Expanding the Efficacy of Project UPLIFT: Distance Delivery of Mindfulness-Based Depression Prevention to People With Epilepsy

Objective: Depression affects about 16% of the U.S. population over a lifetime. People with chronic diseases have especially high rates of comorbid depression; 32% to 48% of people with epilepsy experience depression. This study evaluated the efficacy of a mindfulness-based cognitive therapy interve...

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Bibliographic Details
Published in:	Journal of consulting and clinical psychology Vol. 83; no. 2; pp. 304 - 313
Main Authors:	Thompson, Nancy J., Patel, Archna H., Selwa, Linda M., Stoll, Shelley C., Begley, Charles E., Johnson, Erica K., Fraser, Robert T.
Format:	Journal Article
Language:	English
Published:	United States American Psychological Association 01-04-2015
Subjects:	Adult Aged Chronic illnesses Cognitive Therapy Computer Assisted Therapy Cross-Over Studies Depression - complications Depression - prevention & control Depression - psychology Depressive Disorder, Major - complications Depressive Disorder, Major - prevention & control Depressive Disorder, Major - psychology Epilepsy Epilepsy - complications Epilepsy - psychology Female Georgia Human Humans Intervention Major Depression Male Meditation Mental depression Middle Aged Mindfulness Mindfulness - methods Personal Satisfaction Psychotherapy, Group Remote Consultation Self Report Telemedicine Treatment Effectiveness Evaluation Treatment Outcome United States Young Adult United States Georgia United States > US epilepsy mindfulness-based cognitive therapy telephone Internet major depressive disorder
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Summary:	Objective: Depression affects about 16% of the U.S. population over a lifetime. People with chronic diseases have especially high rates of comorbid depression; 32% to 48% of people with epilepsy experience depression. This study evaluated the efficacy of a mindfulness-based cognitive therapy intervention for preventing major depressive disorder (MDD) episodes in people with epilepsy. Method: Participants (n = 128) were adults from Georgia, Michigan, Texas, and Washington with epilepsy and mild/moderate depressive symptoms. The 8-session weekly Project UPLIFT intervention, based on mindfulness-based cognitive therapy, was group-delivered via Web or telephone. Using a randomized, controlled crossover design, participants were assigned to Project UPLIFT or a treatment-as-usual (TAU) waitlist and assessed at baseline, and after intervening in the intervention group (∼10 weeks) and in the TAU group (∼20 weeks). Assessments included valid self-report measures of depression and MDD, knowledge/skills, and satisfaction with life. Results: The incidence of MDD episodes (new or relapse) from baseline to interim assessment was significantly lower in the intervention condition (0.0%) than in TAU (10.7%). Depressive symptoms decreased significantly more in the intervention condition than in TAU; Web and telephone did not differ. Change in knowledge/skills mediated the effect, which persisted over the 10 weeks of follow-up. Knowledge/skills and life satisfaction increased significantly more in the intervention condition than in TAU. Conclusions: Distance delivery of group mindfulness-based cognitive therapy can prevent episodes of MDD, reduce symptoms of depression, and increase life satisfaction in people with epilepsy. This intervention is easily modified for persons with other chronic diseases and other disparity populations. What is the public health significance of this article? Using distance delivery, Project UPLIFT prevented episodes of MDD and further reduced depressive symptoms among people with epilepsy and mild-to-moderate depressive symptoms. Easily adapted for people with other chronic diseases, many of whom suffer increased rates of depression, interventions like Project UPLIFT have the potential to significantly decrease the prevalence of depression in the population.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0022-006X 1939-2117
DOI:	10.1037/a0038404