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Published in: BMC Psychiatry 1/2006

Open Access 01-12-2006 | Research article

An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care

Authors: Andy Finucane, Stewart W Mercer

Published in: BMC Psychiatry | Issue 1/2006

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Abstract

Background

Mindfulness Based Cognitive Therapy (MBCT) is an 8-week course developed for patients with relapsing depression that integrates mindfulness meditation practices and cognitive theory. Previous studies have demonstrated that non-depressed participants with a history of relapsing depression are protected from relapse by participating in the course. This exploratory study examined the acceptability and effectiveness of MBCT for patients in primary care with active symptoms of depression and anxiety

Methods

13 patients with recurrent depression or recurrent depression and anxiety were recruited to take part in the study. Semi-structured qualitative interviews were conducted three months after completing the MBCT programme. A framework approach was used to analyse the data. Beck depression inventories (BDI-II) and Beck anxiety inventories (BAI) provided quantitative data and were administered before and three months after the intervention.

Results

The qualitative data indicated that mindfulness training was both acceptable and beneficial to the majority of patients. For many of the participants, being in a group was an important normalising and validating experience. However most of the group believed the course was too short and thought that some form of follow up was essential. More than half the patients continued to apply mindfulness techniques three months after the course had ended. A minority of patients continued to experience significant levels of psychological distress, particularly anxiety.
Statistically significant reductions in mean depression and anxiety scores were observed; the mean pre-course depression score was 35.7 and post-course score was 17.8 (p = 0.001). A similar reduction was noted for anxiety with a mean pre-course anxiety score of 32.0 and mean post course score of 20.5 (p = 0.039). Overall 8/11 (72%) patients showed improvements in BDI and 7/11 (63%) patients showed improvements in BAI. In general the results of the qualitative analysis agreed well with the quantitative changes in depression and anxiety reported.

Conclusion

The results of this exploratory mixed methods study suggest that mindfulness based cognitive therapy may have a role to play in treating active depression and anxiety in primary care.
Literature
1.
go back to reference Segal ZV, Williams JMG, Teasdale JD: Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. 2002, Guilford Press Segal ZV, Williams JMG, Teasdale JD: Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. 2002, Guilford Press
2.
go back to reference Teasdale JD, Segal ZV, Williams JMG, Ridgeway V, Soulsby JM, Lau M: Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology. 2000, 68: 615-623. 10.1037/0022-006X.68.4.615.CrossRefPubMed Teasdale JD, Segal ZV, Williams JMG, Ridgeway V, Soulsby JM, Lau M: Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology. 2000, 68: 615-623. 10.1037/0022-006X.68.4.615.CrossRefPubMed
3.
go back to reference Ma SH, Teasdale JD: Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology. 2004, 72 (1): 31-40. 10.1037/0022-006X.72.1.31.CrossRefPubMed Ma SH, Teasdale JD: Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology. 2004, 72 (1): 31-40. 10.1037/0022-006X.72.1.31.CrossRefPubMed
4.
go back to reference Kingston T: Mindfulness-Based Cognitive Therapy for Residual Depressive Symptoms. 2005, Masters dissertation Kingston T: Mindfulness-Based Cognitive Therapy for Residual Depressive Symptoms. 2005, Masters dissertation
5.
go back to reference NHS Centre for Reviews and Dissemination: Improving the recognition and management of depression in primary care. Effective Health Care Bulletin. 2002, 7 (5): 1-12. NHS Centre for Reviews and Dissemination: Improving the recognition and management of depression in primary care. Effective Health Care Bulletin. 2002, 7 (5): 1-12.
6.
go back to reference Shah A: The burden of psychiatric disorder in primary care. International Review of Psychiatry. 1992, 4: 243-250.CrossRef Shah A: The burden of psychiatric disorder in primary care. International Review of Psychiatry. 1992, 4: 243-250.CrossRef
7.
go back to reference Judd LL: The clinical course of unipolar major depressive disorders. Archives of General Psychiatry. 1997, 54: 989-991.CrossRefPubMed Judd LL: The clinical course of unipolar major depressive disorders. Archives of General Psychiatry. 1997, 54: 989-991.CrossRefPubMed
8.
go back to reference Post RM: Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry. 1992, 149: 999-1010.CrossRefPubMed Post RM: Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry. 1992, 149: 999-1010.CrossRefPubMed
9.
go back to reference Nolen-Hoeksema S: Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology. 1991, 100 (4): 569-82. 10.1037/0021-843X.100.4.569.CrossRefPubMed Nolen-Hoeksema S: Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology. 1991, 100 (4): 569-82. 10.1037/0021-843X.100.4.569.CrossRefPubMed
10.
go back to reference Nolen-Hoeksema S: The Role of Rumination in Depressive Disorders and Mixed Anxiety/Depressive Symptoms. Journal of Abnormal Psychology. 2000, 109: 504-511. 10.1037/0021-843X.109.3.504.CrossRefPubMed Nolen-Hoeksema S: The Role of Rumination in Depressive Disorders and Mixed Anxiety/Depressive Symptoms. Journal of Abnormal Psychology. 2000, 109: 504-511. 10.1037/0021-843X.109.3.504.CrossRefPubMed
11.
go back to reference Teasdale JD, Segal ZV, Williams JMG: How does cognitive therapy prevent relapse and why should attentional control (mindfulness) training help?. Behaviour Research and Therapy. 1995, 33: 225-239. 10.1016/0005-7967(94)E0011-7.CrossRef Teasdale JD, Segal ZV, Williams JMG: How does cognitive therapy prevent relapse and why should attentional control (mindfulness) training help?. Behaviour Research and Therapy. 1995, 33: 225-239. 10.1016/0005-7967(94)E0011-7.CrossRef
12.
go back to reference Song F, Freemantle N, Sheldon TA, House A, Mason J: Selective serotonin reuptake inhibitors: Meta-analysis of efficacy and acceptability. British Medical Journal. 1993, 306 (6879): 683-687. 13CrossRefPubMedPubMedCentral Song F, Freemantle N, Sheldon TA, House A, Mason J: Selective serotonin reuptake inhibitors: Meta-analysis of efficacy and acceptability. British Medical Journal. 1993, 306 (6879): 683-687. 13CrossRefPubMedPubMedCentral
13.
go back to reference Ritchie J, Spencer L, O'Conor W: Carrying out qualitative analysis. Qualitative Research Practice. Edited by: Ritchie S, Lewis S. 2003, Sage publications, 220-261. Ritchie J, Spencer L, O'Conor W: Carrying out qualitative analysis. Qualitative Research Practice. Edited by: Ritchie S, Lewis S. 2003, Sage publications, 220-261.
14.
go back to reference Mason O, Hargreaves I: A qualitative study of mindfulness-based cognitive therapy for depression. Journal of Medical Psychology. 2001, 74: 197-212. 10.1348/000711201160911.CrossRef Mason O, Hargreaves I: A qualitative study of mindfulness-based cognitive therapy for depression. Journal of Medical Psychology. 2001, 74: 197-212. 10.1348/000711201160911.CrossRef
15.
go back to reference Kush FR, McRoberts Fleming L: An innovative approach to short-term group cognitive therapy in the combined treatment of anxiety and depression. Group Dynamics: Theory, Research, and Practice. 2000, 4 (2): 176-183. 10.1037/1089-2699.4.2.176.CrossRef Kush FR, McRoberts Fleming L: An innovative approach to short-term group cognitive therapy in the combined treatment of anxiety and depression. Group Dynamics: Theory, Research, and Practice. 2000, 4 (2): 176-183. 10.1037/1089-2699.4.2.176.CrossRef
16.
go back to reference McDermut W, Miller I, Brown R: The Efficacy of Group Psychotherapyfor Depression: A Meta-analysis and Review of the Empirical Research. Clinical Psychology: Science & Practice. 2001, 8 (1): 98-116. 10.1093/clipsy/8.1.98. McDermut W, Miller I, Brown R: The Efficacy of Group Psychotherapyfor Depression: A Meta-analysis and Review of the Empirical Research. Clinical Psychology: Science & Practice. 2001, 8 (1): 98-116. 10.1093/clipsy/8.1.98.
17.
go back to reference Kuyken W, Watkins E, Beck AT: Cognitive-behaviour therapy for mood disorders. Oxford Textbook of Psychotherapy. Edited by: Gabbard, Beck & Holmes. 2005, Oxford, 111-126. Kuyken W, Watkins E, Beck AT: Cognitive-behaviour therapy for mood disorders. Oxford Textbook of Psychotherapy. Edited by: Gabbard, Beck & Holmes. 2005, Oxford, 111-126.
18.
go back to reference Baer R: Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review. Clinical Psychology, Science and Practice. 2003, 10: 125-143. 10.1093/clipsy/bpg015.CrossRef Baer R: Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review. Clinical Psychology, Science and Practice. 2003, 10: 125-143. 10.1093/clipsy/bpg015.CrossRef
19.
go back to reference Wells A: Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. 1997, Wiley, 200-205. Wells A: Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. 1997, Wiley, 200-205.
20.
go back to reference Teasdale JD, Segal ZV, Williams MG: Mindfulness training and problem formulation. Clinical Psychology, Science and Practice. 2003, 10: 157-160. 10.1093/clipsy/bpg017.CrossRef Teasdale JD, Segal ZV, Williams MG: Mindfulness training and problem formulation. Clinical Psychology, Science and Practice. 2003, 10: 157-160. 10.1093/clipsy/bpg017.CrossRef
21.
go back to reference Cohen J: Statistical power analysis for the behavioral sciences. 1988, Hillsdale, NJ: Lawrence Earlbaum Associates Cohen J: Statistical power analysis for the behavioral sciences. 1988, Hillsdale, NJ: Lawrence Earlbaum Associates
Metadata
Title
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care
Authors
Andy Finucane
Stewart W Mercer
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2006
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-6-14

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