scholarly journals Mindfulness based cognitive therapy for recurrent depressive disorder

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S272-S272
Author(s):  
James McLoughlin ◽  
Paula Martin ◽  
Geraldine McCarthy ◽  
Chee Lin Piong
Keyword(s):  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Skill Acquisition ◽  
Treatment Strategies ◽  
Clinical Effectiveness ◽  
Small Scale ◽  
Post Intervention ◽  
Self Compassion ◽  
Paired Samples ◽  
Qualitative Feedback

AimsMindfulness-based therapies have been demonstrated to be effective in reducing anxiety, stress and depressive symptoms in adults. Depression is a chronic relapsing condition. Major depressive disorder is one of the most common causes of ill health and functional impairment.Our goal was to assess the real world clinical effectiveness of Mindfulness Based Cognitive Therapy (MBCT) for Recurrent Depressive Disorder in three domains:-Depression, anxiety and stress levels-Mindfulness level-Self-compassion levelMethodPatients with a diagnosis of Recurrent Depressive Disorder (primary or secondary diagnosis) were referred by their community mental health team to participate in an 8-week educational MBCT programme. Participants completed the Depression, Anxiety and Stress (DASS), 5-Facet Mindfulness and Self Compassion self-rated scales prior to commencing and at the end of the course. They were also invited to give qualitative feedback at the end of the course.Data were collected from four groups who completed the course over a period of twelve months. A paired samples test was used to compare pre and post intervention scores to determine effect size.ResultWe had complete data for 19 participants out of a cohort of 34. Pre intervention scores were similar for both groups.The mean age of the cohort was 47 years (SD of 10 years), 3 male, 16 female.Patients showed a clinically significant reduction of symptoms in depression, anxiety and stress, with respective reductions of 48%, 26% and 43% post intervention. Results were statistically significant for depressaion and stress p <0.001 but not for anxiety p = 0.130.Positive trends were seen in all domains of the 5-Fact Mindfulness and Self Compassions scales, with mean improvements of 28.2% and 35.3% respectively. All results were statistically significant.We also collected anonymized qualitative feedback which highlighted themes of empowerment, skill acquisition and improved coping.ConclusionNumerous studies have demonstrated poor compliance with antidepressant treatments commonly prescribed in Recurrent Depressive Disorder. This small scale study demonstrates a statistical and clinical benefit of MBCT for these patients, supporting greater use of such novel non-pharmacological therapeutic options as treatment strategies..

Pilot study of a well-being app to support New Zealand young people during the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Anna Serlachius ◽  
Anna Boggiss ◽  
David Lim ◽  
Kiralee Schache ◽  
Kate Wallace-Boyd ◽  
...  
Keyword(s):  
New Zealand ◽  
Young People ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Well Being ◽  
Post Intervention ◽  
Factors Affecting ◽  
Self Compassion ◽  
Qualitative Feedback ◽  
The Look

BACKGROUND Well-being apps represent a promising and scalable approach for improving mental health outcomes in youth, especially during a global pandemic when access to face-to-face interventions may be limited. Whitu (seven in the New Zealand Māori language Te Reo) is a newly developed well-being app with seven modules that support young people to learn and practice evidence-based coping skills, including relaxation, mindfulness, self-compassion, healthy eating, and goal-setting. OBJECTIVE During this pilot, we explored the acceptability, usability, and preliminary efficacy of Whitu before refining the app for a randomized controlled trial (RCT). METHODS We recruited 20 New Zealand young people aged 16-25 years via social media to trial the first prototype of the Whitu app over 6 weeks. Within-group differences from baseline to 2- and 6-weeks post intervention in self-reported well-being, depression, anxiety, stress, self-compassion, and optimism were evaluated using repeated-measures ANOVA. A further 21 participants aged 16-30 years were recruited to participate in 4 focus groups to give feedback on the app’s usability and cultural acceptability. Feedback was analyzed using directed content analysis. RESULTS Statistically significant improvements in anxiety (p=.024) and stress (p=.017) were observed from baseline to 2-weeks post intervention. Improvements in well-being (p=.021), depression (p=.031), anxiety (p=.005), and stress (p=.004) were also observed from baseline to 6-weeks. No statistically significant changes were seen in self-compassion, optimism, or sleep. Qualitative feedback comprised of five key themes, namely: factors affecting engagement, issues with functionality, preferences regarding aesthetics, effectiveness and adverse effects, and cultural acceptability. CONCLUSIONS Our preliminary results suggest that Whitu may be an effective app for improving multiple dimensions of young people’s well-being. Modifications to the look and feel, cultural content, and onboarding have been undertaken based on the qualitative feedback, and an RCT is currently underway.

scholarly journals The effectiveness of mindfulness-based cognitive therapy for major depressive disorder: evidence from routine outcome monitoring data

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Dirk E.M. Geurts ◽  
Felix R. Compen ◽  
Marleen H.C.T. Van Beek ◽  
Anne E.M. Speckens
Keyword(s):  
Major Depressive Disorder ◽  
Clinical Practice ◽  
Depressive Symptoms ◽  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Major Depressive ◽  
Mindfulness Skills ◽  
Self Compassion ◽  
Remission Status ◽  
Outcome Monitoring

Background Meta-analyses show efficacy of mindfulness-based cognitive therapy (MBCT) in terms of relapse prevention and depressive symptom reduction in patients with major depressive disorder (MDD). However, most studies have been conducted in controlled research settings. Aims We aimed to investigate the effectiveness of MBCT in patients with MDD presenting in real-world clinical practice. Moreover, we assessed whether guideline recommendations for MBCT allocation in regard to recurrence and remission status of MDD hold in clinical practice. Method This study assessed a naturalistic cohort of patients with (recurrent) MDD, either current or in remission (n = 765), who received MBCT in a university hospital out-patient clinic in The Netherlands. Outcome measures were self-reported depressive symptoms, worry, mindfulness skills and self-compassion. Predictors were MDD recurrence and remission status, and clinical and sociodemographic variables. Outcome and predictor analyses were conducted with linear regression. Results MBCT adherence was high (94%). Patients with a lower level of education had a higher chance of non-adherence. Attending more sessions positively influenced improvement in depressive symptoms. Depressive symptoms significantly reduced from pre- to post-MBCT (Δ mean = 7.7, 95%CI = 7.0–8.5, Cohen's d = 0.75). Improvement of depressive symptoms was independent from MDD recurrence and remission status. Unemployed patients showed less favourable outcomes. Worry, mindfulness skills and self-compassion all significantly improved. These improvements were related to changes in depressive symptoms. Conclusions Previous efficacy results in controlled research settings are maintained in clinical practice. Results illustrate that MBCT is effective in routine clinical practice for patients suffering from MDD, irrespective of MDD recurrence and remission status.

scholarly journals 180. Leveraging the Electronic Medical Record as a Method of Antibiotic Stewardship

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S97-S97
Author(s):  
Christina M Kaul ◽  
Eric Molina ◽  
Donna Armellino ◽  
Mary Ellen Schilling ◽  
Mark Jarrett
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
P Value ◽  
Inpatient Setting ◽  
Post Intervention ◽  
Paired Samples ◽  
Viable Method

Abstract Background Overutilization of antibiotics remains an issue in the inpatient setting. What is more, many protocols geared toward curbing improper antibiotic use rely heavily on resource- and personnel-intensive interventions. Thus, the potential for using the EMR to facilitate antibiotic stewardship remains largely unexplored. Methods We implemented a novel change for ordering certain antibiotics in our EMR: ceftriaxone, daptomycin, ertapenem, imipenem, meropenem, and piperacillin-tazobactam. When ordering one of these antibiotics, providers had to note a usage indication, which assigned a usage duration as per our Antibiotic Stewardship Committee guidelines. Pre-intervention, manual discontinuation was required if a provider did not enter a duration. The intervention was enacted August 2019 in 13 hospitals. Data was collected from January 2018 to February 2020. Antibiotic usage was reported monthly as rate per 1000-patient days. Monthly pre- and post-intervention rates were averaged, respectively. Paired samples t-tests were used to compare pre- and post-intervention rates per unit type per hospital. A p-value of less than 0.05 was considered significant. Units with minimal usage, as defined by a pre- or post-intervention mean of 0, were excluded from analysis. Example of Ordering an Antibiotic Prior to Intervention Example of Ordering an Antibiotic After Intervention Results Ertapenem was noted to have a statistically significant decrease in utilization in seven units at three hospitals. Piperacillin-tazobactam was found to have a decrease in utilization in 19 units at eight hospitals. Daptomycin was found to have a decrease in utilization in one unit. Significant decreases in the utilization of ceftriaxone, imipenem, and meropenem were not noted. Example of Statistically Significant Decreased Utilization in Piperacillin-Tazobactam on a Medical-Surglcal Unit Conclusion Our study showed a statistically significant decrease in use of ertapenem, piperacillin-tazobactam and daptomycin using a simple built-in EMR prompt that curtails provider error. This should allow for an increased ease of integration, as the protocol does not require a host of resources for maintenance. Of note is decreased utilization of piperacillin-tazobactam and ertapenem across multiple hospitals, most notably on the medical and surgical wards. Thus, usage of the EMR without personnel-intensive protocols is a viable method for augmenting antibiotic stewardship in health systems. Disclosures All Authors: No reported disclosures

scholarly journals A Short Mindfulness Retreat for Students to Reduce Stress and Promote Self-Compassion: Pilot Randomised Controlled Trial Exploring Both an Indoor and a Natural Outdoor Retreat Setting

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 910
Author(s):  
Dorthe Djernis ◽  
Mia S. O’Toole ◽  
Lone O. Fjorback ◽  
Helle Svenningsen ◽  
Mimi Y. Mehlsen ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Effect Sizes ◽  
Medium Effect ◽  
Control Group ◽  
Post Intervention ◽  
Pilot Randomised Controlled Trial ◽  
Self Compassion ◽  
Randomised Controlled

Here, we developed and examined a new way of disseminating mindfulness in nature to people without meditation experience, based on the finding that mindfulness conducted in natural settings may have added benefits. We evaluated a 5-day residential programme aiming to reduce stress and improve mental health outcomes. We compared an indoor and an outdoor version of the programme to a control group in a pilot randomised controlled trial (RCT). Sixty Danish university students experiencing moderate to high levels of stress were randomised into a residential mindfulness programme indoors (n = 20), in nature (n = 22), or a control group (n = 18). Participants completed the Perceived Stress Scale and the Self-Compassion Scale (primary outcomes) along with additional secondary outcome measures at the start and end of the program and 3 months after. Stress was decreased with small to medium effect sizes post-intervention, although not statistically significant. Self-compassion increased post-intervention, but effect sizes were small and not significant. At follow-up, changes in stress were not significant, however self-compassion increased for both interventions with medium-sized effects. For the intervention groups, medium- to large-sized positive effects on trait mindfulness after a behavioural task were found post-intervention, and small- to medium-sized effects in self-reported mindfulness were seen at follow-up. Connectedness to Nature was the only outcome measure with an incremental effect in nature, exceeding the control with a medium-sized effect at follow-up. All participants in the nature arm completed the intervention, and so did 97% of the participants in all three arms. Overall, the results encourage the conduct of a larger-scale RCT, but only after adjusting some elements of the programme to better fit and take advantage of the potential benefits of the natural environment.

scholarly journals Grandparent Resilience: Improving Self-Efficacy in Grandparents Raising Grandchildren

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 510-510
Author(s):  
Aimee Fox ◽  
Nathaniel Riggs ◽  
Loriena Yancura ◽  
Christine Fruhauf
Keyword(s):  
Self Efficacy ◽  
Emotional Health ◽  
Well Being ◽  
Individual Variability ◽  
Health Issues ◽  
Grandparents Raising Grandchildren ◽  
Post Intervention ◽  
Paired Samples ◽  
Post Test

Abstract Grandparents often protect against childhood trauma and promote resilience through their nurturance, love, and support when raising grandchildren. Despite the beneficial role grandparents have on their grandchildren, grandparents may experience challenges of their own, including physical, mental, and emotional health issues, lack of resources, and social isolation. Few interventions exist to help grandparents successfully adapt to the challenges they face as primary parenting figures. The purpose of this study was to test preliminary efficacy of a strengths-based intervention for grandparents raising grandchildren aimed at increasing self-care behaviors, managing emotions, and connecting to community resources. Grandparents (N = 137) providing primary care to grandchildren were recruited to participate in a single-group, pre- and post-test design, 6-week intervention. Self-efficacy was assessed at baseline, post-intervention, and at a 6-month follow-up. To evaluate who the intervention might be most beneficial for, grandparents’ service knowledge, perceived support from others, and length of care provided, measured at baseline, were analyzed for moderating effects. Results of paired-samples t-tests reveal significant increases in self-efficacy (p = .013) from baseline to post-test, which were maintained at the 6-month follow-up (p = .010). Hierarchical multiple regression showed interaction effects of the hypothesized moderators were not significant, indicating improvements in self-efficacy regardless of individual variability at baseline. As demonstrated, interventions can be effective at increasing self-efficacy in grandparents raising grandchildren and strengths-based approaches have the potential to provide universal benefits to grandparents, thus improving functioning in grandfamilies and promoting the health and well-being of grandparents and their grandchildren.

The Long-Term Effects of Mindfulness-Based Cognitive Therapy as a Relapse Prevention Treatment for Major Depressive Disorder

2010 ◽  
Vol 38 (5) ◽  
pp. 561-576 ◽  
Author(s):  
Kate L. Mathew ◽  
Hayley S. Whitford ◽  
Maura A. Kenny ◽  
Linley A. Denson
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Relapse Prevention ◽  
Mindfulness Practice ◽  
Long Term Effects ◽  
Major Depressive ◽  
Strong Negative Correlation ◽  
Group 3

Background: Mindfulness-based Cognitive Therapy (MBCT) is a relapse prevention treatment for major depressive disorder. Method: An observational clinical audit of 39 participants explored the long-term effects of MBCT using standardized measures of depression (BDI-II), rumination (RSS), and mindfulness (MAAS). Results: MBCT was associated with statistically significant reductions in depression from pre to post treatment. Gains were maintained over time (Group 1, 1–12 months, p = .002; Group 2, 13–24 months, p = .001; Group 3, 25–34 months, p = .04). Depression scores in Group 3 did begin to worsen, yet were still within the mild range of the BDI-II. Treatment variables such as attendance at “booster” sessions and ongoing mindfulness practice correlated with better depression outcomes (p = .003 and p = .03 respectively). There was a strong negative correlation between rumination and mindful attention (p < .001), consistent with a proposed mechanism of metacognition in the efficacy of MBCT. Conclusion: It is suggested that ongoing MBCT skills and practice may be important for relapse prevention over the longer term. Larger randomized studies of the mechanisms of MBCT with longer follow-up periods are recommended.

Depressive Disorders: Update on Diagnosis, Etiology, and Treatment

2018 ◽  
Author(s):  
Isabelle E. Bauer ◽  
Antonio L Teixeira ◽  
Marsal Sanches ◽  
Jair C. Soares
Keyword(s):  
Depressive Disorder ◽  
Depressive Disorders ◽  
Treatment Strategies ◽  
Premenstrual Dysphoric Disorder ◽  
Brain Volumes ◽  
Somatic Therapy ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
History Of ◽  
Persistent Depressive Disorder

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals.  This review contains 1 table and 52 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress

scholarly journals The Feasibility, Effectiveness, and Process of Change of Mindfulness-Based Cognitive Therapy for Adults With ADHD: A Mixed-Method Pilot Study

2017 ◽  
Vol 24 (6) ◽  
pp. 928-942 ◽  
Author(s):  
Lotte Janssen ◽  
Alicia M. de Vries ◽  
Sevket Hepark ◽  
Anne E. M. Speckens
Keyword(s):  
Executive Functioning ◽  
Cognitive Therapy ◽  
Mixed Method ◽  
Adult Adhd ◽  
Controlled Trial ◽  
Self Report ◽  
Adhd Symptoms ◽  
Process Of Change ◽  
Mindfulness Skills ◽  
Self Compassion

Objective: Mindfulness-Based Cognitive Therapy (MBCT) is a promising psychosocial intervention for adult ADHD. The feasibility and effectiveness of an adapted MBCT program is explored, together with the possible process of change. Method: Mixed-method study with 31 ADHD patients participating in an adapted MBCT program. Self-report questionnaires on ADHD symptoms, executive functioning, mindfulness skills, self-compassion, patient functioning, and health status were administered before and after MBCT. Semi-structured interviews were conducted with 24 patients. Results: A modest drop-out of n = 5 (16%) was found. MBCT resulted in a significant reduction of ADHD symptoms and improvements of executive functioning, self-compassion, and mental health. Qualitative analysis provided insight in facilitators and barriers participants experienced, and their process of change. Conclusion: The adapted MBCT program seemed to be feasible for adults with ADHD and preliminary evidence for the effectiveness is shown. An adequately powered Randomized Controlled Trial (RCT) is needed to further examine the effectiveness of MBCT for ADHD.

scholarly journals Cultivating the compassionate self against depression: An exploration of processes of change

2017 ◽  
Vol 41 (S1) ◽  
pp. S356-S356 ◽  
Author(s):  
M. Matos ◽  
J. Duarte ◽  
C. Duarte ◽  
J. Pinto-Gouveia ◽  
P. Gilbert
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Longitudinal Design ◽  
Self Report ◽  
Processes Of Change ◽  
Post Intervention ◽  
Mediation Analyses ◽  
Self Compassion ◽  
Compassion Focused Therapy ◽  
The Impact

IntroductionCompassion and self-compassion can be protective factors against mental health difficulties, in particular depression. The cultivation of the compassionate self, associated with a range of practices such as slow and deeper breathing, compassionate voice tones and facial expressions, and compassionate focusing, is central to compassion focused therapy (Gilbert, 2010). However, no study has examined the processes of change that mediate the impact of compassionate self-cultivation practices on depressive symptoms.AimsThe aim of this study is to investigate the impact of a brief compassionate self training (CST) intervention on depressive symptoms, and explore the psychological processes that mediate the change at post intervention.MethodsUsing a longitudinal design, participants (general population and college students) were randomly assigned to one of two conditions: Compassionate self training (n = 56) and wait-list control (n = 37). Participants in the CST condition were instructed to practice CST exercises for 15 minutes everyday or in moments of stress during two weeks. Self-report measures of depression, self-criticism, shame and compassion, were completed at pre and post in both conditions.ResultsResults showed that, at post-intervention, participants in the CST condition decreased depression, self-criticism and shame, and increased self-compassion and openness to receive compassion from others. Mediation analyses revealed that changes in depression from pre to post intervention were mediated by decreases in self-criticism and shame, and increases in self-compassion and openness to the compassion from others.ConclusionsThese findings support the efficacy of compassionate self training components on lessening depressive symptoms and promoting mental health.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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