Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
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The Relationship between Depressive Symptoms and the Five Facets of Mindfulness in Patients with Mood Disorders through Mindfulness-Based Cognitive Therapy

기분장애 환자에서 마음챙김에 기초한 인지치료에 따른 우울 증상과 다섯 가지 마음챙김 요소와의 관계

  • Kim, Namwoo (Department of Neuropsychiatry, Seoul National University Hospital) ;
  • Kim, Hyeyoung (Department of Neuropsychiatry, Seoul National University Hospital) ;
  • Cho, Sung Joon (Department of Neuropsychiatry, Seoul National University Hospital) ;
  • Ahn, Yong Min (Department of Neuropsychiatry, Seoul National University Hospital)
  • 김남우 (서울대학교병원 정신건강의학과) ;
  • 김혜영 (서울대학교병원 정신건강의학과) ;
  • 조성준 (서울대학교병원 정신건강의학과) ;
  • 안용민 (서울대학교병원 정신건강의학과)
  • Received : 2017.09.04
  • Accepted : 2017.09.25
  • Published : 2017.11.30
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Abstract

Objectives We aimed to examine whether mindfulness skills are mediating the improvements of depressive symptoms in patients with mood disorders who practiced Mindfulness-Based Cognitive Therapy (MBCT). Methods A total of 19 patients with mood disorder were included in this study. The participants were divided into two subgroups: a normal to mild depression group and a moderate depression group. The participants completed questionnaires to assess depressive symptoms, anxiety, quality of life, suicidal idea, and mindfulness skills which were measured by the Five Facets of Mindfulness Questionnaire (FFMQ) before and after MBCT course. Results The moderate depression group showed improvements through MBCT in depressive symptoms and suicidal idea, but not in anxiety and quality of life. The normal to mild depression group showed no significant change through MBCT. The improvement of depressive symptoms in the moderate depression group was predictable by improvements of the five facets of mindfulness, especially by 'observe' and 'non-react' components. Conclusions This study showed that currently depressive patients with moderate severity but not with normal to mild severity benefit from MBCT in reducing depressive symptoms and suicidal idea. The improvement of depressive symptoms was mediated by improved mindfulness skills through MBCT.

Keywords

References

  1. Kupfer DJ, Frank E, Perel JM, Cornes C, Mallinger AG, Thase ME, et al. Five-year outcome for maintenance therapies in recurrent depression. Arch Gen Psychiatry 1992;49:769-773. https://doi.org/10.1001/archpsyc.1992.01820100013002
  2. Eaton WW, Shao H, Nestadt G, Lee HB, Bienvenu OJ, Zandi P. Population-based study of first onset and chronicity in major depressive disorder. Arch Gen Psychiatry 2008;65:513-520. https://doi.org/10.1001/archpsyc.65.5.513
  3. Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E, et al. Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 2003;361:653-661. https://doi.org/10.1016/S0140-6736(03)12599-8
  4. Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000;68:615-623. https://doi.org/10.1037/0022-006X.68.4.615
  5. Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry 1992;149:936-943. https://doi.org/10.1176/ajp.149.7.936
  6. Williams JM, Kuyken W. Mindfulness-based cognitive therapy: a promising new approach to preventing depressive relapse. Br J Psychiatry 2012;200:359-360. https://doi.org/10.1192/bjp.bp.111.104745
  7. Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Delacorte;1990.
  8. Kuyken W, Warren FC, Taylor RS, Whalley B, Crane C, Bondolfi G, et al. Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: an individual patient data meta-analysis from randomized trials. JAMA Psychiatry 2016;73:565-574. https://doi.org/10.1001/jamapsychiatry.2016.0076
  9. Segal ZV, Williams JMG, Teasdale JD. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing. 1st ed. New York, NY: Guilford Press;2002.
  10. Finucane A, Mercer SW. An exploratory mixed methods study of the acceptability and effectiveness of Mindfulness-Based Cognitive Therapy for patients with active depression and anxiety in primary care. BMC Psychiatry 2006;6:14. https://doi.org/10.1186/1471-244X-6-14
  11. Kenny MA, Williams JM. Treatment-resistant depressed patients show a good response to Mindfulness-based Cognitive Therapy. Behav Res Ther 2007;45:617-625. https://doi.org/10.1016/j.brat.2006.04.008
  12. Kingston T, Dooley B, Bates A, Lawlor E, Malone K. Mindfulnessbased cognitive therapy for residual depressive symptoms. Psychol Psychother 2007;80:193-203. https://doi.org/10.1348/147608306X116016
  13. van Aalderen JR, Donders AR, Giommi F, Spinhoven P, Barendregt HP, Speckens AE. The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: a randomized controlled trial. Psychol Med 2012;42:989-1001. https://doi.org/10.1017/S0033291711002054
  14. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using selfreport assessment methods to explore facets of mindfulness. Assessment 2006;13:27-45. https://doi.org/10.1177/1073191105283504
  15. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Publishing;2013.
  16. McDowell I. Measuring Health: A Guide to Rating Scales and Questionnaires. 3rd Ed. New York, NY: Oxford University Press;2006.
  17. The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28:551-558. https://doi.org/10.1017/S0033291798006667
  18. Reiss S, Peterson RA, Gursky DM, McNally RJ. Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther 1986;24:1-8. https://doi.org/10.1016/0005-7967(86)90143-9
  19. Beck AT, Steer RA, Ranieri WF. Scale for Suicide Ideation: psychometric properties of a self-report version. J Clin Psychol 1988;44:499-505. https://doi.org/10.1002/1097-4679(198807)44:4<499::AID-JCLP2270440404>3.0.CO;2-6
  20. Baer RA, Smith GT, Allen KB. Assessment of mindfulness by selfreport: the Kentucky inventory of mindfulness skills. Assessment 2004;11:191-206. https://doi.org/10.1177/1073191104268029
  21. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56-62. https://doi.org/10.1136/jnnp.23.1.56
  22. Cash M, Whittingham K. What facets of mindfulness contribute to psychological well-being and depressive, anxious, and stress-related symptomatology? Mindfulness 2010;1:177-182. https://doi.org/10.1007/s12671-010-0023-4
  23. Weber B, Jermann F, Gex-Fabry M, Nallet A, Bondolfi G, Aubry JM. Mindfulness-based cognitive therapy for bipolar disorder: a feasibility trial. Eur Psychiatry 2010;25:334-337.
  24. Deckersbach T, Holzel BK, Eisner LR, Stange JP, Peckham AD, Dougherty DD, et al. Mindfulness-based cognitive therapy for nonremitted patients with bipolar disorder. CNS Neurosci Ther 2012;18:133-141. https://doi.org/10.1111/j.1755-5949.2011.00236.x
  25. Williams JM, Alatiq Y, Crane C, Barnhofer T, Fennell MJ, Duggan DS, et al. Mindfulness-based Cognitive Therapy (MBCT) in bipolar disorder: preliminary evaluation of immediate effects on betweenepisode functioning. J Affect Disord 2008;107:275-279. https://doi.org/10.1016/j.jad.2007.08.022
  26. Ives-Deliperi VL, Howells F, Stein DJ, Meintjes EM, Horn N. The effects of mindfulness-based cognitive therapy in patients with bipolar disorder: a controlled functional MRI investigation. J Affect Disord 2013;150:1152-1157. https://doi.org/10.1016/j.jad.2013.05.074
  27. Perich T, Manicavasagar V, Mitchell PB, Ball JR, Hadzi-Pavlovic D. A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder. Acta Psychiatr Scand 2013;127:333-343. https://doi.org/10.1111/acps.12033
  28. Barnhofer T, Crane C, Hargus E, Amarasinghe M, Winder R, Williams JM. Mindfulness-based cognitive therapy as a treatment for chronic depression: a preliminary study. Behav Res Ther 2009;47:366-373. https://doi.org/10.1016/j.brat.2009.01.019
  29. Forkmann T, Wichers M, Geschwind N, Peeters F, van Os J, Mainz V, et al. Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomised controlled trial in patients with residual depressive symptoms. Compr Psychiatry 2014;55:1883-1890. https://doi.org/10.1016/j.comppsych.2014.08.043