August 21, 2014 (Toronto) – A
mindfulness-based therapy for depression has the added benefit of reducing
health-care visits among patients who often see their family doctors, according
to a new study by the Centre for Addiction and Mental Health (CAMH) and the Institute for Clinical Evaluative Sciences
The research showed that frequent health service users who
received mindfulness-based cognitive therapy showed a significant reduction in
non-mental health care visits over a one-year period, compared with those who
received other types of group therapy.
The study was published in the Journal
of Psychosomatic Research.
The mindfulness therapy group had one fewer non-mental
health visit per year, for every two individuals treated with this therapy –
which translates into a reduction of nearly 2,500 visits to primary care
physicians, emergency departments or non-psychiatric specialists in Ontario
over eight years.
“We speculate that mindfulness-based cognitive therapy has
elements that could help people who are high health-care utilizers manage their
distress without needing to goto a doctor,” says Dr. Paul Kurdyak, lead author
and Director of Health Systems Research at CAMH and Lead of the Mental Health
and Addictions Research Program at ICES.
Senior author Dr. Zindel Segal, who developed
mindfulness-based cognitive therapy, says, “the goal of this therapy is to
treat depression or anxiety so this unintended effect is striking, particularly
as there is limited evidence on interventions that effectively reduce high
health care use.” Dr. Segal is Professor of Psychology at the University of
Toronto, and a Senior Scientist with CAMH’s Campbell Family Mental Health
Mindfulness-based cognitive therapy is a structured form of
psychotherapy that combines elements of cognitive-behaviour therapy with
mindfulness meditation. It is delivered in a group setting for eight weekly
sessions.The therapy was originally developed to prevent relapse of symptoms
among people with recurring depression, as an alternative to ongoing medication
treatment. It has been proven
effective in multiple studies, and has been applied toother conditions such
as anxiety and chronic pain.
To conduct their study, researchers identified 10,633
individuals who received group-based mindfulness-based cognitive therapy
between 2003 and 2010, based on billing records from the Ontario Health
Insurance Plan (OHIP). The therapy was delivered by 24 specially trained psychiatrists
or family doctors. Among these patients, 4,851 (46 per cent) were considered
high health service users, having more than five visits to a primary care
physician, emergency department or other specialist in a year.
For comparison, researchersidentified29,795 who received
group therapy, such as cognitive-behaviour or interpersonal psychotherapy,
without a mindfulness component, and who were matched for age, sex and neighbourhood
income; 13,274 of these controls were high service users. For both
groups,non-mental health care visits were examined one year before the therapy,
and one year after it ended.
“Primary care physicians play a large role in managing
patients with distress, and they often report feeling overwhelmed and unable to
effectively deal with cases of medically unexplained symptoms,” says Dr.
Kurdyak. “This study shows the potential of mindfulness-based cognitive therapy
to help both patients and their doctors.”
The Centre for Addiction and Mental Health (CAMH)
is Canada's largest mental health and addiction teaching hospital, as
well as one of the world's leading research centres in its field. CAMH combines
clinical care, research, education, policy development and health promotion to
help transform the lives of people affected by mental health and addiction
issues. CAMH is fully affiliated with the University of Toronto,
and is a Pan American Health Organization/World Health Organization
Collaborating Centre. For more information, please visit www.camh.ca.
Centre for Addiction and Mental Health (CAMH)
(416) 535-8501 ext. 36015