Mindfulness in Bipolar Disorder and Major Depressive Disorder

Abstract

Bipolar disorder is characterized by frequent episodes of depression and/or mania which results in tremendous amounts of disability. Rates of relapse are very high despite pharmacological treatments. Many studies have examined the effectiveness of conjunctive pharmacotherapy and some sort of psychosocial interventions in this patient population. Mindfulness-based cognitive therapy (MBCT) was primarily designed for patients with major depressive disorders as a method to prevent additional depressive recurrences. It has recently been implemented among bipolar patient groups as well. The central goals of this study were: to evaluate the impact of MBCT to reduce depressive symptoms in a group of bipolar and unipolar patients with current depressive symptoms, assess factors that might be mechanisms of action associated with depression reduction in MBCT and compare the result of the intervention between the bipolar and unipolar patient groups. In this study, sixteen adult patients diagnosed with depression or bipolar disorder with current mild to moderate depressive symptoms participated in an 8-week MBCT group program within the same class settings. Depressive symptoms along with levels of mindfulness, self-compassion, rumination, sleep, anxiety and quality of life were assessed at pre-MBCT, post-MBCT and 3-month follow-up. Using repeated measures analysis of variance, changes in these variables were examined from pre to post-MBCT and from post-intervention to 3- month follow-up. We found similar significant changes across both patient groups in depression, rumination, and self-compassion, as well as the observe, act-aware and non-react subscales of mindfulness following MBCT. Only bipolar patients showed significant improvements in the non-judgement quality of mindfulness at post-intervention. In regards to mechanisms of action, significant correlations between reductions in rumination and depression levels were detected across both patient groups. Due to our small sample size mediation analyses could not be employed to further evaluate mechanisms of action. All improvements were maintained at 3-month follow-up. Future studies need to incorporate designs with a larger sample size which would allow further evaluation and confirmation of potential mechanisms of change in MBCT with bipolar and unipolar depressed patients.