Mindfulness-based cognitive therapy (MBCT) reduces the association between depressive symptoms and suicidal cognitions in patients with a history of suicidal depression

Abstract

Objective: In patients with a history of suicidal depression, recurrence of depressive symptoms can easily reactivate suicidal thinking. In this study, we investigated whether training in mindfulness, which is aimed at helping patients "decenter" from negative thinking, could help weaken the link between depressive symptoms and suicidal cognitions.

Method: Analyses were based on data from a recent randomized controlled trial, in which previously suicidal patients were allocated to mindfulness-based cognitive therapy (MBCT), an active control treatment, cognitive psychoeducation (CPE), which did not include any meditation practice, or treatment as usual (TAU). After the end of the treatment phase, we compared the associations between depressive symptoms, as assessed through self-reports on the Beck Depression Inventory-II (Beck, Steer, & Brown, 1996), and suicidal thinking, as assessed through the Suicidal Cognitions Scale (Rudd et al., 2001).

Results: In patients with minimal to moderate symptoms at the time of assessment, comparisons of the correlations between depressive symptoms and suicidal cognitions showed significant differences between the groups. Although suicidal cognitions were significantly related to levels of symptoms in the 2 control groups, there was no such relation in the MBCT group.

Conclusion: The findings suggest that, in patients with a history of suicidal depression, training in mindfulness can help to weaken the association between depressive symptoms and suicidal thinking, and thus reduce an important vulnerability for relapse to suicidal depression.

Figure 1

Scatterplot and regression lines of Beck Depression Inventory-II (BDI-II) (Beck et al., 1996) and Suicidal Cognitions Scale (SCS) scores (Rudd et al., 2001) by group at posttreatment. The top panel shows scores of all participants with past suicidality (MBCT: n = 77, CPE: n = 78, TAU: n = 39). The bottom panel shows scores and regression lines in groups of participants with BDI-II ≥ 3 and ≤ 28 (MBCT: n = 52, CPE: n = 53, TAU: n = 26). MBCT = mindfulness-based cognitive therapy; CPE = cognitive psychoeducation; TAU = treatment as usual.