TY - JOUR
T1 - A randomized controlled pilot study on mindfulness-based cognitive therapy for unipolar depression in patients with chronic pain
AU - De Jong, Marasha
AU - Peeters, Frenk
AU - Gard, Tim
AU - Ashih, Heidi
AU - Doorley, Jim
AU - Walker, Rosemary
AU - Rhoades, Laurie
AU - Kulich, Ronald J.
AU - Kueppenbender, Karsten D.
AU - Alpert, Jonathan E.
AU - Hoge, Elizabeth A.
AU - Britton, Willoughby B.
AU - Lazar, Sara W.
AU - Fava, Maurizio
AU - Mischoulon, David
N1 - Funding Information:
aDepression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts bDepartment of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands cPsyQ Department of Mood Disorders, Mondriaan, Institute of Mental Health, Maastricht, the Netherlands dInstitute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Switzerland eDepartment of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts fTranslational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Switzerland gPrivate practice, LaurieRhoadesTherapy.com hCenter for Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts iCenter for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts jWarren Alpert Medical School at Brown University, Providence, Rhode Island *Corresponding author: Marasha de Jong, MD, Mondriaan, Institute of Mental Health, PsyQ Department of Mood Disorders, Oranjeplein 10, 6224 KD Maastricht, the Netherlands (marasha.dejong@maastrichtuniversity.nl).
Publisher Copyright:
© Copyright 2017 Physicians Postgraduate Press, Inc.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: Chronic pain is a disabling illness, often comorbid with depression. We performed a randomized controlled pilot study on mindfulness-based cognitive therapy (MBCT) targeting depression in a chronic pain population. Method: Participants with chronic pain lasting = 3 months; DSM-IV major depressive disorder (MDD), dysthymic disorder, or depressive disorder not otherwise specified; and a 16-item Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C16) score = 6 were randomly assigned to MBCT (n = 26) or waitlist (n = 14). We adapted the original MBCT intervention for depression relapse prevention by modifying the psychoeducation and cognitive-behavioral therapy elements to an actively depressed chronic pain population. We analyzed an intent-to-treat (ITT) and a per-protocol sample; the per-protocol sample included participants in the MBCT group who completed at least 4 of 8 sessions. Changes in scores on the QIDS-C16 and 17-item Hamilton Depression Rating Sale (HDRS17) were the primary outcome measures. Pain, quality of life, and anxiety were secondary outcome measures. Data collection took place between January 2012 and July 2013. Results: Nineteen participants (73%) completed the MBCT program. No significant adverse events were reported in either treatment group. ITT analysis (n = 40) revealed no significant differences. Repeated-measures analyses of variance for the per-protocol sample (n = 33) revealed a significant treatment × time interaction (F1,31 = 4.67, P = .039, ?2 p = 0.13) for QIDS-C16 score, driven by a significant decrease in the MBCT group (t18 = 5.15, P < .001, d = 1.6), but not in the control group (t13 = 2.01, P = .066). The HDRS17 scores did not differ significantly between groups. The study ended before the projected sample size was obtained, which might have prevented effect detection in some outcome measures. Conclusions: MBCT shows potential as a treatment for depression in individuals with chronic pain, but larger controlled trials are needed.
AB - Objective: Chronic pain is a disabling illness, often comorbid with depression. We performed a randomized controlled pilot study on mindfulness-based cognitive therapy (MBCT) targeting depression in a chronic pain population. Method: Participants with chronic pain lasting = 3 months; DSM-IV major depressive disorder (MDD), dysthymic disorder, or depressive disorder not otherwise specified; and a 16-item Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C16) score = 6 were randomly assigned to MBCT (n = 26) or waitlist (n = 14). We adapted the original MBCT intervention for depression relapse prevention by modifying the psychoeducation and cognitive-behavioral therapy elements to an actively depressed chronic pain population. We analyzed an intent-to-treat (ITT) and a per-protocol sample; the per-protocol sample included participants in the MBCT group who completed at least 4 of 8 sessions. Changes in scores on the QIDS-C16 and 17-item Hamilton Depression Rating Sale (HDRS17) were the primary outcome measures. Pain, quality of life, and anxiety were secondary outcome measures. Data collection took place between January 2012 and July 2013. Results: Nineteen participants (73%) completed the MBCT program. No significant adverse events were reported in either treatment group. ITT analysis (n = 40) revealed no significant differences. Repeated-measures analyses of variance for the per-protocol sample (n = 33) revealed a significant treatment × time interaction (F1,31 = 4.67, P = .039, ?2 p = 0.13) for QIDS-C16 score, driven by a significant decrease in the MBCT group (t18 = 5.15, P < .001, d = 1.6), but not in the control group (t13 = 2.01, P = .066). The HDRS17 scores did not differ significantly between groups. The study ended before the projected sample size was obtained, which might have prevented effect detection in some outcome measures. Conclusions: MBCT shows potential as a treatment for depression in individuals with chronic pain, but larger controlled trials are needed.
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U2 - 10.4088/JCP.15m10160
DO - 10.4088/JCP.15m10160
M3 - Article
C2 - 28252881
AN - SCOPUS:85046872149
VL - 79
SP - 26
EP - 34
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
SN - 0160-6689
IS - 1
ER -