New online therapy for lingering depression symptoms could fill important gap in care

February 06, 2020

An online version of a pioneering therapy aimed at reducing the lingering symptoms of depression can offer additional benefits for patients receiving care, according to a new U of T Scarborough study.

When added to regular depression care, the online version of Mindfulness-based Cognitive Therapy (MBCT) can help treat depression symptoms and help prevent its return, notes U of T Scarborough Professor Zindel Segal, a clinical psychologist and lead author of the study.

"Treatments work well for many suffering from depression, but there remains a considerable group who continue to struggle with lingering symptoms such as sleep, energy or worry," he says.

Clinical data shows that in the absence of treatment, these patients face a significantly higher risk of becoming fully depressed again, notes Segal.

"Patients with these residual symptoms face a gap in care since they are not depressed enough to warrant re-treatment, but receive few resources for managing the symptom burden they still carry."

The digital version of MBCT, called Mindful Mood Balance (MMB), is an online adaptation of the effective treatment developed by Segal and his colleagues. It combines the practice of mindfulness meditation with the tools of cognitive therapy to teach patients adaptive ways of regulating their emotions.

The practice of mindfulness meditation helps patients observe rather than act automatically to any thought, feeling or sensation that comes to mind, setting them up for being able to choose how best to respond, explains Segal.

"Our goal has always been for people to develop skills that they could continue to rely on once treatment had ended," he says.

While research indicates that MBCT is as effective as antidepressant medication in preventing relapse, access remains limited and nearly impossible for those living outside large cities.

"What drove us to develop MMB is to improve access to this treatment. The online version uses the same content as the in-person sessions, except people can now avoid the barriers of cost, travel or wait times, and they can get the care they need efficiently and conveniently," he says.

Segal, along with colleagues Arne Beck (Kaiser Permanente Institute for Health Research) and Sona Dimidjian (University of Colorado Boulder), received a $2 million grant in 2015 from the National Institute for Health (NIH) in the U.S. to develop MMB. The program was tested in a randomized clinical trial of 460 patients in clinics at Kaiser Permanente Colorado, a large American HMO in Colorado.

The results of the study, published in JAMA Psychiatry, found that adding MMB to depression care offered by Kaiser led to greater reductions in depressive and anxious symptoms, higher rates of remission and higher levels of quality of life compared to patients receiving conventional depression care alone.

"An online version of MBCT, when added with usual care, could be a real game changer because it can be offered to a wider group of patients for little cost," says Segal.

Segal admits that even with the positive results, there is work to be done. A common trade-off with online programs is that drop-out rates tend to be higher than in-person treatment. An important next step is looking at ways to cut down on the dropout rate.

"The higher rates of dropout are somewhat offset by fact that you can reach many more people with online treatment," he says. "But, there's still room for improvement and we will be looking at our user metrics and outcomes for ways to make MMB more engaging and durable."

University of Toronto

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to