Recovery from recurrent depression: Randomized controlled trial of the efficacy of mindfulness-based compassionate living compared with treatment-as-usual on depressive symptoms and its consolidation at longer term follow-up.

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to reduce depressive symptoms in patients with recurrent or chronic depression. However, sequential, follow-up interventions are needed to further improve outcome for this group of patients. One possibility is to cultivate mechanisms thought to support recovery from depression, such as (self-)compassion. The current study examined the efficacy of mindfulness-based compassionate living (MBCL) in recurrently depressed patients who previously received MBCT, and consolidation effects of MBCL at follow-up. Part one is a randomized controlled trial (RCT) comparing MBCL in addition to treatment as usual (TAU) with TAU alone. The primary outcome measure was severity of depressive symptoms. Possible mediators and moderators of treatment outcome were examined. Part two is an uncontrolled study of both intervention- and control group on the consolidation of treatment effect of MBCL over the course of a 6-months follow-up period. Patients were recruited between July 2013 and December 2014 (N = 122). MBCL participants (n = 61) showed significant improvements in depressive symptoms (Cohen's d = 0.35), compared to those who only received TAU (n = 61). The results at 6-months follow-up showed a continued improvement of depressive symptoms. As MBCL was not compared with an active control condition, we have little information about the possible effectiveness of non-specific factors. MBCL appears to be effective in reducing depressive symptoms in a population suffering from severe, prolonged, recurrent depressive symptoms. To optimise the (sequential) treatment trajectory, replication of the study in a prospective sequential trial is needed. Registered at ClinicalTrials.gov:NCT02059200.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest The clinical research team declares it had no part in developing the MBCL programme, though Prof. Speckens and Ms. Schuling made modifications to it in collaboration with the original developers following the pilot study (Schuling et al., 2017). The team does not gain income from the sale of books on MBCL, nor does it gain income from giving lectures or workshops about it. Prof. Speckens is founder and clinical director of the Radboudumc Centre for Mindfulness. Ms. Schuling, Dr Van Ravesteijn, Dr Huijbers and Ms. Cillessen are affiliated with the Radboudumc Centre for Mindfulness. Dr Donders is affiliated with the Radboudumc Biostatistics department. Prof. Kuyken is director of the Oxford Mindfulness Centre and funded by the Wellcome Trust (107496/Z/15/Z).