Skip to main content
Log in

A Controlled Evaluation of Mindfulness-Based Cognitive Therapy for Patients with Coronary Heart Disease and Depression

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

This study evaluated the effectiveness of an eight-session mindfulness-based cognitive therapy (MBCT) group intervention programme for treating depression in coronary heart disease (CHD) patients. Thirty-two depressed CHD patients were assigned to an MBCT treatment group, and a demographically and clinically similar group of 30 cases were assigned to a waiting list control group. Participants were evaluated at baseline, 8 weeks, and 6-month follow-up with the Hospital Anxiety and Depression Scale (HADS), Brief Symptom Inventory (BSI), Profile of Mood States (POMS), Psychosocial Adjustment to Illness Scale (PAIS) and the Mindful Attention Awareness Scale (MAAS). After each session, MBCT participants completed the post-session Questionnaire on helpful aspects of therapy and after the programme, completed the Client Satisfaction Questionnaire. At follow-up, 71 % of the MBCT group was clinically recovered from depression compared with 50 % of the control group. The MBCT group showed significantly greater improvement than the control group on all measures with effect sizes at follow-up of d = 0.43–1.0. Increases in mindfulness on the MAAS correlated significantly with improvements on the HADS, BSI, POMS and PAIS. Key helpful aspects of therapy identified by MBCT participants included learning meditation, obtaining group support and developing optimism. There was a high level of satisfaction with the MBCT programme. These results indicate that a randomized controlled trial of MBCT for depressed CHD patients is now warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004). Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosomatic Medicine, 66, 802–813.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  • Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B: Methodological, 57(1), 289–300.

    Google Scholar 

  • Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the hospital anxiety and depression scale: an updated literature review. Journal of Psychosomatic Research, 52, 69–77.

    Article  PubMed  Google Scholar 

  • Bohlmeijer, E., Prenger, R., Taal, E., & Cuijpers, P. (2010). The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. Journal of Psychosomatic Research, 68, 539–544.

    Article  PubMed  Google Scholar 

  • Brown, K., & Ryan, R. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.

    Article  PubMed  Google Scholar 

  • Carney, R., & Freedland, K. (2008). Depression in patients with coronary heart disease. American Journal of Medicine, 121(11, supplement), S20–S27.

    Article  PubMed  Google Scholar 

  • Chan, Y. (2003). Randomized controlled trials—sample size. The magic number. Singapore Medical Journal, 44, 172–174.

    PubMed  Google Scholar 

  • Chiesa, A., & Serretti, A. (2009). Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. The Journal of Alternative and Complementary Medicine, 15, 593–600.

    Article  PubMed  Google Scholar 

  • Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Research, 187, 441–453.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the social sciences (2nd ed.). Mahwah: Lawrence Erlbaum Associates Inc.

    Google Scholar 

  • Derogatis, L. R. (2001). Brief Symptom Inventory (BSI)-18. Administration, scoring and procedures manual. Minneapolis: NCS Pearson, Inc.

    Google Scholar 

  • Derogatis, L., & Lopez, M. (1986). Psychosocial Adjustment to Illness Scale (PAIS & PAIS-SR). Administration scoring and procedures manual. Baltimore: Clinical Psychometric Research.

    Google Scholar 

  • Dickens, C., Cherrington, A., Adeyemi, I., Roughley, K., Bower, P., & Garrett, C. (2013). Characteristics of psychological interventions that improve depression in people with coronary heart disease: a systematic review and meta-regression. Psychosomatic Medicine, 75, 211–221.

    Article  PubMed  Google Scholar 

  • Everson-Rose, S., & Lewis, T. (2005). Psychosocial factors and cardiovascular diseases. Annual Review of Public Health, 26, 469–500.

    Article  PubMed  Google Scholar 

  • First, M., Spitzer, R., Gibbon, M., & Williams, J. (2002). Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient edition with psychotic screen (SCID-I/P W/PSY SCREEN). New York: Biometrics Research.

    Google Scholar 

  • Galante, J., Iribarren, S. J., & Pearce, P. F. (2013). Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. Journal of Research in Nursing, 18(2), 133–155. doi:10.1177/1744987112466087.

    Article  Google Scholar 

  • Glassman, A., for the SADHART (Sertraline Anti-Depressant Heart Attack Randomised Trial) Group, et al. (2002). Sertraline treatment of major depression in patients with acute MI or unstable angina. Journal of the American Medical Association, 288, 701–709.

    Article  PubMed  Google Scholar 

  • Goldston, K., & Baillie, A. J. (2008). Depression and coronary heart disease: a review of the epidemiological evidence, explanatory mechanisms and management approaches. Clinical Psychology Review, 28, 288–306. doi:10.1016/j.cpr.2007.05.005.

    Article  PubMed  Google Scholar 

  • Griffiths, K., Camic, P. M., & Hutton, J. M. (2009). Participant experiences of a mindfulness-based cognitive therapy group for cardiac rehabilitation. Journal of Health Psychology, 14(5), 675–681.

    Article  PubMed  Google Scholar 

  • Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research, 57, 35–43.

    Article  PubMed  Google Scholar 

  • Hans, E., & Hiller, W. (2013). Effectiveness of and dropout from outpatient cognitive behavioral therapy for adult unipolar depression: a meta-analysis of nonrandomized effectiveness studies. Journal of Consulting and Clinical Psychology, 81(1), 75–88. doi:10.1037/a0031080.

    Article  PubMed  Google Scholar 

  • IBM Corp. (2011). IBM SPSS statistics for windows, version 20.0. Armonk: IBM Corp.

    Google Scholar 

  • Igna, R. (2011). Effectiveness of mindfulness-based interventions in chronic pain: a meta-analysis. Highlighting the effectiveness of mindfulness-based interventions in chronic pain. A meta-analytic review. Erdélyi Pszichológiai Szemle, 12(1), 43–57.

  • Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. New York: Delacorte.

    Google Scholar 

  • Klainin-Yobas, P., Cho, M. A. A., & Creedy, D. (2012). Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. International Journal of Nursing Studies, 49, 109–121.

    Article  PubMed  Google Scholar 

  • Larsen, D., Attkinson, C., Hargreaves, W., & Nguyen, T. (1979). Assessment of client/patient satisfaction: development of a general scale. Evaluation and Programme Planning, 2, 197–207.

    Article  Google Scholar 

  • Ledesma, D., & Kumano, H. (2009). Mindfulness-based stress reduction and cancer: a meta-analysis. Psycho-Oncology, 18, 571–579.

    Article  PubMed  Google Scholar 

  • Lespérance, F., Frasure-Smith, N., Koszycki, D., Laliberté, M., van Zyl, L., Baker, B., & for CREATE Investigators. (2007). Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: the Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial. Journal of the American Medical Association, 297, 367–379.

    Article  PubMed  Google Scholar 

  • Lett, H., Blumenthal, J., Babyak, M., Sherwood, A., Strauman, T., Robins, C., & Newman, M. (2004). Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosomatic Medicine, 66, 305–315.

    PubMed  Google Scholar 

  • Leung, Y. W., Flora, D. B., Gravely, S., Irvine, J., Carney, R. M., & Grace, S. L. (2012). The impact of premorbid and postmorbid depression onset on mortality and cardiac morbidity among patients with coronary heart disease: meta-analysis. Psychosomatic Medicine, 74, 786–801.

    Article  PubMed  Google Scholar 

  • Lichtman, J., Bigger, T., Blumenthal, J., Frasure-Smith, N., Kaufmann, P., et al. (2008). Depression and coronary heart disease: recommendations for screening, referral, and treatment. Circulation, 118, 1768–1775.

    Article  PubMed  Google Scholar 

  • Llewelyn, S., Elliott, R., Shapiro, D., Firth, J., & Hardy, G. (1988). Client’s perceptions of significant events in prescriptive and exploratory phases of individual therapy. British Journal of Clinical Psychology, 27, 105–114.

    Article  PubMed  Google Scholar 

  • McCarney, R., Schulz, J., & Grey, A. (2012). Effectiveness of mindfulness-based therapies in reducing symptoms of depression: a meta-analysis. European Journal of Psychotherapy and Counselling, 14, 279–299.

    Article  Google Scholar 

  • McNair, D., Lorr, M., & Droppleman, L. (1992). POMS profile of mood states manual. Toronto: MHS.

    Google Scholar 

  • Miles, M., Huberman, M., & Saldana, J. (2013). Qualitative data analysis: a methods sourcebook (3rd ed.). Thousand Oaks: Sage.

    Google Scholar 

  • O’Hare, A., Whelan, C. T., & Commins, P. (1991). The development of an Irish census-based social class scale. The Economic and Social Review, 22, 135–156.

    Google Scholar 

  • Piet, J., & Hougaard, E. (2011). The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clinical Psychology Review, 31, 1032–1040.

    Article  PubMed  Google Scholar 

  • Piet, J., Würtzen, H., & Zachariae, R. (2012). The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 80, 1007–1020.

    Article  PubMed  Google Scholar 

  • Rugulies, R. (2002). Depression as a predictor for coronary heart disease: a review and meta-analysis. American Journal of Preventative Medicine, 23, 51–61.

    Article  Google Scholar 

  • Rutledge, T., Reis, V., Linke, S., Greenberg, B., & Mills, P. (2006). Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal of the American College of Cardiology, 48, 1527–1537.

    Article  PubMed  Google Scholar 

  • Schulz, K., Altman, D., Moher, D., & CONSORT Group. (2010). CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. British Medical Journal, 340, c332.

    Article  PubMed Central  PubMed  Google Scholar 

  • Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Publications.

    Google Scholar 

  • Snaith, R., & Zigmond, A. (1994). The hospital anxiety and depression scale manual. Windsor, Ontario: NFER-Nelson.

  • Strahan, R., & Carrese- Gerbasi, K. (1972). Short, homogenous versions of the Marlowe-Crowne Social Desirability Scale. Journal of Clinical Psychology, 28, 191–193.

    Article  Google Scholar 

  • Sullivan, M., Wood, L., Terry, J., Brantley, J., & Charles, A. (2009). The Support, Education and Research in Chronic Heart failure Study (SEARCH): a mindfulness-based psychoeducational intervention improves depression and clinical symptoms in patients with chronic heart failure. American Heart Journal, 157, 84–90.

    Article  PubMed  Google Scholar 

  • Tacon, A. M., McComb, J., Caldera, Y., & Randolph, P. (2003). Mindfulness meditation, anxiety reduction and heart disease: a pilot study. Family Community Health, 26, 25–33.

    Article  PubMed  Google Scholar 

  • VanMelle, J., De Jonge, P., Spijkerman, T., et al. (2004). Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosomatic Medicine, 66, 814–822.

    Article  Google Scholar 

  • Vøllestad, J., Birkeland Nielsen, M., & Høstmark Nielsen, G. (2012). Mindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. British Journal of Clinical Psychology, 51, 239–260.

    Article  PubMed  Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alan Carr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

O’Doherty, V., Carr, A., McGrann, A. et al. A Controlled Evaluation of Mindfulness-Based Cognitive Therapy for Patients with Coronary Heart Disease and Depression. Mindfulness 6, 405–416 (2015). https://doi.org/10.1007/s12671-013-0272-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-013-0272-0

Keywords

Navigation