Show simple item record

dc.contributor.authorKuyken, Wen
dc.contributor.authorHayes, Ren
dc.contributor.authorBarrett, Ben
dc.contributor.authorByng, Ren
dc.contributor.authorDalgleish, Ten
dc.contributor.authorKessler, Den
dc.contributor.authorLewis, Gen
dc.contributor.authorWatkins, Een
dc.contributor.authorBrejcha, Cen
dc.contributor.authorCardy, Jen
dc.contributor.authorCausley, Aen
dc.contributor.authorCowderoy, Sen
dc.contributor.authorEvans, Aen
dc.contributor.authorGradinger, Fen
dc.contributor.authorKaur, Sen
dc.contributor.authorLanham, Pen
dc.contributor.authorMorant, Nen
dc.contributor.authorRichards, Jen
dc.contributor.authorShah, Pen
dc.contributor.authorSutton, Hen
dc.contributor.authorVicary, Ren
dc.contributor.authorWeaver, Aen
dc.contributor.authorWilks, Jen
dc.contributor.authorWilliams, Men
dc.contributor.authorTaylor, RSen
dc.contributor.authorByford, Sen
dc.date.accessioned2016-08-26T13:52:45Z
dc.date.available2016-08-26T13:52:45Z
dc.date.issued2015-07-04en
dc.identifier.urihttp://hdl.handle.net/10026.1/5386
dc.description.abstract

BACKGROUND: 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. METHODS: 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. FINDINGS: 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. INTERPRETATION: 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. FUNDING: 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.

en
dc.format.extent63 - 73en
dc.languageengen
dc.language.isoengen
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAntidepressive Agentsen
dc.subjectCognitive Behavioral Therapyen
dc.subjectCombined Modality Therapyen
dc.subjectDepressive Disorder, Majoren
dc.subjectDrug Administration Scheduleen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMindfulnessen
dc.subjectQuality of Lifeen
dc.subjectRecurrenceen
dc.subjectSingle-Blind Methoden
dc.subjectSocioeconomic Factorsen
dc.subjectTreatment Outcomeen
dc.subjectYoung Adulten
dc.titleEffectiveness 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.en
dc.typeJournal Article
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/25907157en
plymouth.issue9988en
plymouth.volume386en
plymouth.publication-statusPublisheden
plymouth.journalLanceten
dc.identifier.doi10.1016/S0140-6736(14)62222-4en
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/00 Groups by role
plymouth.organisational-group/Plymouth/00 Groups by role/Academics
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Centre for Clinical Trials & Health Research
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Centre for Clinical Trials & Health Research/RC reporting group CTPS
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Collaboration for the Advancement of Medical Education Research Assessment
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/PenCLAHRC
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CCT&PS
dc.publisher.placeEnglanden
dc.identifier.eissn1474-547Xen
dc.rights.embargoperiodNot knownen
rioxxterms.versionofrecord10.1016/S0140-6736(14)62222-4en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.typeJournal Article/Reviewen
plymouth.oa-locationhttp://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62222-4/abstracten


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record


All items in PEARL are protected by copyright law.
Author manuscripts deposited to comply with open access mandates are made available in accordance with publisher policies. Please cite only the published version using the details provided on the item record or document. In the absence of an open licence (e.g. Creative Commons), permissions for further reuse of content should be sought from the publisher or author.
Theme by 
@mire NV