Individual Mindfulness-Based Cognitive Therapy in Major Depression: a Feasibility Study

Objectives Mindfulness-based cognitive therapy (MBCT) is currently used as a group therapy; however, there is little evidence regarding the use of individual MBCT (I-MBCT). The primary objective of this pilot trial was to test the feasibility of I-MBCT for major depression in a pilot randomized study using cognitive behavioral therapy (CBT) as a control condition. Methods This parallel two-arm pilot trial was conducted in Canada. Adult participants with major depression were recruited from a tertiary care hospital and two private practice psychiatrists between November 2015 and October 2017. The participants were randomized to receive 12 weeks of I-MBCT or individual CBT. Depression, mindfulness, and rumination were measured at the beginning, middle, and end of the treatment and at 8 weeks follow-up. Results Among the 51 participants initially screened, 52.9% were randomized to I-MBCT (n = 14) or CBT (n = 13). The attrition rate was 29.6%, and 59.3% of the participants were involved in the follow-up. The average attendance rate of the I-MBCT was 9.0 sessions (SD = 4.6). Depression and rumination decreased during the I-MBCT (B = - 1.20, p < 0.001 and B = - 0.60, p < 0.006; within-group effect size: d(rm) = - 1.22 and d(rm) = - 0.83, respectively), and mindfulness increased (B = 2.08, p < 0.003; within-group effect size: d(rm) = 1.31). The decrease in rumination levels during I-MBCT was larger than during CBT (interaction between time and treatment, B (SE) = - 0.57 (0.25), p = 0.03); there were no significant between-group differences for changes in depression and mindfulness. Conclusions A trial comparing I-MBCT to CBT among patients with major depressive disorder seems feasible; however, the sample size should consider the high attrition rate.

Automated summary

This pilot trial examined the feasibility of individual mindfulness-based cognitive therapy (I-MBCT) for major depression and compared its effectiveness to individual cognitive behavioral therapy (CBT). The results showed that I-MBCT significantly reduced depression and rumination, while increasing mindfulness. The decrease in rumination during I-MBCT was greater than during CBT. However, the high attrition rate should be considered in future studies.