TY - JOUR
T1 - Mindfulness-based cognitive therapy v. treatment as usual in people with bipolar disorder
T2 - A multicentre, randomised controlled trial
AU - Hanssen, Imke
AU - Huijbers, Marloes
AU - Regeer, Eline
AU - Lochmann Van Bennekom, Marc
AU - Stevens, Anja
AU - Van Dijk, Petra
AU - Boere, Elvira
AU - Havermans, Rob
AU - Hoenders, Rogier
AU - Kupka, Ralph
AU - Speckens, Anne E.
N1 - Funding Information: This study was funded by ZonMw, the Netherlands Organization for Health Research and Development (Grant Number: 843002803). Funding Information: A. Speckens and M. Huijbers received grants from the Netherlands Organization of Scientific Research during the conduct of this study. A. Speckens is the director of the Radboudumc Center for Mindfulness, department of psychiatry. M. Huijbers and I. Hanssen are mindfulness teachers at the Radboudumc Center for Mindfulness. There are no other disclosures to be reported. Publisher Copyright: © The Author(s), 2023.
PY - 2023/10/7
Y1 - 2023/10/7
N2 - Background Mindfulness-based cognitive therapy (MBCT) seems a promising intervention for bipolar disorder (BD), but there is a lack of randomised controlled trials (RCT) investigating this. The purpose of this multicentre, evaluator blinded RCT was to investigate the added value of MBCT to treatment as usual (TAU) in BD up to 15 months follow-up (NCT03507647). Methods A total of 144 participants with BD type I and II were randomised to MBCT + TAU (n = 72) and TAU (n = 72). Primary outcome was current depressive symptoms. Secondary outcomes were current (hypo)manic and anxiety symptoms, recurrence rates, rumination, dampening of positive affect, functional impairment, mindfulness skills, self-compassion, and positive mental health. Potential moderators of treatment outcome were examined. Results MBCT + TAU was not more efficacious than TAU in reducing current depressive symptoms at post-treatment (95% CI [-7.0 to 1.8], p = 0.303, d = 0.24) or follow-up (95% CI [-2.2 to 6.3], p = 0.037, d = 0.13). At post-treatment, MBCT + TAU was more effective than TAU in improving mindfulness skills. At follow-up, TAU was more effective than MBCT + TAU in reducing trait anxiety and improving mindfulness skills and positive mental health. Exploratory analysis revealed that participants with higher depressive symptoms and functional impairment at baseline benefitted more from MBCT + TAU than TAU. Conclusions In these participants with highly recurrent BD, MBCT may be a treatment option in addition to TAU for those who suffer from moderate to severe levels of depression and functional impairment. Trial registration ClinicalTrials.gov, NCT03507647. Registered the 25 April 2018, https://www.clinicaltrials.gov/ct2/show/NCT01126827.
AB - Background Mindfulness-based cognitive therapy (MBCT) seems a promising intervention for bipolar disorder (BD), but there is a lack of randomised controlled trials (RCT) investigating this. The purpose of this multicentre, evaluator blinded RCT was to investigate the added value of MBCT to treatment as usual (TAU) in BD up to 15 months follow-up (NCT03507647). Methods A total of 144 participants with BD type I and II were randomised to MBCT + TAU (n = 72) and TAU (n = 72). Primary outcome was current depressive symptoms. Secondary outcomes were current (hypo)manic and anxiety symptoms, recurrence rates, rumination, dampening of positive affect, functional impairment, mindfulness skills, self-compassion, and positive mental health. Potential moderators of treatment outcome were examined. Results MBCT + TAU was not more efficacious than TAU in reducing current depressive symptoms at post-treatment (95% CI [-7.0 to 1.8], p = 0.303, d = 0.24) or follow-up (95% CI [-2.2 to 6.3], p = 0.037, d = 0.13). At post-treatment, MBCT + TAU was more effective than TAU in improving mindfulness skills. At follow-up, TAU was more effective than MBCT + TAU in reducing trait anxiety and improving mindfulness skills and positive mental health. Exploratory analysis revealed that participants with higher depressive symptoms and functional impairment at baseline benefitted more from MBCT + TAU than TAU. Conclusions In these participants with highly recurrent BD, MBCT may be a treatment option in addition to TAU for those who suffer from moderate to severe levels of depression and functional impairment. Trial registration ClinicalTrials.gov, NCT03507647. Registered the 25 April 2018, https://www.clinicaltrials.gov/ct2/show/NCT01126827.
KW - Mindfulness-based cognitive therapy
KW - bipolar disorder
KW - effectiveness
KW - randomised controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85178030464&partnerID=8YFLogxK
U2 - https://doi.org/10.1017/S0033291723000090
DO - https://doi.org/10.1017/S0033291723000090
M3 - Article
SN - 0033-2917
VL - 53
SP - 6678
EP - 6690
JO - Psychological Medicine
JF - Psychological Medicine
IS - 14
ER -