Staying well after depression (SWAD). CI Professor Mark W illiams PI Professor Ian Russell Sholto Radford Research Officer firstname.lastname@example.org. Depression and suicide . Depression a prevalent Condition Risk of recurrence
CI Professor Mark Williams
PI Professor Ian Russell
90% for individuals with 3 or more previous episodes.
Summary of results of both trials:
MBCT approximately halved (70% to 39%) the likelihood of depressive relapse in patients who had had three of more episodes of depression
MBCT now recommended by NICE as a treatment for prevention of depression.
123 patients with a history of recurrent depression
MBCT (with or without ADs) was equal if not
slightly better at
preventing relapse than maintenance
antidepressant treatment alone, and better at
improving quality of life.
MBCT is more expensive than maintenance ADs in first 12 mths; then MBCT becomes more cost effective
(Kuyken et al 2008)
Multi centre trial (Bangor Oxford) RCT –
Participants randomised to three conditions:-
Stratification - Centre, cohort, history of suicidality (none, ideation, attempt), antidepressants in past 7 days
Both 8 week courses, 2 hour sessions, 2
MBCT – manualised treatment combines training in mindfulness with cognitive therapy – 1 hour per day home practice (meditation + smaller tasks to cultivate mindfulness.
CPE – Includes all elements of MBCT except experiential cultivation of mindfulness. Learn psychological process involved in relapse, mood monitoring, disengaging from unhelpful patterns of processing.
Pre intervention T0, Post intervention T1, 3 months T2, six months T3, nine months T4, twelve months T5.
Blind assessors – SCID + battery of questionnaires and cognitive tasks
Intention to treat analysis (ITT)
Assessing cognitive measures
Mindfulness, suppression, self compassion, rumination, autobiographical memory and executive capacity
Regression on both the dichotomous outcome (binary logisitc) of relapse and on worst HRSD score (linear) during follow up.