Evidence map›Paper›PMID 21135325›Full record

Trial reportArchives of general psychiatry2010

Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression.

Zindel V Segal, Peter Bieling, Trevor Young, Glenda MacQueen, Robert Cooke, Lawrence Martin, Richard Bloch, Robert D Levitan

5 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Archives of general psychiatry, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 120 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 14 pooled it
32.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00183560 phase4completednot on this map

Prevention of Relapse in Recurrent Depression With MBCT

TypeinterventionalSponsorCentre for Addiction and Mental HealthRan2004 to 2010Enrolled184ConditionsDepressionArmsMindfulness based cognitive therapy (MBCT), Antidepressants, Placebo plus clinical management
NCT01178424 nacompletednot on this map

My Depression Wellness Toolkit Study

TypeinterventionalSponsorCentre for Addiction and Mental HealthRan2010 to 2017Enrolled166ConditionsMajor DepressionArmsMindfulness Based Cognitive Therapy, Cognitive Behaviour Therapy
NCT02190968 nacompletednot on this mapstarted 2015, after this paper: background citation

Reducing Residual Depressive Symptoms With Web-based Mindful Mood Balance.

TypeinterventionalSponsorUniversity of TorontoRan2015 to 2018Enrolled460ConditionsMajor Depressive Disorder, Recurrent, in Remission, Depressive SymptomsArmsUsual Depression Care, Mindful Mood Balance
NCT03272516 nacompletednot on this mapstarted 2017, after this paper: background citation

Mindfulness Based Cognitive Therapy (MBCT) for Primary Care Patients With Mild to Moderate Symptoms of Depression or Anxiety.

TypeinterventionalSponsorUniversity of IcelandRan2017 to 2020Enrolled120ConditionsDepression, AnxietyArmsMindfulness based cognitive therapy (MBCT), Treatment as usual (TAU)
NCT03878160 nacompletednot on this mapstarted 2018, after this paper: background citation

Mindfulness-Based Cognitive Therapy Delivered Via Group Videoconferencing for Acute Coronary Syndrome Patients With Elevated Depression Symptoms

TypeinterventionalSponsorMassachusetts General HospitalRan2018 to 2020Enrolled27ConditionsAcute Coronary Syndrome, Depression, Myocardial Infarction, Unstable AnginaArmsIndividual Interview
3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 14 syntheses or guidelines pooled it, 428 citations in OpenAlex.

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  13. Citalopram versus other anti-depressive agents for depression.The Cochrane database of systematic reviews · 2012
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  19. A randomized controlled trial of a 14-day mindfulness ecological momentary intervention (MEMI) for generalized anxiety disorder.European psychiatry : the journal of the Association of European Psychiatrists · 2023
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60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Zindel V SegalCentre for Addiction and Mental Health, Toronto, ON, Canada. zindel_segal@camh.net
Peter Bieling
Trevor Young
Glenda MacQueen
Robert Cooke
Lawrence Martin
Richard Bloch
Robert D Levitan
University of British Columbia · CACentre for Addiction and Mental Health · CAUniversity of Calgary · CA

Funding

Prevention of Relapse in Recurrent Depression with MBCTR01MH066992 · NIMH · CENTRE FOR ADDICTION AND MENTAL HEALTH · PI SEGAL, ZINDEL · 2004 to 2008
$2.2M
NIMH NIH HHS R01 MH066992
6 · The paper itself

Abstract

contextMindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.

objectiveTo compare rates of relapse in depressed patients in remission receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care.

designPatients who met remission criteria after 8 months of algorithm-informed antidepressant treatment were randomized to receive maintenance antidepressant medication, MBCT, or placebo and were followed up for 18 months.

settingOutpatient clinics at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and St Joseph's Healthcare, Hamilton, Ontario.

participantsOne hundred sixty patients aged 18 to 65 years meeting DSM-IV criteria for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to 1 of the 3 study conditions.

interventionsPatients in remission discontinued their antidepressants and attended 8 weekly group sessions of MBCT, continued taking their therapeutic dose of antidepressant medication, or discontinued active medication and were switched to placebo.

main outcome measureRelapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on module A of the Structured Clinical Interview for DSM-IV.

resultsIntention-to-treat analyses showed a significant interaction between the quality of acute-phase remission and subsequent prevention of relapse in randomized patients (P = .03). Among unstable remitters (1 or more Hamilton Rating Scale for Depression score >7 during remission), patients in both MBCT and maintenance treatment showed a 73% decrease in hazard compared with placebo (P = .03), whereas for stable remitters (all Hamilton Rating Scale for Depression scores ≤7 during remission) there were no group differences in survival.

conclusionsFor depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters.

Indexed as

Psychotherapy, GroupAdolescentAdultAgedAntidepressive AgentsAttentionCognitive Behavioral TherapyCombined Modality TherapyDiagnostic and Statistical Manual of Mental DisordersDrug Administration ScheduleFemaleFollow-Up StudiesHumansMajor Depressive DisorderMaleMiddle AgedAntidepressive Agents

Identifiers

PMID21135325
PMCPMC3311113
OpenAlexW2153222062

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.