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Mindfulness 'as good as medication' for chronic depression

Mind therapy Mindfulness-based cognitive therapy (MBCT) may be just as effective as antidepressants in helping prevent people with chronic depression from relapsing, say UK scientists.

Depression is one of the most common forms of mental illness, affecting more than 350 million people worldwide. It is ranked by the World Health Organization as the leading cause of disability globally.

Treatment usually involves either medication, some form of psychotherapy or a combination of both. Yet many people with depression fail to get better and suffer recurring bouts of illness.

MBCT was developed to help such people by teaching them skills to recognise and respond constructively to thoughts and feelings associated with relapse, aiming to prevent a downward spiral into depression.

"Currently, maintenance antidepressant medication is the key treatment for preventing relapse, reducing the likelihood of relapse or recurrence by up to two-thirds when taken correctly," says study co-author Professor Richard Byng, of the Plymouth University Peninsula Schools of Medicine and Dentistry, UK.

"However, there are many people who, for a number of different reasons, are unable to keep on a course of medication for depression.

In the first large study to compare MBCT and antidepressants, Byng and colleagues found little difference in outcomes, they report in The Lancet.

In this study, 424 adults with recurrent major depression who were on maintenance antidepressant drugs were randomly assigned either to come off their antidepressants slowly and receive MBCT or to stay on their medication.

While 212 patients continued taking their antidepressants, the other 212 attended eight group mindfulness therapy sessions and were given daily home practice as well as an option to have four follow-up sessions over a 12-month period.

Study results show that after two years, relapse rates were similar in both groups -- at 44 per cent in the therapy group versus 47 per cent in the antidepressant drug group.

The study also found that mindfulness training -- often viewed as more costly because it requires more time with a trained therapist -- was not significantly more pricey, particularly when given in group sessions.

"Whilst this study doesn't show that mindfulness-based cognitive therapy works any better than maintenance antidepressant medication in reducing the rate of relapse ... these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions," says study lead author Willem Kuyken of the University of Oxford.