This systematic review protocol outlines a planned investigation into whether Mindfulness-Based Cognitive Therapy (MBCT) effectively reduces depressive symptoms in adults with Treatment-Resistant Depression (TRD) compared to standard care or other active treatments, and whether its safety profile is comparable. The review will search multiple databases and trial registries for randomized clinical trials and quasi-experimental studies without language or date restrictions. Study quality will be assessed with the Cochrane Risk of Bias Tool, and confidence in the evidence will be appraised using GRADE methodology. The protocol was registered in PROSPERO in April 2023.
About 30% of people with major depressive disorder have treatment-resistant depression (TRD), which responds poorly to standard therapies. Online mindfulness-based cognitive therapy (eMBCT) delivered via live video sessions was tested in a small feasibility trial at a Brazilian institute. Twenty-eight outpatients with TRD were randomly assigned to either an 8-week eMBCT program or a control group. The eMBCT group showed large improvements in depression and anxiety symptoms, while the control group showed no significant changes. Between-group comparisons also favored eMBCT for reducing depression and improving clinical global impressions. eMBCT combined with medication appears feasible for TRD, though a future trial with a manualized control is needed.
A systematic review of 15 studies (10 randomized double-blind controlled trials and 5 open-label trials) examined the efficacy of psychedelics for treatment-resistant depression (TRD), a severe subtype of major depressive disorder. The review suggests that both typical and atypical psychedelics can provide rapid and substantial improvement in depressive symptoms, representing an alternative and complementary therapeutic approach to traditional treatments for TRD.