Abstract
BackgroundMindfulness Based Cognitive Therapy (MBCT) has been adopted as an evidence-based treatment for unipolar depressive disorder (UDD). Although MBCT has not been included in the treatment guidelines for bipolar disorder (BD), MBCT is regularly being offered to patients with BD in routine clinical practice. In this pilot study we used routine outcome monitoring (ROM) data to explore whether there are indications that patients with BD might benefit less from MBCT than patients with UDD in terms of feasibility and effectiveness.MethodsThe study population consisted of patients with BD (n = 30) or UDD (n = 501) who received MBCT at the Radboudumc Centre for Mindfulness in Nijmegen, the Netherlands. Patients completed self-report measures of depressive symptom severity, worry, well-being, mindfulness skills and self-compassion pre- and post MBCT as part of the ROM.ResultsThere were significant less patients with BD who decided to start MBCT after intake than patients with UDD. No differences in dropout between groups were found. Results showed significant moderate to large improvements in both groups after MBCT, while no differences between groups were found, on all outcome measures.ConclusionsThis study demonstrates that there are no indications that MBCT, when delivered in heterogeneous patient groups in routine clinical practice, is less beneficial for patients with BD than patients with UDD in terms of feasibility and effectiveness. This lends support to conduct an adequately powered RCT to examine the (cost-)effectiveness of MBCT in BD as the next step before implementing MBCT on a larger scale in patients with BD.
Highlights
Mindfulness Based Cognitive Therapy (MBCT) has been adopted as an evidence-based treatment for unipolar depressive disorder (UDD)
Several previous studies have investigated the clinical effectiveness of MBCT in bipolar disorder (Deckersbach et al 2012; Miklowitz et al 2009; Williams et al 2008; Perich et al 2013; Weber et al 2010, 2017), and, despite limited sample sizes, results seem to support the possible application of MBCT in patients with bipolar disorder
Our aim was to explore whether there are any indications that MBCT for bipolar disorder might result in a higher dropout or a reduced effectiveness in terms of depressive symptom severity, worry, well-being, mindfulness skills, and self-compassion compared to patients with unipolar depressive disorder
Summary
Mindfulness Based Cognitive Therapy (MBCT) has been adopted as an evidence-based treatment for unipolar depressive disorder (UDD). MBCT has not been included in the treatment guidelines for bipolar disorder (BD), MBCT is regularly being offered to patients with BD in routine clinical practice. In this pilot study we used routine outcome monitoring (ROM) data to explore whether there are indications that patients with BD might benefit less from MBCT than patients with UDD in terms of feasibility and effectiveness. MBCT has not yet been included as a treatment option in the NICE-guidelines for bipolar disorder, it is regularly being offered to patients with bipolar disorder in routine clinical practice (Bos et al 2014). The feasibility and effectiveness of MBCT for bipolar disorder was only studied in small, underpowered studies (Lovas and Schuman-Olivier 2018)
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