Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-24T21:51:12.402Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of mindfulness group therapy on a broad range of psychiatric symptoms: A randomised controlled trial in primary health care

Published online by Cambridge University Press:  23 March 2020

J. Sundquist ,
K. Palmér ,
L.M. Johansson  and
K. Sundquist
J. Sundquist*
Affiliation:
Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02Malmö, Sweden
K. Palmér
Affiliation:
Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02Malmö, Sweden
L.M. Johansson
Affiliation:
Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02Malmö, Sweden
K. Sundquist
Affiliation:
Center for Primary Health Care Research, Clinical Research Centre (CRC), Skåne University Hospital, Lund University, Building 28, Floor 11, Jan Waldenströms gata 35, 205 02Malmö, Sweden
*
*Corresponding author. E-mail address:[email protected] (J. Sundquist).
Get access

Abstract

Background:

The need for psychotherapy in primary health care is on the increase but individual-based treatment is costly. The main aim of this randomised controlled trial (RCT) was to compare the effect of mindfulness-based group therapy (MGT) with treatment as usual (TAU), mainly individual-based cognitive behavioural therapy (CBT), on a broad range of psychiatric symptoms in primary care patients diagnosed with depressive, anxiety and/or stress and adjustment disorders. An additional aim was to compare the effect of MGT with TAU on mindful attention awareness.

Methods:

This 8-week RCT took place in 2012 at 16 primary care centres in southern Sweden. The study population included both men and women, aged 20–64 years (n = 215). A broad range of psychiatric symptoms were evaluated at baseline and at the 8-week follow-up using the Symptom Checklist-90 (SCL-90). Mindful attention awareness was also evaluated using the Mindful Attention Awareness Scale (MAAS).

Results:

In both groups, the scores decreased significantly for all subscales and indexes in SCL-90, while the MAAS scores increased significantly. There were no significant differences in the change in psychiatric symptoms between the two groups. The mindfulness group had a somewhat larger change in scores than the control group on the MAAS (P = 0.06, non-significant).

Conclusions:

No significant differences between MGT and TAU, mainly individual-based CBT, were found in treatment effect. Both types of therapies could be used in primary care patients with depressive, anxiety and/or stress and adjustment disorders, where MGT has a potential to save limited resources.

Trial registration:

ClinicalTrials.gov identifier: NCT01476371.

Keywords

Affective disordersAnxiety disordersCognitive behaviour therapy (CBT)Other psychotherapy
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 19 - 27
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nordstrom, ABodlund, OEvery third patient in primary care suffers from depression, anxiety or alcohol problems. Nord J Psychiatry 2008;62(3):250–255.CrossRefGoogle ScholarPubMed
Lejtzen, NSundquist, JSundquist, KLi, XDepression and anxiety in Swedish primary health care: prevalence, incidence, and risk factors. Eur Arch Psychiatry Clin Neurosci 2014;264(3):235–245.CrossRefGoogle Scholar
Oei, TPBullbeck, KCampbell, JMCognitive change process during group cognitive behaviour therapy for depression. J Affect Disord 2006;92(2–3):231–241.CrossRefGoogle ScholarPubMed
Cuijpers, PBerking, MAndersson, GQuigley, LKleiboer, ADobson, KSA meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Can J Psychiatry 2013;58(7):376–385.CrossRefGoogle ScholarPubMed
Chiesa, ASerretti, AMindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Res 2011;187(3):441–453.CrossRefGoogle ScholarPubMed
Huijbers, MJSpijker, JDonders, ARvan Schaik, DJvan Oppen, PRuhe, HGet al.Preventing relapse in recurrent depression using mindfulness-based cognitive therapy, antidepressant medication or the combination: trial design and protocol of the MOMENT study. BMC Psychiatry 2012;12:125.CrossRefGoogle ScholarPubMed
Segal, ZVWilliams, JMGTeasdale, JDMindfulness-based cognitive therapy for depression: a new approach to preventing relapse New York: Guilford Press; 2002.Google Scholar
Kuyken, WWatkins, EHolden, EWhite, KTaylor, RSByford, Set al.How does mindfulness-based cognitive therapy work?. Behav Res Ther 2010;48(11):1105–1112.CrossRefGoogle ScholarPubMed
Mani, MKavanagh, DJHides, LStoyanov, SRReview and evaluation of mindfulness-based iPhone apps. JMIR mHealth uHealth 2015;3(3):e82.CrossRefGoogle ScholarPubMed
Marchand, WRMindfulness-based stress reduction, mindfulness-based cognitive therapy, and zen meditation for depression, anxiety, pain, and psychological distress. J Psychiatr Pract 2012;18(4):233–252.CrossRefGoogle ScholarPubMed
Vollestad, JNielsen, MBNielsen, GHMindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. Br J Clin Psychol 2012;51(3):239–260.CrossRefGoogle ScholarPubMed
Kuyken, WWarren, FCTaylor, RSWhalley, BCrane, CBondolfi, Get al.Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: an individual patient data meta-analysis from randomized trials. JAMA Psychiatry 2016;73(6):565–574.CrossRefGoogle ScholarPubMed
Segal, ZVBieling, PYoung, TMacQueen, GCooke, RMartin, Let al.Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Arch Gen Psychiatry 2010;67(12):1256–1264.CrossRefGoogle ScholarPubMed
Kuyken, WHayes, RBarrett, BByng, RDalgleish, TKessler, Det al.Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. Lancet 2015;386(9988):63–73.CrossRefGoogle ScholarPubMed
Sundquist, JLilja, APalmer, KMemon, AAWang, XJohansson, LMet al.Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomised controlled trial. Br J Psychiatry 2015;206(2):128–135.CrossRefGoogle ScholarPubMed
Kabat-Zinn, JLipworth, LBurncy, RSellers, WFour-year follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance. Clin J Pain 1986;2(3):159–174.CrossRefGoogle Scholar
Kabat-Zinn, JMassion, AOKristeller, JPeterson, LGFletcher, KEPbert, Let al.Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry 1992;149(7):936–943.Google ScholarPubMed
Kabat-Zinn, JMindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Pract 2003;10(2):144–156.CrossRefGoogle Scholar
Lipman, RSDepression scales derived from the Hopkins symptom checklist. In: Sartorius, NBan, T editors. Assessment of Depression. Berlin: Springer; 1986. p. 232–248.CrossRefGoogle Scholar
Guy, WEarly Clinical Drug Evaluation (ECDEU) Assessment Manual Rockville: National Institute of Health; 1976.Google Scholar
Katz, MMKoslow, SHBerman, NSecunda, SMaas, JWCasper, Ret al.A multi-vantaged approach to measurement of behavioral and affect states for clinical and psychobiological research. Psychol Rep 1984;55(2):619–671.CrossRefGoogle ScholarPubMed
Derogatis, LRLipman, RSCovi, LSCL-90: an outpatient psychiatric rating scale--preliminary report. Psychopharmacol Bull 1973;9(1):13–28.Google ScholarPubMed
Rickels, KA serendipitous life: from german POW to American psychiatrist: Evergreen: Notting Hill Press; 2011.Google Scholar
Bech, PBille, JMoller, SBHellstrom, LCOstergaard, SDPsychometric validation of the Hopkins Symptom Checklist (SCL-90) subscales for depression, anxiety, and interpersonal sensitivity. J Affect Disord 2014;160: 98–103.CrossRefGoogle ScholarPubMed
Derogatis, LRSymptom checklist-90-revised. Handbook of psychiatric measures. American Psychiatric Association; 2000. p. 81–84.Google Scholar
Derogatis, LRSavitz, KLThe SCL-90-R and the Brief Symptom Inventory (BSI) in primary care. In: Maruish, ME editors. Handbook of psychological assessment in primary care settings, 236. Lawrence Erlbaum Associates; 2000. p. 297–334.Google Scholar
Fridell, MCesarec, ZJohansson, MSMTSwedish norms, standardization and validation of the symptom checklist 90 Stockholm: SIS; 2002.Google Scholar
Brown, KWRyan, RMThe benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol 2003;84(4):822–848.CrossRefGoogle ScholarPubMed
Thase, MELarsen, KGKennedy, SHAssessing the ‘true’ effect of active antidepressant therapy v. placebo in major depressive disorder: use of a mixture model. Br J Psychiatry 2011;199(6):501–507.CrossRefGoogle ScholarPubMed
Cohen, JStatistical power analysis for the behavioral sciences, 1st ed., Hillsdale, N.J: L. Erlbaum Associates; 1969.Google Scholar
Davis, DMHayes, JAWhat are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy 2011;48(2):198–208.CrossRefGoogle ScholarPubMed
Khoury, BLecomte, TFortin, GMasse, MTherien, PBouchard, Vet al.Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev 2013;33(6):763–771.CrossRefGoogle ScholarPubMed
Toneatto, TNguyen, LDoes mindfulness meditation improve anxiety and mood symptoms? A review of the controlled research. Can J Psychiatry 2007;52(4):260–266.CrossRefGoogle ScholarPubMed
Kearney, DJMcDermott, KMalte, CMartinez, MSimpson, TLAssociation of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample. J Clin Psychol 2012;68(1):101–116.CrossRefGoogle Scholar
Würtzen, HDalton, SOElsass, PSumbundu, ADSteding-Jensen, MKarlsen, RVet al.Mindfulness significantly reduces self-reported levels of anxiety and depression: Results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. Eur J Cancer 2013;49(6):1365–1373.CrossRefGoogle ScholarPubMed
Teasdale, JSegal, ZWilliams, JMindfulness training and problem formulation. Clin Psychol Sci Pract 2003;10(2):157–160.CrossRefGoogle Scholar
Jha, APStanley, EAKiyonaga, AWong, LGelfand, LExamining the protective effects of mindfulness training on working memory capacity and affective experience. Emotion 2010;10(1):54–64.CrossRefGoogle ScholarPubMed
Zeidan, FGordon, NSMerchant, JGoolkasian, PThe effects of brief mindfulness meditation training on experimentally induced pain. J Pain 2010;11(3):199–209.CrossRefGoogle ScholarPubMed
Zeidan, FJohnson, SKDiamond, BJDavid, ZGoolkasian, PMindfulness meditation improves cognition: evidence of brief mental training. Conscious Cogn 2010;19(2):597–605.CrossRefGoogle ScholarPubMed
Teasdale, JDSegal, ZVWilliams, JMRidgeway, VASoulsby, JMLau, MAPrevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000;68(4):615–623.CrossRefGoogle ScholarPubMed
Sipe, WEEisendrath, SJMindfulness-based cognitive therapy: theory and practice. Can J Psychiatry 2012;57(2):63–69.CrossRefGoogle ScholarPubMed
Gotink, RAMeijboom, RVernooij, MWSmits, MHunink, MG8-week mindfulness based stress reduction induces brain changes similar to traditional long-term meditation practice - a systematic review. Brain Cogn 2016;108: 32–41.CrossRefGoogle ScholarPubMed
Yang, CCBarros-Loscertales, APinazo, DVentura-Campos, NBorchardt, VBustamante, JCet al.State and training effects of mindfulness meditation on brain networks reflect neuronal mechanisms of its antidepressant effect. Neural Plast 2016;2016:9504642.CrossRefGoogle ScholarPubMed
Hansson, MBodlund, OChotai, JPatient education and group counselling to improve the treatment of depression in primary care: a randomized controlled trial. J Affect Disord 2008;105(1–3):235–240.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.