Efficacy of mindfulness-based cognitive therapy in relation to prior history of depression: randomised controlled trial

Background: There appears to be consensus that patients with only one or two prior depressive episodes do not benefit from treatment with mindfulness-based cognitive therapy (MBCT). Aims: To investigate whether the effect of MBCT on residual depressive symptoms is contingent on the number of previous depressive episodes (trial number NTR1084). Method: Currently non-depressed adults with residual depressive symptoms and a history of depression (≤2 prior episodes: n = 71; ≥3 episodes: n = 59) were randomised to MBCT (n = 64) or a waiting list (control: n = 66) in an open-label, randomised controlled trial. The main outcome measured was the reduction in residual depressive symptoms (Hamilton Rating Scale for Depression, HRSD-17). Results: Mindfulness-based cognitive therapy was superior to the control condition across subgroups (β = -0.56, P<0.001). The interaction between treatment and subgroup was not significant (β = 0.45, P = 0.16). Conclusions: Mindfulness-based cognitive therapy reduces residual depressive symptoms irrespective of the number of previous episodes of major depression.