{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T12:19:57Z","timestamp":1793708397619,"version":"4.6.1"},"reference-count":124,"publisher":"National Institute for Health and Care Research","issue":"73","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/non-commercial-government-licence\/non-commercial-government-licence.htm"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["08\/56\/01"],"award-info":[{"award-number":["08\/56\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"Background<\/jats:title>Individuals with a history of recurrent depression have a high risk of repeated depressive relapse\/recurrence. Maintenance antidepressant medication (m-ADM) for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to m-ADM. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce the risk of relapse\/recurrence compared with usual care but has not yet been compared with m-ADM in a definitive trial.<\/jats:p><\/jats:sec>Objectives<\/jats:title>To establish whether MBCT with support to taper and\/or discontinue antidepressant medication (MBCT-TS) is superior to and more cost-effective than an approach of m-ADM in a primary care setting for patients with a history of recurrent depression followed up over a 2-year period in terms of preventing depressive relapse\/recurrence. Secondary aims examined MBCT\u2019s acceptability and mechanism of action.<\/jats:p><\/jats:sec>Design<\/jats:title>Single-blind, parallel, individual randomised controlled trial.<\/jats:p><\/jats:sec>Setting<\/jats:title>UK general practices.<\/jats:p><\/jats:sec>Participants<\/jats:title>Adult patients with a diagnosis of recurrent depression and who were taking m-ADM.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Participants were randomised to MBCT-TS or m-ADM with stratification by centre and symptomatic status. Outcome data were collected blind to treatment allocation and the primary analysis was based on the principle of intention to treat. Process studies using quantitative and qualitative methods examined MBCT\u2019s acceptability and mechanism of action.<\/jats:p><\/jats:sec>Main outcomes measures<\/jats:title>The primary outcome measure was time to relapse\/recurrence of depression. At each follow-up the following secondary outcomes were recorded: number of depression-free days, residual depressive symptoms, quality of life, health-related quality of life and psychiatric and medical comorbidities.<\/jats:p><\/jats:sec>Results<\/jats:title>In total, 212 patients were randomised to MBCT-TS and 212 to m-ADM. The primary analysis did not find any evidence that MBCT-TS was superior to m-ADM in terms of the primary outcome of time to depressive relapse\/recurrence over 24 months [hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.67 to 1.18] or for any of the secondary outcomes. Cost-effectiveness analysis did not support the hypothesis that MBCT-TS is more cost-effective than m-ADM in terms of either relapse\/recurrence or quality-adjusted life-years. In planned subgroup analyses, a significant interaction was found between treatment group and reported childhood abuse (HR 1.89, 95% CI 1.06 to 3.38), with delayed time to relapse\/recurrence for MBCT-TS participants with a more abusive childhood compared with those with a less abusive history. Although changes in mindfulness were specific to MBCT (and not m-ADM), they did not predict outcome in terms of relapse\/recurrence at 24 months. In terms of acceptability, the qualitative analyses suggest that many people have views about (dis)\/continuing their ADM, which can serve as a facilitator or a barrier to taking part in a trial that requires either continuation for 2 years or discontinuation.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>There is no support for the hypothesis that MBCT-TS is superior to m-ADM in preventing depressive relapse\/recurrence among individuals at risk for depressive relapse\/recurrence. Both treatments appear to confer protection against relapse\/recurrence. There is an indication that MBCT may be most indicated for individuals at greatest risk of relapse\/recurrence. It is important to characterise those most at risk and carefully establish if and why MBCT may be most indicated for this group.<\/jats:p><\/jats:sec>Trial registration<\/jats:title>Current Controlled Trials ISRCTN26666654.<\/jats:p><\/jats:sec>Funding<\/jats:title>This project was funded by the NIHR Health Technology Assessment programme and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula and will be published in full inHealth Technology Assessment<\/jats:italic>; Vol. 19, No. 73. See the NIHR Journals Library website for further project information.<\/jats:p><\/jats:sec>","DOI":"10.3310\/hta19730","type":"journal-article","created":{"date-parts":[[2015,9,18]],"date-time":"2015-09-18T12:03:37Z","timestamp":1442577817000},"page":"1-124","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse\/recurrence: results of a randomised controlled trial (the PREVENT study)"],"prefix":"10.3310","volume":"19","clinical-trial-number":[{"clinical-trial-number":"isrctn26666654","registry":"10.18810\/isrctn","type":"results"}],"author":[{"given":"Willem","family":"Kuyken","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Hayes","sequence":"additional","affiliation":[{"name":"Exeter Medical School, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Barrett","sequence":"additional","affiliation":[{"name":"Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Byng","sequence":"additional","affiliation":[{"name":"Primary Care Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Dalgleish","sequence":"additional","affiliation":[{"name":"Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kessler","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glyn","family":"Lewis","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Watkins","sequence":"additional","affiliation":[{"name":"Mood Disorders Centre, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Morant","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rod S","family":"Taylor","sequence":"additional","affiliation":[{"name":"Exeter Medical School, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Byford","sequence":"additional","affiliation":[{"name":"Centre for the Economics of Mental and Physical Health, Institute of Psychiatry, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2015,9]]},"reference":[{"key":"key20150917102955564_ref1-bib1","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1001\/archpsyc.1997.01830230015002","article-title":"The clinical course of unipolar major depressive disorders","volume":"54","author":"Judd","year":"1997","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib2","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/S0140-6736(07)61415-9","article-title":"Depression, chronic diseases, and decrements in health: results from the World Health Surveys","volume":"370","author":"Moussavi","year":"2007","journal-title":"Lancet"},{"key":"key20150917102955564_ref1-bib3","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1016\/S0140-6736(96)07492-2","article-title":"Alternative projections of mortality and disability by cause 1990\u20132020: global burden of disease study","volume":"349","author":"Murray","year":"1997","journal-title":"Lancet"},{"key":"key20150917102955564_ref1-bib4","volume-title":"Thrive \u2013 the Power of Evidence-Based Psychological Therapies","author":"Layard","year":"2014"},{"key":"key20150917102955564_ref1-bib5","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1001\/archpsyc.1990.01810240013002","article-title":"Three-year outcomes for maintenance therapies in recurrent depression","volume":"47","author":"Frank","year":"1990","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib6","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1001\/archpsyc.1992.01820100013002","article-title":"Five-year outcome for maintenance therapies in recurrent depression","volume":"49","author":"Kupfer","year":"1992","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib7","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1001\/archpsyc.61.11.1097","article-title":"The burden of major depression avoidable by longer-term treatment strategies","volume":"61","author":"Vos","year":"2004","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib8","volume-title":"Depression: the Treatment and Management of Depression in Adults (Update)","author":"National Institute for Health and Care Excellence","year":"2009"},{"key":"key20150917102955564_ref1-bib9","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/S0140-6736(03)12599-8","article-title":"Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review","volume":"361","author":"Geddes","year":"2003","journal-title":"Lancet"},{"key":"key20150917102955564_ref1-bib10","first-page":"111","article-title":"Teaching \u2013 social science or performing art","volume":"54","author":"Dawe","year":"1984","journal-title":"Harvard Educ Rev"},{"key":"key20150917102955564_ref1-bib11","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1001\/archpsyc.58.3.241","article-title":"A randomized trial of relapse prevention of depression in primary care","volume":"58","author":"Katon","year":"2001","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib12","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.genhosppsych.2003.12.001","article-title":"Patients\u2019 preferences in the treatment of depressive disorder in primary care","volume":"26","author":"van Schaik","year":"2004","journal-title":"Gen Hosp Psychiatry"},{"key":"key20150917102955564_ref1-bib13","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1176\/appi.ajp.163.1.101","article-title":"Continuity of antidepressant treatment for adults with depression in the United States","volume":"163","author":"Olfson","year":"2006","journal-title":"Am J Psychiatry"},{"key":"key20150917102955564_ref1-bib14","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/j.1600-0447.2006.00974.x","article-title":"Why people do not take their psychotropic drugs as prescribed: results of the 2000 National Psychiatric Morbidity Survey","volume":"116","author":"Cooper","year":"2007","journal-title":"Acta Psychiatr Scand"},{"key":"key20150917102955564_ref1-bib15","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1016\/j.brat.2009.07.010","article-title":"Improving access to psychological therapy: initial evaluation of two UK demonstration sites","volume":"47","author":"Clark","year":"2009","journal-title":"Behav Res Ther"},{"key":"key20150917102955564_ref1-bib16","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1136\/bmj.332.7548.1030","article-title":"The case for psychological treatment centres","volume":"332","author":"Layard","year":"2006","journal-title":"BMJ"},{"key":"key20150917102955564_ref1-bib17","doi-asserted-by":"publisher","first-page":"120","DOI":"10.3399\/bjgp09X395139","article-title":"Psychological treatment of depression in primary care: a meta-analysis","volume":"59","author":"Cuijpers","year":"2009","journal-title":"Br J Gen Pract"},{"key":"key20150917102955564_ref1-bib18","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/S0006-3223(02)01384-7","article-title":"Psychosocial intervention development for the prevention and treatment of depression: promoting innovation and increasing access","volume":"52","author":"Hollon","year":"2002","journal-title":"Biol Psychiatry"},{"key":"key20150917102955564_ref1-bib19","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1001\/jama.1997.03540280071036","article-title":"The National Depressive and Manic\u2013Depressive Association consensus statement on the undertreatment of depression","volume":"277","author":"Hirschfeld","year":"1997","journal-title":"JAMA"},{"key":"key20150917102955564_ref1-bib20","volume-title":"Mindfulness-Based Cognitive Therapy for Depression","author":"Segal","year":"2013","edition":"2nd edn."},{"key":"key20150917102955564_ref1-bib21","author":"The Mindfulness Initiative"},{"key":"key20150917102955564_ref1-bib22","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/1748-5908-9-62","article-title":"Accessibility and implementation in UK services of an effective depression relapse prevention programme \u2013 mindfulness-based cognitive therapy (MBCT): ASPIRE study protocol","volume":"9","author":"Rycroft-Malone","year":"2014","journal-title":"Implement Sci"},{"key":"key20150917102955564_ref1-bib23","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1007\/s12671-012-0121-6","article-title":"The implementation of mindfulness-based cognitive therapy: learning from the UK health service experience","volume":"4","author":"Crane","year":"2013","journal-title":"Mindfulness"},{"key":"key20150917102955564_ref1-bib24","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1037\/0022-006X.68.4.615","article-title":"Prevention of relapse\/recurrence in major depression by mindfulness-based cognitive therapy","volume":"68","author":"Teasdale","year":"2000","journal-title":"J Consult Clin Psychol"},{"key":"key20150917102955564_ref1-bib25","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1037\/0022-006X.72.1.31","article-title":"Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects","volume":"72","author":"Ma","year":"2004","journal-title":"J Consult Clin Psychol"},{"key":"key20150917102955564_ref1-bib26","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1037\/0022-006X.75.6.1000","article-title":"Mindfulness-based cognitive therapy: evaluating current evidence and informing future research","volume":"75","author":"Coelho","year":"2007","journal-title":"J Consult Clin Psychol"},{"key":"key20150917102955564_ref1-bib27","volume-title":"MRC Final Report: Brain Sciences II Trial Platform \u2018Preventing Depression Relapse in NHS Practice Using Mindfulness-Based Cognitive Therapy\u2019","author":"Kuyken","year":"2007"},{"key":"key20150917102955564_ref1-bib28","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1037\/a0013786","article-title":"Mindfulness-based cognitive therapy to prevent relapse in recurrent depression","volume":"76","author":"Kuyken","year":"2008","journal-title":"J Consult Clin Psychol"},{"key":"key20150917102955564_ref1-bib29","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1111\/j.1600-0447.2007.01061.x","article-title":"Under\/over-recruitment to mental health trials","volume":"116","author":"White","year":"2007","journal-title":"Acta Psychiatr Scand"},{"key":"key20150917102955564_ref1-bib30","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1017\/S135246580999004X","article-title":"Participants\u2019 experiences of mindfulness-based cognitive therapy: \u2018It changed me in just about every way possible\u2019","volume":"37","author":"Allen","year":"2009","journal-title":"Behav Cogn Psychother"},{"key":"key20150917102955564_ref1-bib31","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1176\/appi.ps.54.5.698","article-title":"Cost-effectiveness of collaborative care for depression in a primary care veteran population","volume":"54","author":"Liu","year":"2003","journal-title":"Psychiatr Serv"},{"key":"key20150917102955564_ref1-bib32","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.1176\/appi.ajp.158.10.1638","article-title":"Cost-effectiveness of a collaborative care program for primary care patients with persistent depression","volume":"158","author":"Simon","year":"2001","journal-title":"Am J Psychiatry"},{"key":"key20150917102955564_ref1-bib33","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1097\/00005650-200210000-00011","article-title":"Cost-effectiveness of a program to prevent depression relapse in primary care","volume":"40","author":"Simon","year":"2002","journal-title":"Med Care"},{"key":"key20150917102955564_ref1-bib34","volume-title":"Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse","author":"Segal","year":"2002"},{"key":"key20150917102955564_ref1-bib35","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1001\/archpsyc.63.7.749","article-title":"Cognitive reactivity to sad mood provocation and the prediction of depressive relapse","volume":"63","author":"Segal","year":"2006","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib36","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1080\/14639947.2011.564831","article-title":"Compassion in the landscape of suffering","volume":"12","author":"Feldman","year":"2011","journal-title":"Contemp Buddhism"},{"key":"key20150917102955564_ref1-bib37","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1016\/j.brat.2010.08.003","article-title":"How does mindfulness-based cognitive therapy work?","volume":"48","author":"Kuyken","year":"2010","journal-title":"Behav Res Ther"},{"key":"key20150917102955564_ref1-bib38","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1016\/j.cpr.2009.06.005","article-title":"Mindful emotion regulation: an integrative review","volume":"29","author":"Chambers","year":"2009","journal-title":"Clin Psychol Rev"},{"key":"key20150917102955564_ref1-bib39","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1016\/j.brat.2009.03.007","article-title":"Mindfulness and reduced cognitive reactivity to sad mood: evidence from a correlational study and a non-randomized waiting list controlled study","volume":"47","author":"Raes","year":"2009","journal-title":"Behav Res Ther"},{"key":"key20150917102955564_ref1-bib40","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1037\/a0017151","article-title":"Minding one\u2019s emotions: mindfulness training alters the neural expression of sadness","volume":"10","author":"Farb","year":"2010","journal-title":"Emotion"},{"key":"key20150917102955564_ref1-bib41","doi-asserted-by":"publisher","first-page":"e7194","DOI":"10.1136\/bmj.e7194","article-title":"Does mindfulness based cognitive therapy prevent relapse of depression?","volume":"345","author":"Kuyken","year":"2012","journal-title":"BMJ"},{"key":"key20150917102955564_ref1-bib42","volume-title":"Full Catastrophe Living: How to Cope with Stress, Pain and Illness using Mindfulness Meditation","author":"Kabat-Zinn","year":"1990"},{"key":"key20150917102955564_ref1-bib43","volume-title":"Cognitive Therapy of Depression","author":"Beck","year":"1979"},{"key":"key20150917102955564_ref1-bib44","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1001\/archpsyc.62.4.417","article-title":"Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression","volume":"62","author":"Hollon","year":"2005","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib45","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.brat.2004.03.003","article-title":"Teasdale\u2019s differential activation hypothesis: implications for mechanisms of depressive relapse and suicidal behaviour","volume":"42","author":"Lau","year":"2004","journal-title":"Behav Res Ther"},{"key":"key20150917102955564_ref1-bib46","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1001\/archpsyc.58.4.381","article-title":"Preventing recurrent depression using cognitive therapy with and without a continuation phase: a randomized clinical trial","volume":"58","author":"Jarrett","year":"2001","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib47","volume-title":"Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-Patient Edition (SCID-I\/NP)","author":"First","year":"2002"},{"key":"key20150917102955564_ref1-bib48","volume-title":"British National Formulary","author":"Joint Formulary Committee","year":"2012","edition":"63rd edn."},{"key":"key20150917102955564_ref1-bib49","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1097\/YIC.0b013e3282f948f5","article-title":"The GRID-HAMD: standardization of the Hamilton Depression Rating Scale","volume":"23","author":"Williams","year":"2008","journal-title":"Int Clin Psychopharmacol"},{"key":"key20150917102955564_ref1-bib50","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1001\/archpsyc.56.8.763","article-title":"The role of residual subthreshold depressive symptoms in early episode relapse in unipolar major depressive disorder","volume":"56","author":"Judd","year":"1999","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib51","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1001\/archgenpsychiatry.2010.168","article-title":"Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression","volume":"67","author":"Segal","year":"2010","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib52","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1177\/1073191113490790","article-title":"Development and validation of the mindfulness-based interventions \u2013 teaching assessment criteria (MBI:TAC)","volume":"20","author":"Crane","year":"2013","journal-title":"Assessment"},{"key":"key20150917102955564_ref1-bib53","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1002\/cpp.320","article-title":"The mindfulness-based cognitive therapy adherence scale: inter-rater reliability, adherence to protocol and treatment distinctiveness","volume":"9","author":"Segal","year":"2002","journal-title":"Clin Psychol Psychother"},{"key":"key20150917102955564_ref1-bib54","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1001\/archpsyc.1987.01800180050009","article-title":"The longitudinal interval follow-up evaluation \u2013 a comprehensive method for assessing outcome in prospective longitudinal studies","volume":"44","author":"Keller","year":"1987","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib55","volume-title":"The Beck Depression Inventory \u2013 Second Edition","author":"Beck","year":"1996"},{"key":"key20150917102955564_ref1-bib56","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/0163-8343(82)90026-3","article-title":"An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation \u2013 theoretical considerations and preliminary results","volume":"4","author":"Kabat-Zinn","year":"1982","journal-title":"Gen Hosp Psychiatry"},{"key":"key20150917102955564_ref1-bib57","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/0168-8510(96)00822-6","article-title":"EuroQol: the current state of play","volume":"37","author":"Brooks","year":"1996","journal-title":"Health Policy"},{"key":"key20150917102955564_ref1-bib58","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","article-title":"A new facility for the measurement of health-related quality of life","volume":"16","author":"EuroQol Group","year":"1990","journal-title":"Health Policy"},{"key":"key20150917102955564_ref1-bib59","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1017\/S0033291798006667","article-title":"Development of the World Health Organization WHOQOL-BREF quality of life assessment","volume":"28","author":"Harper","year":"1998","journal-title":"Psychol Med"},{"key":"key20150917102955564_ref1-bib60","first-page":"273","article-title":"Development of the WHOQOL-BREF quality of life assessment","volume":"6","author":"Orley","year":"1997","journal-title":"Qual Life Res"},{"key":"key20150917102955564_ref1-bib61","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression","volume":"23","author":"Hamilton","year":"1960","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"key20150917102955564_ref1-bib62","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E","article-title":"Sample size and optimal designs for reliability studies","volume":"7","author":"Walter","year":"1998","journal-title":"Stat Med"},{"key":"key20150917102955564_ref1-bib63","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1037\/0022-006X.51.2.318","article-title":"Hamilton Rating Scale for Depression: reliability and validity of judgements of novice raters","volume":"51","author":"O\u2019Hara","year":"1983","journal-title":"J Consult Clin Psychol"},{"key":"key20150917102955564_ref1-bib64","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/BF00844934","article-title":"Chapman-Waldrop A. Compliance with an outpatient stress reduction program: rates and predictors of program completion","volume":"11","author":"Kabat-Zinn","year":"1988","journal-title":"J Behav Med"},{"key":"key20150917102955564_ref1-bib65","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/BF00845519","article-title":"The clinical use of mindfulness meditation for the self-regulation of chronic pain","volume":"8","author":"Kabat-Zinn","year":"1985","journal-title":"J Behav Med"},{"key":"key20150917102955564_ref1-bib66","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1176\/ajp.149.7.936","article-title":"Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders","volume":"149","author":"Kabat-Zinn","year":"1992","journal-title":"Am J Psychiatry"},{"key":"key20150917102955564_ref1-bib67","doi-asserted-by":"publisher","first-page":"422","DOI":"10.4278\/0890-1171-15.6.422","article-title":"Evaluation of a wellness-based mindfulness stress reduction intervention: a controlled trial","volume":"15","author":"Williams","year":"2001","journal-title":"Am J Health Promot"},{"key":"key20150917102955564_ref1-bib68","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1136\/bmj.321.7273.1389","article-title":"Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. II: cost-effectiveness","volume":"321","author":"Bower","year":"2000","journal-title":"BMJ"},{"key":"key20150917102955564_ref1-bib69","first-page":"122","article-title":"Measuring preferences for depressive health states: a comparison of the EuroQol instrument, time-trade-off and contingent valuation","volume":"32","author":"Konig","year":"2005","journal-title":"Psychiatr Prax"},{"key":"key20150917102955564_ref1-bib70","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1080\/00207411.1994.11449286","article-title":"Development of the WHOQOL \u2013 rationale and current status","volume":"23","author":"Kuyken","year":"1994","journal-title":"Int J Ment Health"},{"key":"key20150917102955564_ref1-bib71","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1016\/0277-9536(95)00112-K","article-title":"The World Health Organization Quality of Life Assessment (WHOQOL) \u2013 position paper from the World Health Organization","volume":"41","author":"Kuyken","year":"1995","journal-title":"Soc Sci Med"},{"key":"key20150917102955564_ref1-bib72","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1093\/clipsy.bpg015","article-title":"Mindfulness training as a clinical intervention: a conceptual and empirical review","volume":"10","author":"Baer","year":"2003","journal-title":"Clin Psychol Sci Pract"},{"key":"key20150917102955564_ref1-bib73","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/S0022-3999(03)00573-7","article-title":"Mindfulness-based stress reduction and health benefits","volume":"57","author":"Grossman","year":"2004","journal-title":"J Psychosom Res"},{"key":"key20150917102955564_ref1-bib74","volume-title":"Statistical Principles for Clinical Trials","author":"International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use","year":"1998"},{"key":"key20150917102955564_ref1-bib75","doi-asserted-by":"publisher","first-page":"295","DOI":"10.7326\/0003-4819-148-4-200802190-00008","article-title":"Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration","volume":"148","author":"Boutron","year":"2008","journal-title":"Ann Intern Med"},{"key":"key20150917102955564_ref1-bib76","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7326\/0003-4819-152-11-201006010-00232","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials","volume":"152","author":"Schulz","year":"2010","journal-title":"Ann Intern Med"},{"key":"key20150917102955564_ref1-bib77","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1017\/S003329179700545X","article-title":"The development of a refined measure of dysfunctional parenting and assessment of its relevance in patients with affective disorders","volume":"27","author":"Parker","year":"1997","journal-title":"Psychol Med"},{"key":"key20150917102955564_ref1-bib78","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/1745-6215-11-99","article-title":"Study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse\/recurrence: the PREVENT trial","volume":"11","author":"Kuyken","year":"2010","journal-title":"Trials"},{"key":"key20150917102955564_ref1-bib79","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/1745-6215-13-84","article-title":"Nonadherence to treatment protocol in published randomised controlled trials: a review","volume":"13","author":"Dodd","year":"2012","journal-title":"Trials"},{"key":"key20150917102955564_ref1-bib80","doi-asserted-by":"publisher","first-page":"2675","DOI":"10.1002\/sim.4780142407","article-title":"Effect of non-random missing data mechanisms in clinical trials","volume":"14","author":"Choi","year":"1995","journal-title":"Stat Med"},{"key":"key20150917102955564_ref1-bib81","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1191\/096228099671525676","article-title":"Multiple imputation: a primer","volume":"8","author":"Schafer","year":"1999","journal-title":"Stat Methods Med Res"},{"key":"key20150917102955564_ref1-bib82","volume-title":"Data Protection Act","author":"Great Britain","year":"1998"},{"key":"key20150917102955564_ref1-bib83","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1186\/1745-6215-15-217","article-title":"Update to the study protocol for a randomized controlled trial comparing mindfulness-based cognitive therapy with maintenance anti-depressant treatment in the prevention of depressive relapse\/recurrence: the PREVENT trial","volume":"15","author":"Kuyken","year":"2014","journal-title":"Trials"},{"key":"key20150917102955564_ref1-bib84","volume-title":"Guide to the Methods of Technology Appraisal","author":"National Institute for Health and Care Excellence","year":"2013"},{"key":"key20150917102955564_ref1-bib85","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1377\/hlthaff.18.5.163","article-title":"Depression in the workplace: effects on short-term disability","volume":"18","author":"Kessler","year":"1999","journal-title":"Health Aff (Millwood)"},{"key":"key20150917102955564_ref1-bib86","volume-title":"Quality of Life and Pharmacoeconomics in Clinical Trials","author":"Kind","year":"1996","edition":"2nd edn."},{"key":"key20150917102955564_ref1-bib87","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1192\/bjp.bp.112.122283","article-title":"Using generic preference-based measures in mental health: psychometric validity of the EQ-5D and SF-6D","volume":"205","author":"Mulhern","year":"2014","journal-title":"Br J Psychiatry"},{"key":"key20150917102955564_ref1-bib88","volume-title":"A Social Tariff for EuroQoL: Results from a UK General Population Survey","author":"Dolan","year":"1995"},{"key":"key20150917102955564_ref1-bib89","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1002\/hec.901","article-title":"Calculation of quality-adjusted life-years in the published literature: a review of methodology and transparency","volume":"13","author":"Richardson","year":"2004","journal-title":"Health Econ"},{"key":"key20150917102955564_ref1-bib90","volume-title":"Unit Costs of Health and Social Care 2013","author":"Curtis","year":"2013"},{"key":"key20150917102955564_ref1-bib91","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1097\/01.jom.0000052967.43131.51","article-title":"The World Health Organization Health and Work Performance Questionnaire (HPQ)","volume":"45","author":"Kessler","year":"2003","journal-title":"J Occupat Environ Med"},{"key":"key20150917102955564_ref1-bib92","volume-title":"A Ready Reckoner for Staff Costs in the NHS","author":"Netten","year":"1998"},{"key":"key20150917102955564_ref1-bib93","volume-title":"Unit Costs of Health and Social Care 2008","author":"Barrett","year":"2008"},{"key":"key20150917102955564_ref1-bib94","volume-title":"British National Formulary","author":"Joint Formulary Committee","year":"2010","edition":"60th edn."},{"key":"key20150917102955564_ref1-bib95","volume-title":"NHS Reference Costs 2012\u20132013","author":"Department of Health","year":"2013"},{"key":"key20150917102955564_ref1-bib96","doi-asserted-by":"publisher","first-page":"460","DOI":"10.2165\/00019053-199610050-00003","article-title":"A practical guide for calculating indirect costs of disease","volume":"10","author":"Koopmanschap","year":"1996","journal-title":"Pharmacoeconomics"},{"key":"key20150917102955564_ref1-bib97","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4899-4541-9","volume-title":"An Introduction to the Bootstrap","author":"Efron","year":"1993"},{"key":"key20150917102955564_ref1-bib98","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1136\/bmj.320.7243.1197","article-title":"How should cost data in pragmatic randomised trials be analysed?","volume":"320","author":"Thompson","year":"2000","journal-title":"BMJ"},{"key":"key20150917102955564_ref1-bib99","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198529446.001.0001","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond","year":"2005"},{"key":"key20150917102955564_ref1-bib100","doi-asserted-by":"publisher","first-page":"3219","DOI":"10.1002\/1097-0258(20001215)19:23<3219::AID-SIM623>3.0.CO;2-P","article-title":"Analysis of cost data in randomized trials: an application of the non-parametric bootstrap","volume":"19","author":"Barber","year":"2000","journal-title":"Stat Med"},{"key":"key20150917102955564_ref1-bib101","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1192\/bjp.187.2.106","article-title":"A guide to cost-effectiveness acceptability curves","volume":"187","author":"Fenwick","year":"2005","journal-title":"Br J Psychiatry"},{"key":"key20150917102955564_ref1-bib102","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1002\/hec.635","article-title":"Representing uncertainty: the role of cost-effectiveness acceptability curves","volume":"10","author":"Fenwick","year":"2001","journal-title":"Health Econ"},{"key":"key20150917102955564_ref1-bib103","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1146\/annurev.clinpsy.3.022806.091432","article-title":"Mediators and mechanisms of change in psychotherapy research","volume":"3","author":"Kazdin","year":"2007","journal-title":"Ann Rev Clin Psychol"},{"key":"key20150917102955564_ref1-bib104","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1177\/1073191105283504","article-title":"Using self-report assessment methods to explore facets of mindfulness","volume":"13","author":"Baer","year":"2006","journal-title":"Assessment"},{"key":"key20150917102955564_ref1-bib105","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1001\/archpsyc.59.10.877","article-title":"Mediators and moderators of treatment effects in randomized clinical trials","volume":"59","author":"Kraemer","year":"2002","journal-title":"Arch Gen Psychiatry"},{"key":"key20150917102955564_ref1-bib106","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.brat.2008.10.001","article-title":"How do psychological treatments work? Investigating mediators of change","volume":"47","author":"Murphy","year":"2009","journal-title":"Behav Res Ther"},{"key":"key20150917102955564_ref1-bib107","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/j.1468-2850.2007.00081.x","article-title":"Cognitive processes in cognitive therapy: evaluation of the mechanisms of change in the treatment of depression","volume":"14","author":"Garratt","year":"2007","journal-title":"Clin Psychol Sci Pract"},{"key":"key20150917102955564_ref1-bib108","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","article-title":"Regression models and life tables","volume":"34","author":"Cox","year":"1972","journal-title":"J R Stat Soc Ser B Stat Methodol"},{"key":"key20150917102955564_ref1-bib109","volume-title":"Introduction to Statistical Mediation Analysis","author":"Mackinnon","year":"2008"},{"key":"key20150917102955564_ref1-bib110","doi-asserted-by":"publisher","first-page":"e002889","DOI":"10.1136\/bmjopen-2013-002889","article-title":"What can qualitative research do for randomised controlled trials? A systematic mapping review","volume":"3","author":"O\u2019Cathain","year":"2013","journal-title":"BMJ Open"},{"key":"key20150917102955564_ref1-bib111","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1471-244X-6-14","article-title":"An exploratory mixed methods study of the acceptability and effectiveness of mindfulness-based cognitive therapy for patients with active depression and anxiety in primary care","volume":"6","author":"Finucane","year":"2006","journal-title":"BMC Psychiatry"},{"key":"key20150917102955564_ref1-bib112","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1348\/000711201160911","article-title":"A qualitative study of mindfulness-based cognitive therapy for depression","volume":"74","author":"Mason","year":"2001","journal-title":"Br J Med Psychol"},{"key":"key20150917102955564_ref1-bib113","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"key20150917102955564_ref1-bib114","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1186\/1471-244X-12-185","article-title":"Mindfulness-based cognitive therapy in obsessive\u2013compulsive disorder \u2013 a qualitative study on patients\u2019 experiences","volume":"12","author":"Hertenstein","year":"2012","journal-title":"BMC Psychiatry"},{"key":"key20150917102955564_ref1-bib115","volume-title":"An Introduction to Qualitative Research","author":"Flick","year":"2006","edition":"3rd edn."},{"key":"key20150917102955564_ref1-bib116","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1016\/j.cpr.2011.05.002","article-title":"The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis","volume":"31","author":"Piet","year":"2011","journal-title":"Clin Psychol Rev"},{"key":"key20150917102955564_ref1-bib117","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1037\/a0035036","article-title":"Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial","volume":"82","author":"Williams","year":"2014","journal-title":"J Consult Clin Psychol"},{"key":"key20150917102955564_ref1-bib118","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/1471-244X-12-3","article-title":"The DARE study of relapse prevention in depression: design for a phase 1\/2 translational randomised controlled trial involving mindfulness-based cognitive therapy and supported self monitoring","volume":"12","author":"Shawyer","year":"2012","journal-title":"BMC Psychiatry"},{"key":"key20150917102955564_ref1-bib119","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1177\/0004867414525841","article-title":"Mindfulness-based cognitive therapy for recurrent depression: a translational research study with 2-year follow-up","volume":"48","author":"Meadows","year":"2014","journal-title":"Aust N Z J Psychiatry"},{"key":"key20150917102955564_ref1-bib120","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/1471-244X-12-125","article-title":"Preventing relapse in recurrent depression using mindfulness-based cognitive therapy, antidepressant medication or the combination: trial design and protocol of the MOMENT study","volume":"12","author":"Huijbers","year":"2012","journal-title":"BMC Psychiatry"},{"key":"key20150917102955564_ref1-bib121","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1176\/appi.ajp.2013.12060734","article-title":"Maintenance cognitive-behavioral therapy and manualized psychoeducation in the treatment of recurrent depression: a multicenter prospective randomized controlled trial","volume":"170","author":"Stangier","year":"2013","journal-title":"Am J Psychiatry"},{"key":"key20150917102955564_ref1-bib122","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jpsychires.2009.09.008","article-title":"Clinical characteristics and treatment outcome of depression in patients with and without a history of emotional and physical abuse","volume":"44","author":"Miniati","year":"2010","journal-title":"J Psychiatr Res"},{"key":"key20150917102955564_ref1-bib123","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1176\/appi.ajp.157.2.229","article-title":"Multiple recurrences of major depressive disorder","volume":"157","author":"Solomon","year":"2000","journal-title":"Am J Psychiatry"},{"key":"key20150917102955564_ref1-bib124","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1037\/0022-006X.73.4.647","article-title":"Preventing relapse\/recurrence in recurrent depression with cognitive therapy: a randomized controlled trial","volume":"73","author":"Bockting","year":"2005","journal-title":"J Consult Clin Psychol"}],"container-title":["Health Technology Assessment"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/publications\/hta19730\/hta19730.xml","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2002273","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/publications\/hta19730\/hta19730.xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/njl-admin.nihr.ac.uk\/document\/download\/2002759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T06:12:05Z","timestamp":1718086325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/hta19730\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9]]},"references-count":124,"journal-issue":{"issue":"73","published-online":{"date-parts":[[2015,9]]}},"alternative-id":["10.3310\/hta19730"],"URL":"https:\/\/doi.org\/10.3310\/hta19730","relation":{},"ISSN":["1366-5278","2046-4924"],"issn-type":[{"value":"1366-5278","type":"print"},{"value":"2046-4924","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9]]},"assertion":[{"value":"This content has been made freely available to all.","name":"free","label":"Free to read"}]}}