Added value of Mindfulness-Based Cognitive Therapy for Depression: A Tree-based Qualitative Interaction Analysis. (November 2019)

• Record Type: Journal Article
• Authors: ter Avest, Marleen J.; Dusseldorp, Elise; Huijbers, Marloes J.; van Aalderen, Joël R.; Cladder-Micus, Mira B.; Spinhoven, Philip; Greven, Corina U.; Speckens, Anne E.M.
• Is Part Of: Behaviour research and therapy. Volume 122(2019)
• Publication Date: 2019-11
• Subjects: MBCT -- Mindfulness -- Depression -- Quality of life -- Precision medicine -- QUINT; IPD Individual Patient Data -- ITT Intention-To-Treat -- MBCT Mindfulness-Based Cognitive Therapy -- MBI(s) Mindfulness-Based Intervention(s) -- MDD Major Depressive Disorder -- PP Per Protocol -- RCT(s) Randomized-Controlled Trial(s) -- TAU Treatment As Usual -- QUINT Qualitative INteraction Trees; Cognitive therapy -- Periodicals; Psychotherapy -- Periodicals; 616.891
• DOI: 10.1016/j.brat.2019.103467
• Languages: English
• ISSNs: 0005-7967

Abstract

Abstract: Aim: To identify moderators of treatment effect for Mindfulness-Based Cognitive Therapy (MBCT) versus Treatment As Usual (TAU) in depressed patients. Methods: An individual patient data-analysis was performed on three randomized-controlled trials, investigating the effect of MBCT + TAU versus TAU alone ( N = 292). Patients were either in (partial) remission, currently depressed or had chronic, treatment-resistant depression. Outcomes were depressive symptoms and quality of life. The QUalitative INteraction Trees (QUINT) method was used to identify subgroups that benefited more from either condition. Results: MBCT + TAU outperformed TAU in reducing depressive symptoms. For both conditions, the effect of baseline depressive symptoms on post-treatment depressive symptoms was curvilinear. QUINT analyses revealed that MBCT + TAU was more beneficial than TAU for patients with an earlier onset and higher rumination levels in terms of depressive symptom reduction and for patients with a lower quality of life in terms of improving quality of life. Conclusions: The results suggest that MBCT might be more beneficial for those with earlier onset and higher levels of rumination and for patients with a lower quality of life. Sophisticated analytical techniques such as QUINT can be used in future research to improve personalized assignment of MBCT to patients. Long-term outcome could also be integrated in this. Highlights: The QUINT method seems a promising method to facilitate personalized treatment. Several subgroups are identified who benefit from MBCT as an add-on to TAU. This is a first step to improve personalized assignment of MBCT for depression. More research is needed before implementation in clinical practice can take place.