***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: This pilot study investigated the effectiveness of Mindfulness-Based Cognitive Therapy ( MBCT ) , a treatment combining mindfulness meditation and interventions taken from cognitive therapy , in patients suffering from chronic-recurrent depression . Currently symptomatic patients with at least three previous episodes of depression and a history of suicidal ideation were r and omly allocated to receive either MBCT delivered in addition to treatment-as-usual ( TAU ; N = 14 completers ) or TAU alone ( N = 14 completers ) . Depressive symptoms and diagnostic status were assessed before and after treatment phase . Self-reported symptoms of depression decreased from severe to mild levels in the MBCT group while there was no significant change in the TAU group . Similarly , numbers of patients meeting full criteria for depression decreased significantly more in the MBCT group than in the TAU group . Results are consistent with previous uncontrolled studies . Although based on a small sample and , therefore , limited in their generalizability , they provide further preliminary evidence that MBCT can be used to successfully reduce current symptoms in patients suffering from a protracted course of the disorder BACKGROUND The goal of this study was to investigate psychosocial disability in relation to depressive symptom severity during the long-term course of unipolar major depressive disorder ( MDD ) . METHODS Monthly ratings of impairment in major life functions and social relationships were obtained during an average of 10 years ' systematic follow-up of 371 patients with unipolar MDD in the National Institute of Mental Health Collaborative Depression Study .  R and om regression models were used to examine variations in psychosocial functioning associated with 3 levels of depressive symptom severity and the asymptomatic status . RESULTS A progressive gradient of psychosocial impairment was associated with a parallel gradient in the level of depressive symptom severity , which ranges from asymptomatic to subthreshold depressive symptoms to symptoms at the minor depression/dysthymia level to symptoms at the MDD level . Significant increases in disability occurred with each stepwise increment in depressive symptom severity . CONCLUSIONS During the long-term course , disability is pervasive and chronic but disappears when patients become asymptomatic . Depressive symptoms at levels of subthreshold depressive symptoms , minor depression/ dysthymia , and MDD represent a continuum of depressive symptom severity in unipolar MDD , each level of which is associated with a significant stepwise increment in psychosocial disability For people at risk of depressive relapse , mindfulness-based cognitive therapy ( MBCT ) has an additive benefit to usual care ( H. F. Coelho , P. H. Canter , & E. Ernst , 2007 ) . This study asked if , among patients with recurrent depression who are treated with antidepressant medication ( ADM )  , MBCT is comparable to treatment with maintenance ADM ( m-ADM ) in ( a ) depressive relapse prevention , ( b ) key secondary outcomes , and ( c ) cost effectiveness . The study design was a parallel 2-group r and omized controlled trial comparing those on m-ADM ( N = 62 ) with those receiving MBCT plus support to taper/discontinue antidepressants ( N = 61 ) . Relapse/recurrence rates over 15-month follow-ups in MBCT were 47 % , compared with 60 % in the m-ADM group ( hazard ratio = 0.63 ; 95 % confidence interval : 0.39 to 1.04 ) . MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains . There was no difference in average annual cost between the 2 groups . Rates of ADM usage in the MBCT group was significantly reduced , and 46 patients ( 75 % ) completely discontinued their ADM . For patients treated with ADM , MBCT may provide an alternative approach for relapse prevention UNLABELLED While cognitive behavior therapy has been found to be effective in the treatment of generalized anxiety disorder ( GAD ) , a significant percentage of patients struggle with residual symptoms . There is some conceptual basis for suggesting that cultivation of mindfulness may be helpful for people with GAD . Mindfulness-based cognitive therapy ( MBCT ) is a group treatment derived from mindfulness-based stress reduction ( MBSR ) developed by Jon Kabat-Zinn and colleagues . MBSR uses training in mindfulness meditation as the core of the program . MBCT incorporates cognitive strategies and has been found effective in reducing relapse in patients with major depression ( Teasdale , J. D. , Segal , Z. V. , Williams , J. M. G. , Ridgeway , V. , Soulsby , J. , & Lau , M. ( 2000 ) . Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy . Journal of Consulting and Clinical Psychology , 6 , 615 - 623 ) . METHOD Eligible subjects recruited to a major academic medical center participated in the group MBCT  course and completed measures of anxiety , worry , depressive symptoms , mood states and mindful awareness in everyday life at baseline and end of treatment . RESULTS Eleven subjects ( six female and five male ) with a mean age of 49 ( range=36 - 72 ) met criteria and completed the study . There were significant reductions in anxiety and depressive symptoms from baseline to end of treatment . CONCLUSION MBCT may be an acceptable and potentially effective treatment for reducing anxiety and mood symptoms and increasing awareness of everyday experiences in patients with GAD . Future directions include development of a r and omized clinical trial of MBCT for GAD Cognitive Reactivity ( CR ) refers to the degree to which a mild dysphoric state reactivates negative thinking patterns , and it has been found to play a key causal role in depressive relapse . Although Mindfulness-Based Cognitive Therapy ( MBCT ) directly aims to address this mechanism of CR , the relationship between mindfulness and CR has not been tested to date . Using a cross-sectional design ( Study 1 ; n = 164 ) and a non-r and omized waiting list controlled design ( Study 2 ; MBCT [ n = 18 ] vs. waiting list [ n = 21 ] ) , the authors examined the relationship between naturally occurring levels of mindfulness ( Study 1 ) and MBCT ( Study 2 ) on the one h and , and CR on the other h and . In line with predictions , it was found that ( a ) trait mindfulness is significantly negatively correlated with CR , even when controlled for current depressive symptoms and prior history of depression ( Study 1 ) , and that ( b ) MBCT , compared to a matched control group , significantly reduces CR , and that this effect of MBCT on reduction of CR is mediated by a positive change in mindfulness skills ( Study 2 ) . Results provide first evidence for the cl aim that mindfulness practice s in MBCT are design ed to address the process of CR Background Bipolar disorder is highly recurrent and rates of comorbidity are high . Studies have pointed to anxiety comorbidity as one factor associated with risk of suicide attempts and poor overall outcome . This study aim ed to explore the feasibility and potential benefits of a new psychological treatment ( Mindfulness-based Cognitive Therapy : MBCT ) for people with bipolar disorder focusing on between-episode anxiety and depressive symptoms . Methods The study used data from a pilot r and omized trial of MBCT for people with bipolar disorder in remission , focusing on between-episode anxiety and depressive symptoms . Immediate effects of MBCT versus waitlist on levels of anxiety and depression were compared between unipolar and bipolar participants . Results The results suggest that MBCT led to improved immediate outcomes in terms of anxiety which were specific to the bipolar group . Both bipolar and unipolar participants allocated to MBCT showed reductions in residual depressive symptoms relative to those allocated to the waitlist condition . Limitations Analyses were based on a small sample , limiting power . Additionally the study recruited participants with suicidal ideation or behaviour so the findings can not immediately be generalized to individuals without these symptoms . Conclusions The study , although preliminary , suggests an immediate effect of MBCT on anxiety and depressive symptoms among bipolar participants with suicidal ideation or behaviour , and indicates that further research into the use of MBCT with bipolar patients may be warranted Mindfulness-based cognitive therapy ( MBCT ) is an efficacious psychosocial intervention for recurrent depression ( Kuyken et al. , 2008 ; Ma & Teasdale , 2004 ; Teasdale et al. , 2000 ) . To date , no compelling research addresses MBCT 's mechanisms of change . This study determines whether MBCT 's treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment , and /or by alterations in post-treatment cognitive reactivity . The study was embedded in a r and omized controlled trial comparing MBCT with maintenance antidepressants ( mADM ) with 15-month follow-up ( Kuyken et al. , 2008 ) . Mindfulness and self-compassion were assessed before and after MBCT treatment ( or at equivalent time points in the mADM group ) . Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group . One hundred and twenty-three patients with ≥3 prior depressive episodes , and successfully treated with antidepressants , were r and omized either to mADM or MBCT  . The MBCT arm involved participation in MBCT , a group-based psychosocial intervention that teaches mindfulness skills , and discontinuation of ADM . The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up . Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up . Mindfulness and self-compassion were measured using self-report question naire . Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction . MBCT 's effects were mediated by enhancement of mindfulness and self-compassion across treatment . MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome . Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group . MBCT 's treatment effects are mediated by augmented self-compassion and mindfulness , along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome . This decoupling is associated with the cultivation of self-compassion across treatment Recovered recurrently depressed patients were r and omized to treatment as usual ( TAU ) or TAU plus mindfulness-based cognitive therapy ( MBCT ) . Replicating previous findings , MBCT reduced relapse from 78 % to 36 % in 55 patients with 3 or more previous episodes ; but in 18 patients with only 2 ( recent ) episodes corresponding figures were 20 % and 50 % . MBCT was most effective in preventing relapses not preceded by life events . Relapses were more often associated with significant life events in the 2-episode group . This group also reported less childhood adversity and later first depression onset than the 3-or-more-episode group , suggesting that these groups represented distinct population s. MBCT is an effective and efficient way to prevent relapse/recurrence in recovered depressed patients with 3 or more previous episodes Objectives : To examine whether mindfulness meditation ( MM ) was associated with changes in objective ly measured polysomnographic ( PSG ) sleep profiles and to relate changes in PSG sleep to subjectively reported changes in sleep and depression within the context of a r and omized controlled trial . Previous studies have indicated that mindfulness and other forms of meditation training are associated with improvements in sleep quality . However , none of these studies used objective PSG sleep recordings within longitudinal r and omized controlled trials of naïve subjects . Methods : Twenty-six individuals with partially remitted depression were r and omized into an 8-week Mindfulness-Based Cognitive Therapy ( MBCT ) course or a waitlist control condition . Pre-post measurements included PSG sleep studies and subjectively reported sleep and depression symptoms . Results : According to PSG sleep , MM practice was associated with several indices of increased cortical arousal , including more awakenings and stage 1 sleep and less slow-wave sleep relative to controls , in proportion to amount of MM practice . According to sleep diaries , subjectively reported sleep improved post MBCT but not above and beyond controls . Beck Depression Inventory scores decreased more in the MBCT group than controls . Improvements in depression were associated with increased subjective sleep continuity and increased PSG arousal . Conclusions : MM is associated with increases in objective ly measured arousal during sleep with simultaneous improvements in subjectively reported sleep quality and mood disturbance . This pattern is similar to the profiles of positive responders to common antidepressant medications . BDI = Beck Depression Inventory ; EEG = electroencephalogram ; EMG = electromyogram ; EOG = electrooculogram ; HRSD = Hamilton Rating Scale for Depression ; MBCT = Mindfulness-Based Cognitive Therapy ; MM = mindfulness meditation ; NWAK = number of awakenings ; PSG = polysomnograph ; RCT = r and omized controlled trial ; REM = rapid eye movement ; SE = sleep efficiency ; SOL = sleep onset latency ; SWS = slow-wave sleep ; TIB = time in bed ; TST = total sleep time ; WASO = wake after sleep onset This study evaluated mindfulness-based cognitive therapy ( MBCT ) , a group intervention design ed to train recovered recurrently depressed patients to disengage from dysphoria-activated depressogenic thinking that may mediate relapse/recurrence . Recovered recurrently depressed patients ( n = 145 ) were r and omized to continue with treatment as usual or , in addition , to receive MBCT .  Relapse/recurrence to major depression was assessed over a 60-week study period . For patients with 3 or more previous episodes of depression ( 77 % of the sample ) , MBCT significantly reduced risk of relapse/recurrence . For patients with only 2 previous episodes , MBCT did not reduce relapse/recurrence .  MBCT 
    Output:
    
Results of this meta- analysis indicate that MBCT is an effective intervention for relapse prevention in patients with recurrent MDD in remission , at least in case of three or more previous MDD episodes