Background

Mindfulness-based cognitive therapy (MBCT) is an increasingly popular treatment for major depression and anxiety disorder, but has shown inconsistent efficacy for bipolar disorder (BD). Therefore, we conducted a meta-analysis to assess the general efficacy of MBCT for BD.

Methods

Ten studies were identified that fulfilled the current inclusion criteria, including three controlled and seven uncontrolled studies. The effects of MBCT on depression, anxiety, mania, stress, mindfulness ability, and emotional regulation were assessed by comparing psychometric scale scores within groups (pre- vs. post-intervention) across trials as well as between groups (control vs. MBCT) across controlled trials.

Results

Within-group comparison revealed a reduction in symptoms of depression (g = 0.37, 95%CI = 0.09−0.64, P = 0.009) and anxiety (g = 0.45, 95%CI =0.16−0.75, P = 0.002) following treatment compared to baseline. Stress symptoms were also significantly reduced (g = 0.39, 95%CI = 0.09−0.69, P = 0.01), mindfulness ability (g = 0.63, 95%CI = 0.39−0.87, P<0.00001) and emotion regulation (g = 0.62, 95%CI=0.14−1.10, P = 0.01) were significantly improved compared to baseline. However, symptoms of mania were not alleviated (g=−0.26, 95%CI=−1.43−0.91, P = 0.66). Subgroup analysis indicated that symptoms of depression and anxiety were still significantly improved at 3 months post-intervention (g = 0.46, 95%CI = 0.13−0.80, P = 0.006 and g = 0.57, 95%CI = 0.21−0.94, P = 0.002, respectively) but not at 12 months (g = 0.04, 95%CI = −0.29−0.37, P = 0.82 and g = 0.17, 95%CI =−0.16−0.50, P = 0.31). In between-groups analysis of controlled studies, MBCT significantly reduced depressive symptoms (g = 0.3, 95%CI =-0.05−0.65, P = 0.09) but not anxiety symptoms (g = 0.51, 95%CI = −0.20−1.22, P = 0.16).

Conclusion

Mindfulness-based cognitive therapy appears effective for alleviation of depression and anxiety among BD patients, possibly by improving emotional regulation and mindfulness abilities. However, efficacy appears time-limited and inconsistent, necessitating additional larger-scale studies and the development of post-intervention programs for sustained efficacy.

中文翻译：

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基于正念的双相情感障碍认知疗法：系统评价和荟萃分析。

背景

基于正念的认知疗法（MBCT）是一种针对重度抑郁症和焦虑症的日益流行的疗法，但已显示出对躁郁症（BD）的疗效不一致。因此，我们进行了荟萃分析以评估MBCT对BD的一般疗效。

方法

确定了十项符合当前纳入标准的研究，包括三项对照研究和七项非对照研究。MBCT对抑郁症，焦虑症，躁狂症，压力，正念能力和情绪调节的影响通过比较各试验组之间（干预前与干预后）以及各组之间（对照组与MBCT）的心理量表评分来评估跨对照试验。

结果

组内比较揭示在抑郁症的症状的减少（克 = 0.37，95％CI = 0.09-0.64，P  = 0.009）和焦虑（克 = 0.45，95％CI = 0.16-0.75，P  = 0.002）以下处理相比基线。压力症状也显着减轻（g  = 0.39，95％CI = 0.09-0.69，P  = 0.01），正念能力（g  = 0.63，95％CI = 0.39-0.87，P <0.00001）和情绪调节（g  = 0.62） （95％CI = 0.14-1.10，P  = 0.01）与基线相比有显着改善。但是，躁狂症状并未缓解（g = -0.26，95％CI = -1.43-0.91，P = 0.66）。亚组分析表明，干预后3个月，抑郁和焦虑症状仍显着改善（g  = 0.46，95％CI = 0.13-0.80，P  = 0.006，g  = 0.57，95％CI = 0.21-0.94，P  =分别为0.002）但在12个月时没有达到（g  = 0.04，95％CI = -0.29-0.37，P  = 0.82和g  = 0.17，95％CI = -0.16-0.50，P  = 0.31）。在对照研究的组间分析中，MBCT显着降低了抑郁症状（g  = 0.3，95％CI = -0.05-0.65，P  = 0.09），但没有焦虑症状（g  = 0.51，95％CI = -0.20-1.22，P = 0.16）。

结论

基于正念的认知疗法似乎可通过改善情绪调节和正念能力来减轻BD患者的抑郁和焦虑。但是，疗效似乎是有时间限制和前后矛盾的，因此有必要进行更多的大规模研究，并制定干预后计划以保持疗效。