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TOPLINE:

In patients with depression resistant to National Health Service (NHS) Talking Therapies, mindfulness-based cognitive therapy (MBCT) plus treatment as usual was more effective in alleviating symptoms than treatment as usual alone, a new trial found. Additionally, MBCT plus treatment as usual had a 99% probability of being cost-effective.

METHODOLOGY:

• Researchers conducted a parallel, randomized, controlled, superiority trial across three sites in the United Kingdom (2021-2023).
• The study included 234 patients with major depressive disorder (mean age, 42.5 years; 71% women; 86% White) who couldn't achieve remission after ≥ 12 sessions of NHS Talking Therapies.
• Participants were randomly assigned to receive either treatment as usual alone (n = 116) or MBCT plus treatment as usual (n = 118), with minimization on the basis of depression severity, antidepressant use, and recruitment site.
• The primary outcome was depression symptoms, measured using the Patient Health Questionnaire-9 at 34 weeks. Cost-effectiveness was assessed using the Adult Service Use Schedule.

TAKEAWAY:

• Participants who received MBCT plus treatment as usual had significantly reduced depression symptoms than those who received treatment as usual alone (P = .0006).
• MBCT plus treatment as usual resulted in lower costs and higher utility scores than treatment as usual alone during the study period.
• Analysis revealed a 99% probability that MBCT plus treatment as usual was cost-effective at the £20,000 per quality-adjusted life-year threshold.
• No serious adverse events related to the trial or treatment were observed.

IN PRACTICE:

"Our findings show that psychological further-line treatment for depression can bring clinical benefit at an affordable price, potentially helping to reduce the long-term disability burden and economic costs associated with difficult-to-treat depression," the authors wrote.

SOURCE:

The study was led by Thorsten Barnhofer, PhD, School of Psychology, University of Surrey, Guildford, England. It was published online in the June 2025 issue of The Lancet Psychiatry.

LIMITATIONS:

The study was limited by a short follow-up period of 6 months. The representativeness of the findings was limited by a predominance of female and White participants. The trial was not powered for subgroup analyses, preventing gender-specific analyses. Additionally, limited information was available on the type and quality of psychologic treatment patients received as treatment as usual.

DISCLOSURES:

The study was funded by the UK National Institute for Health and Care Research. One author reported writing a book on MBCT. Several authors reported having financial or professional ties with various organizations. Details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.