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. 2017 Sep-Dec;17(3):282-295.
doi: 10.1016/j.ijchp.2017.07.004. Epub 2017 Aug 17.

Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis

Lilisbeth Perestelo-Perez  1   2 , Jorge Barraca  3 , Wenceslao Peñate  4 , Amado Rivero-Santana  2   5 , Yolanda Alvarez-Perez  5
Affiliations

Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis

Lilisbeth Perestelo-Perez et al. Int J Clin Health Psychol. 2017 Sep-Dec.

Abstract
in English, Spanish

Background/Objective: This systematic review aims to evaluate the effect of interventions based on the mindfulness and/or acceptance process on ruminative thoughts, in patients with depression. Method: Electronic searches in Medline, Embase, Cochrane Central, PsycInfo, and Cinahl until December 2016, in addition to hand-searches of relevant studies, identified eleven studies that fulfilling inclusion criteria. Results: A meta-analysis of the effect of the intervention compared to usual care showed a significant and moderate reduction of ruminative thoughts (g = -0.59, 95% CI: -0.77, -0.41; I2 = 0%). Furthermore, findings suggest that mindfulness/acceptance processes might mediate changes in rumination, and that they in turn mediate in the clinical effects of interventions. A meta-analysis of three studies that compared the intervention to other active treatments (medication, behavioral activation and cognitive-behavioral therapy, respectively) showed no significant differences. Conclusions: Mindfulness-based cognitive therapy compared to usual care, produces a significant and moderate reduction in rumination. This effect seems independent of the treatment phase (acute or maintenance) or the number of past depressive episodes, and it was maintained one month after the end of treatment. However, further controlled studies with real patients that compare the most commonly used cognitive-behavioral techniques to treat ruminative thoughts to the acceptance and mindfulness techniques are needed.

Antecedentes/Objetivo: Revisión sistemática para evaluar el efecto de las intervenciones basadas en la atención plena y/o en el proceso de aceptación de pensamientos rumiativos en la depresión. Método: Búsquedas sistemáticas en Medline, Embase, Cochrane Central, PsycInfo y Cinahl hasta diciembre 2016 y búsquedas manuales identificaron once estudios. Resultados: Un metanálisis que comparó el efecto de la intervención basada en Mindfulness con la atención habitual mostró una reducción significativa y moderada de pensamientos rumiativos. Los hallazgos sugieren que los procesos de atención/aceptación producen cambios en las rumiaciones e influyen en el efecto clínico de las intervenciones. Otro metanálisis con estudios que compararon la intervención basada en Mindfulness con otros tratamientos activos (medicación, activación conductual y terapia cognitivo-conductual, respectivamente) no mostraron diferencias significativas (g = −0,02, 95% CI: −0,39, 0,35; I2 = 0%). Conclusiones: Mindfulness en comparación con la atención habitual, produce una reducción significativa y moderada en la rumia. Este efecto parece independiente de la fase de tratamiento o del número de episodios depresivos pasados, y se mantuvo un mes después del final del tratamiento. Sin embargo, se necesitan más estudios controlados con pacientes reales que comparen las técnicas cognitivo-conductuales más utilizadas para tratar los pensamientos rumiativos con técnicas de aceptación y atención plena.

Keywords: Depression; Meta-analysis; Mindfulness; Rumination; Systematic review.

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Figures

Figure 1
Figure 1
Flow chart of the selection process.
Figure 2
Figure 2
Meta-analysis of rumination post-scores, separately by design.
See this image and copyright information in PMC

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References

    1. Aldao A., Nolen-Hoeksema S., Schweizer S. Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review. 2010;30:217–237. - PubMed
    1. A-Tjak J.G.L., Davis M.L., Morina N., Powers M.B., Smits J.A.J., Emmelkamp P.M.G. A Meta-Analysis of the Efficacy of Acceptance and Commitment Therapy for Clinically Relevant Mental and Physical Health Problems. Psychotherapy and Psychosomatics. 2015;84:30–36. - PubMed
    1. Barraca J. Mental control from a third-wave behavior therapy perspective. International Journal of Clinical and Health Psychology. 2012;12:109–121.
    1. Batink T., Peeters F., Geschwind N., van Os J., Wichers M. How Does MBCT for Depression Work? Studying Cognitive and Affective Mediation Pathways. PLoS ONE. 2013;8:e72778. - PMC - PubMed
    1. Beck A., Steer R., Brown G. Psychological Corporation; San Antonio, TX: 1996. Manual for the Beck Depression Inventory–II.