Predicting which intervention works better for whom: Moderators of treatment effect of Mindfulness-Based Cognitive Therapy and Positive Psychology Intervention in patients with bipolar disorder.
Study Goal
The researchers aimed to identify moderators of treatment effect (depressive symptoms and well-being) of Mindfulness-Based Cognitive Therapy (MBCT) compared to Positive Psychology Intervention (PPI) and treatment as usual (TAU) in patients with bipolar disorder.
Results Summary
The study found that patients with more severe depressive symptoms benefited more from MBCT than PPI. Other variables associated with better response to MBCT included higher baseline anxiety, lower well-being, and being married.
Population
Patients with bipolar disorder.
Effective Dosage
Not specified
Duration
Outcomes were assessed at baseline, posttreatment, and 12 months after baseline.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-Based Cognitive Therapy (MBCT) | decrease | depressive symptoms | patients with bipolar disorder | - | associated with stronger response | #1 |
Mindfulness-Based Cognitive Therapy (MBCT) | decrease | anxiety | patients with bipolar disorder | - | associated with stronger response | #2 |
Mindfulness-Based Cognitive Therapy (MBCT) | increase | well-being | patients with bipolar disorder | - | associated with stronger response | #3 |
Mindfulness-Based Cognitive Therapy (MBCT) | increase | self-focused positive rumination | patients with bipolar disorder | - | associated with stronger response | #4 |
Mindfulness-Based Cognitive Therapy (MBCT) | increase | self-compassion | patients with bipolar disorder | - | associated with stronger response | #5 |
Mindfulness-Based Cognitive Therapy (MBCT) | decrease | depressive symptoms | patients with bipolar disorder who are married | - | associated with stronger response | #6 |
Positive Psychology Intervention (PPI) | decrease | depressive symptoms | male patients with bipolar disorder | - | associated with stronger response | #7 |
Mindfulness-Based Cognitive Therapy (MBCT) | decrease | depressive symptoms | patients with bipolar disorder | - | associated with better response than PPI | #8 |
Mindfulness-Based Cognitive Therapy (MBCT) | decrease | symptomatology | patients with bipolar disorder with more severe symptomatology | - | benefit more from | #9 |
BACKGROUND: This study aimed to identify moderators of treatment effect (i.e. depressive symptoms and well-being) of Mindfulness-Based Cognitive Therapy (MBCT) and Positive Psychology Intervention (PPI) in patients with bipolar disorder. METHODS: Data were drawn from two multicenter randomized controlled trials investigating effectiveness of MBCT vs treatment as usual (TAU; n = 144) and PPI vs TAU (n = 97) in bipolar disorder. Outcomes were assessed at baseline, posttreatment, and 12 months after baseline. Data were analyzed using separate linear regression models, comparing the pooled MBCT or PPI outcomes to TAU, and comparing MBCT to PPI. RESULTS: The exploratory analyses not corrected for multiple comparisons showed a number of variables that were associated with stronger response to the interventions, including higher baseline anxiety, lower well-being, and lower levels of self-focused positive rumination, well-being, and self-compassion, and variables associated with a stronger response to either MBCT (higher levels of depression and anxiety and being married) or PPI (being male). After correcting for multiple testing, depressive symptoms appeared to be the most robust variable associated with better response to MBCT than PPI. LIMITATIONS: The RCTs handled slightly different enrollment criteria and outcome measures. CONCLUSIONS: The most robust finding is that patients with more severe symptomatology seem to benefit more from MBCT than PPI. CLINICAL IMPLICATIONS: This is a first step to improve personalized assignment of third-wave CBT interventions for patients with bipolar disorder. However, before definite treatment assignment criteria can be formulated and implemented in clinical practice, these findings should be replicated.