Mindfulness-based cognitive therapy as an adjunctive treatment for treatment-resistant depression: A systematic review

Background

Treatment-Resistant Depression is a significant mental health challenge characterized by an inadequate response to standard treatments. Mindfulness-Based Cognitive Therapy has shown promise for depression, but its effectiveness for Treatment-Resistant Depression remains unclear.

Objective

This systematic review evaluated the effectiveness and safety of Mindfulness-Based Cognitive Therapy as an adjunctive treatment for Treatment-Resistant Depression.

Methods

We searched MEDLINE, Embase, Web of Science, ClinicalTrials.gov, and PsycInfo up to June 15, 2024, without language restrictions. Randomized controlled trials comparing Mindfulness-Based Cognitive Therapy plus treatment as usual to treatment as usual alone in individuals with Treatment-Resistant Depression were included. The primary outcome was depressive symptom severity. Secondary outcomes included quality of life, rumination, mindfulness skills, and self-compassion.

Results

The review included 13 studies with a total of 864 participants. Preliminary evidence suggests that Mindfulness-Based Cognitive Therapy significantly may help reduce depressive symptoms compared to treatment as usual or active controls, with effect sizes ranging from moderate to large (Cohen’s d = 0.54 to 1.04) in well-designed studies. Some improvements were also noted in quality of life (d = 0.36 to 0.51), rumination (d = 0.39), mindfulness skills (d = 0.73), and self-compassion (d = 0.21 to 0.64).

Conclusions

While encouraging, the current evidence suggests that Mindfulness-Based Cognitive Therapy maybe a promising intervention for Treatment-Resistant Depression However, methodological limitations, including heterogeneity in study designs and TRD definitions, preclude definitive conclusions. Future research should prioritize well-designed randomized controlled trials to establish its efficacy and optimal implementation.