RESPOND

Major Depression is a highly common and debilitating disorder. If not treated sufficiently, it tends to take a recurrent or chronic lifetime course that causes a significant burden and puts patients at increased risk for physical and neurodegenerative disorders. Since the introduction of the Increasing Access to Psychological Therapies Services (IAPT) many more patients in the UK are being provided with state-of-the-art psychological treatments for depression. However, about half of those who come to the end of this care pathway, have still not responded sufficiently.

Mindfulness-Based Cognitive Therapy (MBCT), a training combining intensive training in mindfulness meditation and components of cognitive therapy for depression, has previously been shown to be effective in treatment non-responders. However, further research is necessary to provide more definitive evidence. If our study shows that MBCT benefits people who haven’t improved after IAPT, it will justify its use in this context in the National Health Service (NHS) to help more patients with depression recover, an aim that seems particularly pertinent in these times.

We want to find out (a) whether MBCT can lead to lasting reductions in depressive symptoms in patients who have previously not responded to intensive psychological therapy in IAPT and (b) whether the treatment could be introduced at a reasonable cost.

In a randomised controlled trial (RCT), we will compare MBCT intervention to treatment-as-usual (TAU). We will work together with IAPT services across the UK to recruit 234 patients, who will be chosen by chance to either participate in MBCT or continue with what would be their usual care.

In order to make sure that the research is conducted safely, the MBCT treatment and all assessments will be delivered via videoconferencing. We will assess changes directly after the end of the treatment period and six months thereafter.