Numerous scientific publications have documented that Mindfulness-Based Cognitive Therapy is an effective treatment for the prevention of recurrent depression. Now a PhD project from the Department of Clinical Medicine at Aarhus University is embarking on a study of how and why.

2017.02.13 | Nanna Jespersgård

"We intend to investigate patterns of connectivity and activity in the brain and whether these neural patterns can predict who will experience relapse, and who can be helped most by MBCT. In addition, we will test what happens in the brain when individuals at risk become dysphoric, and when they practice mindfulness exercises from the MBCT programme," says Anne Maj van der Velden. (Photo of model: Colourboks)

Recruitment to the first scientific study, in which patients with recurrent depression will take part in brain scans and other scientific studies of what are known as mechanisms of action for Mindfulness-Based Cognitive Therapy (MBCT), is currently underway. MBCT is an evidence-based psychotherapeutic treatment that integrates systematic training in mindfulness meditation with techniques from cognitive behavioural therapy.

As part of her PhD project, Anne Maj van der Velden will study both how – and for whom – MBCT makes a difference. Something that has become urgent in a time when more and more people are suffering from the severe and potentially fatal disease.

One in five Danes experience an episode of depression during their lifetime. After one episode with depression half will relapse, and after three episodes with depression the risk of relapse is as high as 80 per cent. MBCT is recommended by the Danish and a number of international health authorities for the prevention of relapse of depression, and research shows that MBCT can reduce the risk of relapse on pair with antidepressant medicine.

"We know that it works, but we need to develop a greater understanding of how and why MBCT has a preventive effect on depression. We also lack knowledge about why MBCT can prevent depression in some people, but not in others," explains Anne Maj van der Velden. The PhD project is expected to involve 60 people with recurrent depression.

"We intend to investigate patterns of connectivity and activity in the brain and whether these neural patterns can predict who will experience relapse, and who can be helped most by MBCT. In addition, we will test what happens in the brain when individuals at risk become dysphoric, and when they practice mindfulness exercises from the MBCT programme," says Anne Maj van der Velden, who is placed in an interdisciplinary set-up between the Centre of Functionally Integrative Neuroscience (CFIN), the Interacting Minds Centre and the Danish Center for Mindfulness.

Biological and psychological theories co-exist

In addition to looking at patterns of connectivity and activity in the brain, the PhD project shall examine a number of factors believed to potentially affect the efficacy of the mindfulness techniques. These include demographic markers, such as whether the depressive person has a history of childhood trauma, and biomarkers in the blood. The hope is to achieve a better understanding of the complex disease, where biological and psychological theories co-exist and offers hypotheses as to why the disease arises and how it can be prevented.

"We know, for example, that a high level of inflammation is linked to an increased risk of developing depression, but we do not know whether the level of inflammation affects how individuals at risk will respond to MBCT, so this is one of the markers we will test for," explains Anne Maj van der Velden.

Lone Overby Fjorback, who is a senior medical consultant in psychiatry, associate professor and head of the Danish Center for Mindfulness at the Department of Clinical Medicine, Aarhus University, oversees the clinical aspects of the project. She underlines that the research in mechanisms of action, which is the focal point of the PhD project is time-consuming, but at the same time important for the understanding and future optimisation of evidence-based forms of treatment.

"Research on mechanisms of action has many phases, because the same intervention is studied through different methodological lenses, but it is necessary if we want to understand which mechanisms make a difference. On the other hand it is pointless to continue to examine whether MBCT has a preventive effect," says Lone Overby Fjorback and refers to the conclusion of a meta-analysis in the acknowledged scientific journal JAMA, as well as a newly-published Danish review article in the Journal of the Danish Medical Association. Both articles reaching the conclusion that MBCT can effectively reduce risk of relapse.

Aarhus - York - Harvard - Oxford involved in the project

The PhD project is placed in a strong international and interdisciplinary team and comprises collaborations between Aarhus University, depression researchers at Oxford University, 'mind-wandering experts' at York University, biomarker researchers at VIA in Aarhus and neuroscientists at Harvard Medical School.

Contact:

PhD student Anne Maj van der Velden
Interacting Minds Centre, Center of Functionally Integrative Neuroscience (CFIN) and the Danish Center for Mindfulness, Department of Clinical Medicine, Faculty of Health, Aarhus University
Email: am.vandervelden@cas.au.dk
Direct tel.: (+45) 8716 2408
Mobile: (+45) 5389 3384 or (+45) 2937 5967