Mindfulness-Based Cognitive Therapy (MBCT) for depression with chronic physical health problems

Background

Depression: With depression an individual has a low mood and other symptoms each day for at least two weeks. Other symptoms include changes in patterns of sleep, eating, energy, concentration and may include feelings of worthlessness, inappropriate guilt and suicidal thoughts. Symptoms have become severe enough to interfere with normal day-to-day activities.

MBCT/MBSR: Mindfulness-based stress reduction (MBSR) is an 8-week, class-based program in which people learn mindfulness practices; recognise patterns of thinking and feeling that cause distress and exacerbate symptoms; improve self-awareness and learn to step out of patterns of reactivity. Over time and with practice, people typically report being better able to cope both with their chronic health problems but also with their lives more generally. Mindfulness-based cognitive therapy is a derivative of MBSR tailored specifically for people with recurrent depression. MBSR/MBCT is based on the premise that the mind is known to be a factor in stress and stress-related disorders, and meditation has been shown to positively effect a range of autonomic physiological processes, such as lowering blood pressure and reducing overall arousal and emotional reactivity. The program brings meditation and yoga together so that the virtues of both can be experienced simultaneously.

Project aims

MBCT/MBSR in either a primary care or specialist medical outpatient clinic. The intervention will be delivered to mixed illness groups with weekly 2 hour sessions for 8 weeks.

Project outcomes

• To demonstrate the practicality of screening for depression in people with ongoing physical health problems in primary care and attending medical outpatients.
• To determine the suitability of MBCT/ MBSR to people with long-term physical health problems
• To assess how effective the intervention is on different psychological outcomes including depression using a range of measures.
• To fine tune the MBCT/MBSR intervention to make it as effective as possible in helping people with their physical and mental health.
• To address the most important uncertainties identified in recent work and lay the groundwork for a high quality research project that will inform the NICE guidance for depression with other existing medical conditions, along with each of the NICE guidelines for named long term conditions.

The research also aims to investigate the processes via which necessary changes to MBSR/CT are identified for different patient groups and how they are incorporated into treatment, thereby developing a blue print by which treatment services and individual practitioners can adapt treatment for the needs of individual patients.

Related PenCLAHRC projects

• MBCT-YP: Mindfulness-Based Cognitive Therapy to prevent relapse in young people
• The MYRIAD Project: Mindfulness and Resilience in Adolescence
• Improving the mental health of children and young people with long term conditions

Related publications

Panagioti M, Bower P, Kontopantelis E, Lovell K, Gilbody S, Waheed W, Dickens C, Archer J, Simon G, Ell K, Huffman JC, Richards DA, van der Feltz-Cornelis C, Adler DA, Bruce M, Buszewicz M, Cole MG, Davidson KW, de Jonge P, Gensichen J, Huijbregts K, Menchetti M, Patel V, Rollman B, Shaffer J, Zijlstra-Vlasveld MC, Coventry PA. Association Between Chronic Physical Conditions and the Effectiveness of Collaborative Care for DepressionAn Individual Participant Data Meta-analysis. JAMA Psychiatry (2016), 73(9):978-989