Abstract
BackgroundHome practice is considered a key element in increasing treatment effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depression. However, long-term longitudinal research into the associations between home practice and depression outcomes is scarce. The current study examined the prospective associations between the extent of formal home practice and subsequent depression severity during 15 months of follow-up.MethodsData from two randomized-controlled trials on MBCT for recurrent depression were used (n = 200). Depressive symptoms were assessed at 3-month intervals: 0 (baseline), 3 (posttreatment), 6, 9, 12, and 15 months. Formal home practice frequency was calculated for each 3-month period. Autoregressive latent trajectory (ALT) modelling was applied.ResultsParticipants practiced formal exercises on 57% (SD = 0.22, range 0–1) of the days during MBCT, equivalent to an average of 4 days per week, which showed a rapid decline after MBCT. The level of depressive symptoms did not change over the full study period. A small positive association was found between formal home practice frequency during each three-month period on subsequent depressive symptoms, but sensitivity analyses did not confirm this. More robust, a small negative association was found between levels of depressive symptoms at each measurement point and formal home practice frequency during the subsequent three-month periods.ConclusionsThe hypothesis that more frequent home practice would lead to reductions in depressive symptoms was not confirmed in the current study. Rather, it seems that patients with higher levels of depression may subsequently practice less frequently at home. The interplay between home practice and outcome might not be as straightforward as expected. However, these results are preliminary and should be replicated first before recommendations for clinical practice can be formulated.
Highlights
Major depressive disorder (MDD) is the most common form of depressive disorders, and the leading cause of disease burden worldwide (American Psychiatric Association 2013; World Health Organization 2017)
This study was based on data from the MOMENT study which consists of two randomized controlled trials (RCTs) that investigated the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT), maintenance antidepressant medication and the combination of both to prevent relapse/ recurrence in patients with recurrent depression in remission during 15 months of follow-up (Huijbers et al 2015, 2016)
A rapid decline of formal home practice frequency was found during the follow-up periods, where formal home practice reached a plateau at 21% of the available number of days to practice, equivalent to an average of about 1.5 days a week
Summary
Major depressive disorder (MDD) is the most common form of depressive disorders, and the leading cause of disease burden worldwide (American Psychiatric Association 2013; World Health Organization 2017). The current study examined the prospective associations between the extent of formal home practice and subsequent depression severity during 15 months of follow-up. A small positive association was found between formal home practice frequency during each three-month period on subsequent depressive symptoms, but sensitivity analyses did not confirm this. A small negative association was found between levels of depressive symptoms at each measurement point and formal home practice frequency during the subsequent three-month periods. Conclusions The hypothesis that more frequent home practice would lead to reductions in depressive symptoms was not confirmed in the current study. Rather, it seems that patients with higher levels of depression may subsequently practice less frequently at home. These results are preliminary and should be replicated first before recommendations for clinical practice can be formulated
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