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Reference: Williams, JM, Russell, IT, Crane, C et al., (2010). Staying well after depression: trial design and protocol. BMC psychiatry, 10 (1), 23.Citable link to this page:


Staying well after depression: trial design and protocol.

Abstract: BACKGROUND: Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group. METHODS/DESIGN: This trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter. DISCUSSION: This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression--that in people who become suicidal when depressed.

Peer Review status:Peer reviewedPublication status:PublishedVersion:Publisher's versionNotes:© 2010 Williams et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Bibliographic Details

Publisher: BioMed Central Ltd.

Publisher Website:

Journal: BMC psychiatrysee more from them

Publication Website:

Issue Date: 2010


Urn: uuid:21d268d0-8093-4bff-9bb5-f2f4e2451713

Source identifier: 139622

Eissn: 1471-244X


Issn: 1471-244X Item Description

Type: Journal article;

Language: eng

Version: Publisher's versionKeywords: Humans Recurrence Treatment Outcome Clinical Protocols Meditation Suicide Cognitive Therapy Psychotherapy, Group Adolescent Adult Aged Randomized Controlled Trials as Topic Middle Aged Research Design Psychometrics Depressive Disorder, Major Female Male Tiny URL: pubs:139622


Author: Williams, JM - institutionUniversity of Oxford Oxford, MSD, Psychiatry grantNumber067797-Z-02-A fundingWellcome Trust - - - Russe



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