| Title |
Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial
|
|---|---|
| Published in |
The Lancet, April 2015
|
| DOI | 10.1016/s0140-6736(14)62222-4 |
| Pubmed ID | |
| Authors |
Willem Kuyken, Rachel Hayes, Barbara Barrett, Richard Byng, Tim Dalgleish, David Kessler, Glyn Lewis, Edward Watkins, Claire Brejcha, Jessica Cardy, Aaron Causley, Suzanne Cowderoy, Alison Evans, Felix Gradinger, Surinder Kaur, Paul Lanham, Nicola Morant, Jonathan Richards, Pooja Shah, Harry Sutton, Rachael Vicary, Alice Weaver, Jenny Wilks, Matthew Williams, Rod S Taylor, Sarah Byford |
| Abstract |
Individuals with a history of recurrent depression have a high risk of repeated depressive relapse or recurrence. Maintenance antidepressants for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to medication. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce risk of relapse or recurrence compared with usual care, but has not yet been compared with maintenance antidepressant treatment in a definitive trial. We aimed to see whether MBCT with support to taper or discontinue antidepressant treatment (MBCT-TS) was superior to maintenance antidepressants for prevention of depressive relapse or recurrence over 24 months. In this single-blind, parallel, group randomised controlled trial (PREVENT), we recruited adult patients with three or more previous major depressive episodes and on a therapeutic dose of maintenance antidepressants, from primary care general practices in urban and rural settings in the UK. Participants were randomly assigned to either MBCT-TS or maintenance antidepressants (in a 1:1 ratio) with a computer-generated random number sequence with stratification by centre and symptomatic status. Participants were aware of treatment allocation and research assessors were masked to treatment allocation. The primary outcome was time to relapse or recurrence of depression, with patients followed up at five separate intervals during the 24-month study period. The primary analysis was based on the principle of intention to treat. The trial is registered with Current Controlled Trials, ISRCTN26666654. Between March 23, 2010, and Oct 21, 2011, we assessed 2188 participants for eligibility and recruited 424 patients from 95 general practices. 212 patients were randomly assigned to MBCT-TS and 212 to maintenance antidepressants. The time to relapse or recurrence of depression did not differ between MBCT-TS and maintenance antidepressants over 24 months (hazard ratio 0·89, 95% CI 0·67-1·18; p=0·43), nor did the number of serious adverse events. Five adverse events were reported, including two deaths, in each of the MBCT-TS and maintenance antidepressants groups. No adverse events were attributable to the interventions or the trial. We found no evidence that MBCT-TS is superior to maintenance antidepressant treatment for the prevention of depressive relapse in individuals at risk for depressive relapse or recurrence. Both treatments were associated with enduring positive outcomes in terms of relapse or recurrence, residual depressive symptoms, and quality of life. National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme, and NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula. |
X Demographics
The data shown below were collected from the profiles of 518 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 129 | 25% |
| United States | 47 | 9% |
| Canada | 32 | 6% |
| Australia | 14 | 3% |
| Netherlands | 14 | 3% |
| Ireland | 11 | 2% |
| Sweden | 10 | 2% |
| France | 9 | 2% |
| Spain | 7 | 1% |
| Other | 42 | 8% |
| Unknown | 203 | 39% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 343 | 66% |
| Practitioners (doctors, other healthcare professionals) | 81 | 16% |
| Scientists | 70 | 14% |
| Science communicators (journalists, bloggers, editors) | 24 | 5% |
Mendeley readers
The data shown below were compiled from readership statistics for 1,178 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 7 | <1% |
| United States | 4 | <1% |
| Germany | 2 | <1% |
| Netherlands | 2 | <1% |
| Norway | 1 | <1% |
| Ireland | 1 | <1% |
| Australia | 1 | <1% |
| Brazil | 1 | <1% |
| France | 1 | <1% |
| Other | 8 | <1% |
| Unknown | 1150 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 186 | 16% |
| Student > Bachelor | 147 | 12% |
| Researcher | 141 | 12% |
| Student > Ph. D. Student | 117 | 10% |
| Other | 87 | 7% |
| Other | 263 | 22% |
| Unknown | 237 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Psychology | 408 | 35% |
| Medicine and Dentistry | 202 | 17% |
| Social Sciences | 61 | 5% |
| Nursing and Health Professions | 59 | 5% |
| Neuroscience | 43 | 4% |
| Other | 130 | 11% |
| Unknown | 275 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1013. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 December 2023.
All research outputs
#16,252
of 25,867,969 outputs
Outputs from The Lancet
#458
of 43,050 outputs
Outputs of similar age
#117
of 280,622 outputs
Outputs of similar age from The Lancet
#6
of 473 outputs
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