Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression: A protocol for systematic review and meta-analysis.

This systematic review protocol outlines a planned investigation into whether Mindfulness-Based Cognitive Therapy (MBCT) effectively reduces depressive symptoms in adults with Treatment-Resistant Depression (TRD) compared to standard care or other active treatments, and whether its safety profile is comparable. The review will search multiple databases and trial registries for randomized clinical trials and quasi-experimental studies without language or date restrictions. Study quality will be assessed with the Cochrane Risk of Bias Tool, and confidence in the evidence will be appraised using GRADE methodology. The protocol was registered in PROSPERO in April 2023.

Study at a glance

Abstract

Major Depressive Disorder (MDD) is a global health issue, and a significant portion of individuals with MDD experience Treatment-Resistant Depression (TRD), characterized by the lack of response to adequately trialed antidepressant medication and therapy. This systematic review aims to investigate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) as an intervention for individuals with TRD. We will conduct a thorough search for publications of randomized clinical trials and quasi-experimental studies in MEDLINE, Embase, PsycINFO, Web of Science databases, and ClinicalTrials.gov. Furthermore, reference lists of included studies will be manually screened for additional relevant articles, with no restrictions on language or publication date. The search will be conducted from the inception of the databases until June 2024. Our PICO-guided research questions are: (1) In adults with Treatment-Resistant Depression, is MBCT more effective than standard care or other active treatments in reducing depressive symptoms? (2) In adults with Treatment-Resistant Depression, does MBCT demonstrate a comparable safety profile to standard care or other active treatments? The quality of the included studies will be assessed independently using the Cochrane Risk of Bias Tool (RoB 2). This study seeks to evaluate the effectiveness and tolerability of Mindfulness-Based Cognitive Therapy as an intervention for Treatment-Resistant Depression, and will employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to appraise the confidence in the evidence. Prospero registration ID: CRD42023411978. Registered on April 07, 2023.