Mindfulness Based Cognitive Therapy for Chronic Pain and Comorbid Unipolar Depression

Mass General Brigham

Status: Unknown

Conditions: Major Depressive Disorder; Chronic Pain; Dysthymic Disorder; Depressive Disorder NOS

Treatments: Behavioral: Mindfulness Based Cognitive Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT01473615

2011P001699

Details and patient eligibility

About

The primary aim of this study is to test the feasibility and efficacy of Mindfulness Based Cognitive Therapy (MBCT) training for the treatment of depressive symptoms in patients with chronic pain. The study also aims to elucidate the mechanisms underlying MBCT on a psychological and neurobiological level. For this purpose the study subjects will fill out several psychological questionnaires related to mindfulness, depression and chronic pain. Moreover this study involves optional fMRI scans of the brain and blood measures before and after the intervention.

Main hypotheses:

1. The MBCT training will be a feasible intervention in patients with chronic pain and co-morbid depression as defined by no occurrence of serious adverse events related to the intervention and a retention rate of more than 70% in the subjects assigned to the MBCT arm.
2. Patients who have completed the MBCT training will demonstrate a significant decrease in depressive symptoms as measured on the Quick Inventory of Depressive Symptomatology - Clinician rated (QIDS-C16), and the Hamilton Rating Scale for Depression (HRSD17) (QIDS-C/HRDS) severity scale for depressive symptoms (the primary outcome measure), compared to the control group.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• The presence of Chronic Pain, which has persisted for at least 3 months.
• Meets criteria of Major Depressive Disorder, Dysthymic Disorder or Depressive disorder NOS as defined by DSM-IV criteria.
• Have a minimum score of depressive symptoms of > 10 as rated on the QIDS-C, administered during the screen.
• Able to provide written informed consent.
• Adults 18 years or older
• English-language literacy.

Exclusion criteria

• Serious suicide or homicide risk, as assessed by evaluating clinician.
• Severe and unstable medical illness including cardiovascular, hepatic, renal, respiratory, endocrine, neurological or hematological disease for which hospitalization is likely to be required within the next half year.
• The following DSM-IV disorders: any bipolar disorder (current or past), current psychotic symptoms, or a primary psychotic disorder (current or past). Entry of patients with anxiety disorder will be permitted if the depressive disorder is judged to be the predominant disorder, in order to increase accrual of a clinically relevant sample.
• Active diagnosis of substance abuse or dependence disorders within the last 3 months.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Treatment As Usual + Mindfulness Based Cognitive Therapy

Experimental group

Description:

Subjects randomized into the intervention group will receive, a manualized 8-week MBCT group skills program with sessions that each last 2 hours, in addition to their treatment as usual (TAU).

Treatment:

Behavioral: Mindfulness Based Cognitive Therapy

Treatment As Usual

No Intervention group

Description:

Patients randomized into the TAU group will continue to receive their care as usual and be put on a waitlist. They will be offered the MBCT treatment after the completion of the study.