THE QUESTION Doctors generally prescribe antidepressants to help people avoid the recurrences that are common with chronic depression. Might mindfulness therapy, which helps people change the way they respond to feelings and experiences that trigger their bouts of depression, offer an alternative for those who do not want to take antidepressants long-term?
THIS STUDY involved 424 adults — their average age was about 50 — who had been diagnosed with major depressive disorder but were in remission and were taking antidepressants. They were randomly assigned either to continue taking the drugs or to taper off the antidepressants and participate in mindfulness-based cognitive therapy classes.
The therapy group attended a two-hour class weekly for eight weeks and periodic refresher classes for the next year, learning skills to help them become more aware of thoughts and feelings associated with their particular experiences with depression and to react more constructively to what otherwise might have led to a depressive episode. Over a two-year period, the number of depression-free days was virtually the same for people still taking antidepressants and those who had shifted their treatment to mindfulness therapy. In that time, 44 percent of the therapy group, vs. 47 percent of the antidepressant group, had a relapse. Ratings on overall quality of life were virtually the same for the two groups.
WHO MAY BE AFFECTED? Adults with chronic depression. Although people can experience a single episode of depression, it is more common for depression to persist and for people to experience several episodes. In the United States, major depression is one of the most common mental health disorders, with about 16 million adults (roughly 7 percent of the population) experiencing at least one depressive episode in the past year.
CAVEATS All participants were taking antidepressants at the start of the study; whether the findings would apply to people with major depression who had never taken antidepressants was not tested. Mindfulness therapy groups led by different therapists might yield different results. Two people in each group died during the study, but none of the deaths were found to be related to their treatment.
FIND THIS STUDY April 20 online issue of the Lancet (www.thelancet.com; click on “View more Research articles”).