Mindfulness-based cognitive therapy of benefit to select patients with bipolar disorder

When added to standard treatment, mindfulness-based cognitive therapy (MBCT) may have favourable effects for patients with bipolar disorder and moderate to severe levels of depression and functional impairment, according to a study.

The study involved 144 participants (mean age was 46.6 years, 60 percent women) with bipolar disorder type I and II. They were randomly assigned to receive treatment as usual (TAU) alone (n=72) or in combination with MBCT (n=72). TAU consisted of pharmacotherapy, psychoeducation, and self-management interventions. MBCT was given after completing 15 months of TAU.

In the MBCT plus TAU group, participants who attended not more than four MBCT sessions (n=18) did not differ from those who completed MBCT. Moreover, 51 (71 percent) participants reported still practicing formal mindfulness exercises regularly at 3 months (mean frequency per week 3.5, mean minutes per week 21.0). At 6 months, the number of participants who still practiced MBCT decreased to 37 (51 percent) participants (mean frequency per week 2.7, mean minutes per week 15.2), and this remained until 15 months.

Results showed that compared with TAU alone, MBCT plus TAU had comparable effects in terms of reducing the primary study endpoint of current depressive symptoms at post-treatment (adjusted group difference, 0.24, 95 percent confidence interval [CI], −7.0 to 1.8; p=0.303) or follow-up (adjusted group difference, –1.59, 95 percent CI, −2.2 to 6.3; p=0.037).

In terms of secondary outcomes, TAU was more effective than MBCT plus TAU at reducing trait anxiety and improving mindfulness skills and positive mental health.

Of note, exploratory analysis indicated that participants with higher depressive symptoms and functional impairment at baseline benefitted more from the addition of MBCT.