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Mindfulness-Based Cognitive Therapy Reduces Symptoms of Depression in People With a Traumatic Brain Injury: Results From a Randomized Controlled Trial

Bédard, Michel PhD; Felteau, Melissa MAEd; Marshall, Shawn MD; Cullen, Nora MD; Gibbons, Carrie MPH; Dubois, Sacha MPH; Maxwell, Hillary MPH; Mazmanian, Dwight PhD; Weaver, Bruce MSc; Rees, Laura PhD; Gainer, Rolf PhD; Klein, Rupert PhD; Moustgaard, Amy PhD

Journal of Head Trauma Rehabilitation: July/August 2014 - Volume 29 - Issue 4 - p E13–E22
doi: 10.1097/HTR.0b013e3182a615a0
Original Articles

Objective: We sought to determine if we could reduce symptoms of depression in individuals with a traumatic brain injury using mindfulness-based cognitive therapy.

Setting: The study was conducted in a community setting.

Participants: We enrolled adults with symptoms of depression after a traumatic brain injury.

Design: We conducted a randomized controlled trial; participants were randomized to the 10-week mindfulness-based cognitive therapy intervention arm or to the wait-list control arm.

Main Measures: The primary outcome measure was symptoms of depression using the Beck Depression Inventory-II.

Results: The parallel group analysis revealed a greater reduction in Beck Depression Inventory-II scores for the intervention group (6.63, n = 38,) than the control group (2.13, n = 38, P = .029). A medium effect size was observed (Cohen d = 0.56). The improvement in Beck Depression Inventory-II scores was maintained at the 3-month follow-up.

Conclusion: These results are consistent with those of other researchers that use mindfulness-based cognitive therapy to reduce symptoms of depression and suggest that further work to replicate these findings and improve upon the efficacy of the intervention is warranted.

Department of Health Sciences, Lakehead University, (Dr Bédard, Mr Dubois), Northern Ontario School of Medicine, (Dr Bédard, Mr Dubois, Mr Weaver), and Research Department, St. Joseph's Care Group, Thunder Bay, Ontario, Canada (Dr Bédard, Mss Gibbons and Maxwell, and Mr Dubois); St. Francis Xavier University, Antigonish, NS (Ms Felteau); Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada (Dr Marshall); Institute for Rehabilitation Research and Development, (Dr Marshall), Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada (Dr Marshall), Electromyography Laboratory, (Dr Marshall), and Acquired Brain Injury Rehabilitation Program, The Ottawa Hospital Rehabilitation Centre, Ottawa, Ontario, Canada (Dr Marshall); West Park Healthcare Centre, (Dr Cullen), NeuroRehabilitation, Toronto Rehab, (Dr Cullen), and Division of Physiatry, University of Toronto, Toronto, Ontario (Dr Cullen); Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada (Mr Mazmanian, Dr Klein); Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada (Dr Rees); Brookhaven Hospital, Tulsa, OK (Dr Gainer); Neurologic Rehabilitation Institute of Ontario, Etobicoke, Ontario, Canada (Dr Gainer); and Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada (Dr Moustgaard).

Corresponding Author: Michel Bédard, PhD, Department of Health Sciences, Lakehead University, 955 Oliver Rd, Thunder Bay, Ontario P7B 5E1, Canada (mbedard@lakeheadu.ca).

This study was funded by the Ontario Neurotrauma Foundation (grant ABI-MIND2-476). Michel Bédard was a Canada Research Chair in Aging and Health at the time this study was conducted (www.chairs.gc.ca); he acknowledges the support of the Canada Research Chair Program.

The authors thank the facilitators who include clinicians from the Ottawa Hospital (Jennifer Heron, Nancy McCormick, Elly Nadorp, and Evelyn Tan), St Joseph's Care Group (Mandy Byerley-Vita, John Clack, Dr Mary Donaghy, and Roxane Siddall), and Toronto Rehab (Sucheta Heble, and Martin Vera) for their contributions. Dr Zindal Segal is a consultant for this study, and the authors thank him for his feedback and support.

Trial Registration: ClinicalTrials.gov NCT00745940.

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins