Mindfulness may combat ‘hard to treat' depression
But offering an additional course of mindful cognitive behavioural therapy, delivered through a weekly video call, could help reduce symptoms for people with difficult-to-treat depression, according to their new study.
NHS talking Therapies, which has been dubbed one of the most ambitious treatment services of its kind in the world, offered treatment to 1.83 million people in 2023/24.
Struggling with feelings of depression, excessive worry, social anxiety, post-traumatic stress or obsessions and compulsions? NHS Talking Therapies can help.
The service is effective, confidential and free.
Your GP can refer you or refer yourself at https://t.co/hLaEBNYcHL pic.twitter.com/VD8EdQsjKP
— NSFT mental health (@NSFTtweets) May 13, 2025
People whose symptoms do not respond to low-intensity treatment, or who present with more complex illnesses, are offered high-intensity treatment.
But figures suggest that 50% of people with depression who complete high-intensity therapies still have lingering symptoms – also known as difficult-to-treat depression.
Academics said there has been little research into treatment options when people with depression have not shown remission of symptoms during a previous psychological therapy, as they set out to examine whether mindfulness-based cognitive therapy (MBCT) could help.
The eight-week treatment uses 'mindfulness practice as a means of helping patients become better at recognising and disengaging from habitual maladaptive patterns of thinking', they said.
It works by using intensive training in mindfulness meditation to help people develop skills to respond better to negative mood and stress, in addition to cognitive behavioural therapy principles which seek to change negative thought patterns.
The new study, led by an expert from the University of Surrey and published in the journal Lancet Psychiatry, saw 234 patients who still had depression symptoms after NHS Talking Therapies split into two groups.
One group received MCBT, delivered via video conferences, while the other group had treatment as usual.
Around six in 10 of all the people involved in the study were taking antidepressants.
Six months after treatment, patients who took part in the MCBT course had a larger reduction in symptoms compared to those who had treatment as usual.
Researchers also said that MBCT was a cost-effective tool – costing around £100 per patient.
The research team suggested that the tool could be considered as a treatment option for NHS patients with hard-to-treat depression.
Professor Thorsten Barnhofer, co-author of the study and professor of clinical psychology at the University of Surrey, said: 'For the thousands of people who finish talking therapy but still find themselves living with depression, this study offers real hope.
'We found that mindfulness-based cognitive therapy not only helps people feel better, but also does so in a way that could ease pressure on NHS services.
'These are results we can't afford to ignore – for individuals, for clinicians, and for a system stretched to its limits.'
Study co-author Professor Barney Dunn, from the University of Exeter, added: 'We know there's a gap in services for people with depression who haven't got better through NHS Talking Therapies.
'These people often don't qualify for further specialist mental health care, and so are left with no further options.
'We've shown that offering MBCT to this group can be effective and cost-efficient to deliver, and we hope this will lead to it being implemented widely.
'We need investment in this and other areas where there are gaps in service, to ultimately save the NHS money.'
Study co-author Barbara Barrett, professor of health economics at King's College London, said: 'We are highly encouraged by our findings, which reveal that MBCT treatment offers a powerful dual benefit for this group: superior patient outcomes coupled with notable cost savings for the NHS.'
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