Aim: To identify moderators of treatment effect for Mindfulness-Based Cognitive Therapy (MBCT) versus Treatment As Usual (TAU) in depressed patients.Methods: An individual patient data-analysis was... Show moreAim: To identify moderators of treatment effect for Mindfulness-Based Cognitive Therapy (MBCT) versus Treatment As Usual (TAU) in depressed patients.Methods: An individual patient data-analysis was performed on three randomized-controlled trials, investigating the effect of MBCT + TAU versus TAU alone (N = 292). Patients were either in (partial) remission, currently depressed or had chronic, treatment-resistant depression. Outcomes were depressive symptoms and quality of life. The Qualitative INteraction Trees (QUINT) method was used to identify subgroups that benefited more from either condition.Results: MBCT + TAU outperformed TAU in reducing depressive symptoms. For both conditions, the effect of baseline depressive symptoms on post-treatment depressive symptoms was curvilinear. QUINT analyses revealed that MBCT + TAU was more beneficial than TAU for patients with an earlier onset and higher rumination levels in terms of depressive symptom reduction and for patients with a lower quality of life in terms of improving quality of life.Conclusions: The results suggest that MBCT might be more beneficial for those with earlier onset and higher levels of rumination and for patients with a lower quality of life. Sophisticated analytical techniques such as QUINT can be used in future research to improve personalized assignment of MBCT to patients. Long-term outcome could also be integrated in this. Show less
Luenen, S. van; Kraaij, V.; Garnefski, N.; Spinhoven, P.; Akker-van Marie, M.E. van den 2019
Objective: The aim of this study was to evaluate the cost-utility of a guided Internet-based intervention for people living with HIV and depressive symptoms, compared to attention only (control... Show moreObjective: The aim of this study was to evaluate the cost-utility of a guided Internet-based intervention for people living with HIV and depressive symptoms, compared to attention only (control condition). It was previously found that the intervention was effective in decreasing depressive symptoms, compared to the control group.Methods: This economic evaluation was conducted alongside a randomized controlled trial. The control group received attention only and was put on a waiting list. Quality adjusted life years were calculated over six months. The study was conducted from a societal perspective and included intervention costs, healthcare costs, and non healthcare costs. Participants completed a pretest, a post-test after two to three months, and a second post-test after six months. Cost-utility acceptability curves were constructed and two sensitivity analyses were conducted.Results: No differences between the intervention and the control group were found in quality adjusted life years and total societal costs. The results indicate that the intervention is likely to be cost-effective, compared to attention only. The findings of the sensitivity analyses point in the same direction.Conclusion: More research with larger samples is necessary to confirm the findings. The outcomes of this study may inform policy makers to decide which interventions will be included in policies. The guided Internet intervention may improve psychological care for people living with HIV and depressive symptoms, against low costs. Show less
