://doi.org/10.1001/archgenpsychiatry.2010.168

Type of Study: Randomized controlled trial
Number of Participants: 160

Population:

• Age — 18–65 years
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were users of outpatient services recruited from treatment centers.

Location/Institution: Outpatient clinics at the Centre for Addiction and Mental Health, Toronto, and Ontario, Canada; and St Joseph’s Healthcare, Hamilton, Ontario

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare rates of relapse in depressed patients in remission receiving Mindfulness-Based Cognitive Therapy (MBCT) against maintenance antidepressant pharmacotherapy or a placebo. Participants were randomly allocated to receive either MBCT delivered in addition to treatment-as-usual (TAU), or TAU alone. Measures utilized were the Structured Clinical Interview for DSM-IV, the Hamilton Rating Scale for Depression (HRSD), and the Quick Inventory of Depressive Symptomatology. Results indicate that MBCT and antidepressants had similar outcomes. Limitations include concerns regarding sufficient power to detect small effects, and possible bias.

Length of controlled postintervention follow-up: 18 months.

Bondolfi, G., Jermann, F., Van der Linden, M., Gex-Fabry, M., Bizzini, L., Rouget, B. W., Myers-Arrazola, L., Gonzalez, C., Segal, Z., Aubry, J-M., & Bertschy, G. (2010). Depression relapse prophylaxis with Mindfulness-Based Cognitive Therapy: Replication and extension in the Swiss health care system. Journal of Affective Disorders, 122(3), 224–231. https://doi.org/10.1016/j.jad.2009.07.007

Type of Study: Randomized controlled trial
Number of Participants: 60

Population:

• Age — MBCT+TAU: 27–63 years; TAU: 24–66 years
• Race/Ethnicity — Not specified
• Gender — MBCT+TAU: 74% Female; TAU: 69% Female
• Status — Participants were individuals with history of recurrent major depression.

Location/Institution: Geneva and Lausanne University Hospitals, Switzerland

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to determine the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) compared to treatment as usual (TAU). Participants were randomly assigned to MBCT and TAU, or TAU alone. Measures utilized include the Structured Clinical Interview for DSM-IV, the Hamilton Rating Scale for Depression (HRSD), the Montgomery–Asberg Depression Rating Scale, and the Beck Depression Inventory II. Results indicate that over a 14-month prospective follow-up period, time to relapse was significantly longer with MBCT+TAU than TAU alone, although both groups relapsed at similar rates. Analyses of homework adherence revealed that following treatment termination, the frequency of brief and informal mindfulness practice remained unchanged over 14 months, whereas the use of longer formal meditation decreased over time. Limitations include small sample size, and relapse monitoring was 14 months in duration and prospective reporting of mindfulness practice would have yielded more precise frequency estimates compared to the retrospective method that was utilized.

Length of controlled postintervention follow-up: 14 months.

Godfrin, K. A., & van Heeringen, C. (2010). The effects of Mindfulness-Based Cognitive Therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study. Behaviour Research and Therapy, 48(8), 738–746. https://doi.org/10.1016/j.brat.2010.04.006

Type of Study: Randomized controlled trial
Number of Participants: 106

Population:

• Age — 18 years or older
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were depressed patients with a history of at least 3 depressive episodes.

Location/Institution: University Department of Psychiatry of the University Hospital Ghent

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate the effects of Mindfulness-Based Cognitive Therapy (MBCT) on the relapse in depression and the time to first relapse since study participation, as well as on several mood states and the quality of life of the participants. Participants were randomly assigned to MBCT and treatment as usual (TAU), or TAU alone. Measures utilized include the Structured Clinical Interview for DSM-IV, the Hamilton Rating Scale for Depression (HRSD), the Profile of Moods Scale, and the Beck Depression Inventory II. Results indicate that at the end of the study period relapse/recurrence was significantly reduced and the time until first relapse increased in the MBCT plus TAU condition in comparison with TAU alone. The MBCT plus TAU group also showed a significant reduction in both short and longer-term depressive mood and better mood states and quality of the life. Limitations include possible selection bias, and unclear to what extent differences in amount of clinical contact with expectations for benefit have influenced the findings.

Length of controlled postintervention follow-up: 14 months.

Manicavasgar , V., Parker G., & Perich, T. (2011). Mindfulness-Based Cognitive Therapy vs. cognitive behaviour therapy as a treatment for non-melancholic depression. Journal of Affective Disorders, 130(1-2), 138–144. https://doi.org/10.1016/j.jad.2010.09.027

Type of Study: Randomized controlled trial
Number of Participants: 69

Population:

• Age — 18 years or older
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were adults who met criteria for a current episode of major depressive disorder.

Location/Institution: Black Dog Institute, Prince of Wales Hospital Campus, NSW, Australia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the comparative effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavior Therapy (CBT) as treatments for non-melancholic depression. Participants were randomly assigned to either an 8-week MBCT or CBT group therapy condition. Measures utilized include the Composite International Diagnostic Interview, the Beck Depression Inventory II, Beck Anxiety Inventory, and the Social and Occupational Functioning Scale. Results indicate that there were significant improvements in pregroup to postgroup depression and anxiety scores in both treatment conditions and no significant differences between the two treatment conditions. However, significant differences were found when participants in the two treatment conditions were dichotomized into those with a history of four or more episodes of depression vs. those with less than four. In the CBT condition, participants with four or more previous episodes of depression demonstrated greater improvements in depression than those with less than four previous episodes. No such differences were found in the MBCT treatment condition. No significant differences in depression or anxiety were found between the two treatment conditions at 6- and 12-month follow-ups. Limitations include small sample size, and the lack of randomization of all subjects (only 3 of the 11 groups were randomized).

Length of controlled postintervention follow-up: 6 and 12 months.

Williams, J. M. G., Crane, C., Barnhofer, T., Brennan, K., Duggan, D. S., Fennell, M. J., Hackmann, A., Krusche, A., Muse, K., Von Rohr, I. R., Shah, D., Crane, R. S., Eames, C., Jones, M., Radford, S., Silverton, S., Sun, Y., Weathereley-Jones, E., Whita Mindfulness-Based Cognitive Therapy for preventing relapse in recurrent depression: A randomized dismantling trial. Journal of Consulting and Clinical Psychology, 82(2), 275–286. https://doi.org/10.1037/a0035036

Type of Study: Randomized controlled trial
Number of Participants: 274

Population:

• Age — 18–68 years (Mean=43 years)
• Race/Ethnicity — 95% Caucasian
• Gender — 72% Female
• Status — Participants were users of outpatient services recruited through referrals from primary care and mental health clinics.

Location/Institution: Oxford, England, and Bangor, North Wales

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare Mindfulness-Based Cognitive Therapy (MBCT) with both cognitive psychological education (CPE) - a modification of MBCT without training in meditation, and treatment as usual (TAU) in preventing relapse to major depressive disorder (MDD) in people currently in remission following at least 3 previous episodes. Participants were randomly assigned to MBCT plus TAU, CPE plus TAU, and TAU alone. Measures utilized include the Structured Clinical Interview for DSM-IV, the Beck Scale for Suicidal Ideation, the Suicide Attempt and Self-Injury Interview, the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory–II (BDI-II) and the Childhood Trauma Questionnaire (CTQ). Results indicate that there were no significant differences between the groups for the likelihood of relapse. However, analyses did show that for those with history of childhood trauma, MBCT made a significant difference. Limitations include lack of generalizability to other ethnic populations, and small sample size issues that limited some analyses.

Length of controlled postintervention follow-up: 12 months.

Eisendrath, S. J., Gillung, E., Delucchi, K., Mathalon, D. H., Yang, T. T., Satre, D. D., Rosser, R., Sipe, W. E. B., & Wolkowitz, O. M. (2015). A preliminary study: Efficacy of Mindfulness-Based Cognitive Therapy versus sertraline as first-line treatments for major depressive disorder. Mindfulness, 6, 475–482. https://doi.org/10.1007/s12671-014-0280-8

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 43

Population:

• Age — 18–70 years
• Race/Ethnicity — 24 White, 6 Asian, 5 Other, 4 African American, and 4 Hispanic
• Gender — 31 Female
• Status — Participants were individuals with major depressive disorders recruited via flyers, Craigslist, and clinical referrals.

Location/Institution: University of California, San Francisco Medical Center

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to investigate the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) compared to sertraline (antidepressant medication), for patients with acute major depression. MCBT participants were recruited to match the gender, age, and depressive severity of a depressed control group that completed 8 weeks of sertraline therapy two years prior to the current study. Measures utilized include the Hamilton Rating Scale for Depression (HRSD), Quick Inventory of Depressive Symptamotology-Self Report (QIDS-SR16), the Five Facet Mindfulness Scale (FFMQ), the Self Compassion Scale (SCS), the Experience Questionnaire, Ruminative Response Scale, and the Structured Clinical Interview for DSM-IV. Results indicate that both MBCT and sertraline were effective in reducing depressive symptom ratings. Limitations include the nonrandomization of participants, the time disparity between the two studies, and small sample size.

Length of controlled postintervention follow-up: None.