Can Mindfulness Therapy Ease Resistant Depression?

TOPLINE:

In patients with depression resistant to National Health Service (NHS) Talking Therapies, mindfulness-based cognitive therapy (MBCT) plus treatment as usual was more effective in alleviating symptoms than treatment as usual alone, a new trial found. Additionally, MBCT plus treatment as usual had a 99% probability of being cost-effective.

METHODOLOGY:

• Researchers conducted a parallel, randomized, controlled, superiority trial across three sites in the United Kingdom (2021-2023).

• The study included 234 patients with major depressive disorder (mean age, 42.5 years; 71% women; 86% White) who couldn't achieve remission after ≥ 12 sessions of NHS Talking Therapies.

• Participants were randomly assigned to receive either treatment as usual alone (n = 116) or MBCT plus treatment as usual (n = 118), with minimization on the basis of depression severity, antidepressant use, and recruitment site.

• The primary outcome was depression symptoms, measured using the Patient Health Questionnaire-9 at 34 weeks. Cost-effectiveness was assessed using the Adult Service Use Schedule.

TAKEAWAY:

• Participants who received MBCT plus treatment as usual had significantly reduced depression symptoms than those who received treatment as usual alone (P = .0006).

• MBCT plus treatment as usual resulted in lower costs and higher utility scores than treatment as usual alone during the study period.

• Analysis revealed a 99% probability that MBCT plus treatment as usual was cost-effective at the £20,000 per quality-adjusted life-year threshold.

• No serious adverse events related to the trial or treatment were observed.

IN PRACTICE:

"Our findings show that psychological further-line treatment for depression can bring clinical benefit at an affordable price, potentially helping to reduce the long-term disability burden and economic costs associated with difficult-to-treat depression," the authors wrote.

SOURCE:

The study was led by Thorsten Barnhofer, PhD, School of Psychology, University of Surrey, Guildford, England. It was published online in the June 2025 issue of The Lancet Psychiatry.

Note: This article originally appeared on Medscape.