Abstract
BackgroundDialectical behavioral therapy (DBT) skills have become increasingly used to treat several psychiatric conditions, including major depressive disorder (MDD). The aim of the study was to investigate the efficacy of an intervention that combines emotion regulation and mindfulness skills of DBT to prevent depression relapse/recurrence.MethodsA total of 75 individuals (79% females; mean age, 52 years) with a diagnosis of MDD in complete or partial remission were recruited. Participants were randomly allocated either to an intervention combining emotion regulation and mindfulness skills (ER + M group, n = 37) or to a psychoeducative program (n = 38). After the 10-week treatment period, participants were followed for 1 year. Analyses were run in per-protocol (PP) and intention-to-treat (ITT) samples. The primary outcome measure was time to depression relapse/recurrence.ResultsER + M training was not more effective than the control intervention in preventing depression relapse. However, PP and ITT analyses showed that participants trained in ER + M presented a significant reduction in depressive symptoms and overall psychopathology. Based on the PP and ITT analyses, neither of the interventions were related with an increase in dispositional mindfulness.ConclusionsMore studies are needed to confirm the efficacy of ER + M to decrease depressive symptoms and overall psychopathology.Trial registrationNCT02747134. Registered on 20 April 2016.
Highlights
Dialectical behavioral therapy (DBT) skills have become increasingly used to treat several psychiatric conditions, including major depressive disorder (MDD)
Patient flow and dropout Of the 110 participants assessed for eligibility, a total of 75 were randomized to Emotion regulation (ER) + M (37 patients) or psychoeducation (38)
Our findings indicate that ER + M was not superior to psychoeducation in terms of the primary outcome measure: time to depressive relapse
Summary
Dialectical behavioral therapy (DBT) skills have become increasingly used to treat several psychiatric conditions, including major depressive disorder (MDD). The World Health Organization estimates that, by the year 2030, depression will be the leading cause of disease burden globally [2]. This disorder has a highly recurrent nature and a poor long-term prognosis because the Dialectical Behavioral Therapy (DBT) is a multicomponent treatment initially developed for patients with borderline personality disorder [4]. In subjects with an MDD diagnosis, some studies have compared the effects of DBT skills training to antidepressant medications (AM). Findings from a pilot study conducted by Harley et al showed that skills training was more efficacious than treatment as usual (TAU) to decrease depression in individuals with treatment-resistant MDD [9]
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