Mindfulness therapy shows no evidence of added risk of worsening depression

In Madison, researchers went back through the records of 1,258 adults to test a concern that had followed mindfulness-based cognitive therapy, or MBCT, for years: could a treatment intended to prevent depression’s return also make symptoms worse? Their answer, published in JAMA Network Open, was no evidence of increased risk compared with control conditions.

The team from the Center for Healthy Minds, UW–Madison’s Department of Educational Psychology and several universities reevaluated individual participant data from nine randomized controlled trials. MBCT combines cognitive behavioral therapy with mindfulness practices such as meditation, and is used to help people with recurrent depression prevent relapse.

The safety question arose after limited studies reported patient-reported harm. Those studies had no control group, however, so they could not show whether worsening symptoms were linked to MBCT or would also have occurred without it. In the new analysis, some secondary comparisons found evidence that MBCT reduced the risk of worsening relative to other treatments, including antidepressants.

And what does that change in practice? For adults whose recurrent depression is in partial or full remission, the findings support continued access to MBCT without evidence that the therapy itself raises the risk of symptom worsening. That matters because the treatment is already widely adopted across health care systems, and depression affects nearly 332 million people worldwide.

The boundary is clear. The trials did not focus on people with acute depression, so the result cannot automatically be extended to them or to other clinical populations. Simon Goldberg, a UW–Madison associate professor and Center for Healthy Minds faculty member, said future randomized trials should assess patient experiences more broadly; the current findings support MBCT as helpful and not harmful to the average patient.