Mindfulness-based cognitive therapy for bipolar disorder: understanding mindfulness in the context of a randomized-controlled trial

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Copyright: Perich, Tania
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Abstract
Mindfulness-based Cognitive Therapy has been found to be effective in preventing relapse to depression for those with a history of depression. However, there have been no randomized-controlled trials of Mindfulness-based Cognitive Therapy (MBCT) for patients with bipolar disorder. The aim of this thesis was to examine the efficacy of MBCT in bipolar disorder and to examine the relationship of trait mindfulness to bipolar disorder symptoms and treatment outcome. In the first study, differences on trait mindfulness scores were examined between those diagnosed with bipolar disorder according to DSM-IV(N=90), a control group (N=66) and those with a history of depression (N=36). No significant differences were found on trait mindfulness scores between the groups after controlling for current symptoms and co-morbid anxiety disorder diagnoses. In subsequent studies, 95 participants diagnosed with bipolar disorder were randomly allocated to either MBCT (N=48) or treatment as usual (TAU) (N=47). Intention-to-Treat (ITT) analysis found no significant differences between the conditions on depression or mania clinician-rated scales over a 12-month follow-up period. However, there were trends for lower trait anxiety and stress scores, and significantly lower state anxiety scores over the 12-month follow-up period in the MBCT condition. There were no significant differences between the conditions on relapse rates for depressive or hypo/manic episodes or time to relapse at 12-month follow-up. There was a trend for mindfulness to increase from pre- to post-treatment in the bipolar disorder participants who were allocated to the MBCT condition. Greater trait mindfulness in this group was associated with lower trait anxiety at 12-month follow-up. Quantity of meditation practice throughout the trial was not associated with treatment outcome, however undertaking meditation practice for a minimum of 3 days per week was associated with improvements in trait anxiety and depression. MBCT does not appear to reduce relapse to depression or hypo/mania in bipolar disorder, however MBCT may be beneficial in assisting in the management of anxiety.  
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Author(s)
Perich, Tania
Supervisor(s)
Manicavasagar, Vijaya
Mitchell, Philip
Ball, Jillian
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Publication Year
2011
Resource Type
Thesis
Degree Type
PhD Doctorate
UNSW Faculty
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