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The role of kindly presence in depression prevention

The role of kindly presence in depression prevention. Dr Rebecca Crane, Centre for Mindfulness Research and Practice, School of Psychology Bangor University UK. The Scale of the Problem: Population Health and Mental Well-being. WHO - mental illness = biggest health burden by 2030

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The role of kindly presence in depression prevention

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  1. The role of kindly presence in depression prevention Dr Rebecca Crane, Centre for Mindfulness Research and Practice, School of Psychology Bangor University UK

  2. The Scale of the Problem: Population Health and Mental Well-being • WHO - mental illness = biggest health burden by 2030 • Mental illness = biggest single cause of morbidity across the world (40% of the total in Britain) • Depression = leading cause and increasing year by year • Use of anti-depressants in the UK increased from 9m prescriptions in 1991 to 47m in 2011 • Much of the burden from physical ill health comes from the stress that such illnesses cause the sufferer • Cost of depression and anxiety to UK economy is estimated at £17 billion or 1.5% of GDP • In the most deprived areas of the UK, 9 -10% of population are on (often long-term) antidepressant prescriptions.

  3. First MBCT Clinical Trials 3 centre study (Teasdale et al, 2000) Single centre replication study (Ma & Teasdale, 2004) Summary of results of both trials: MBCT approximately halved the likelihood of depressive relapse in patients who had had three of more episodes of depression

  4. Replications of original MBCT research – 9 studies/1258 participants • reduction in the risk of depressive relapse/recurrence over 60 weeks compared with usual care • 31% risk reduction - trials with no active control • 21% risk reduction - trials with active control • 23% risk reduction - trials comparing MBCT to anti-depressants • treatment effect of MBCT on the risk of depressive relapse/recurrence is larger in participants with higher levels of depression symptoms at baseline

  5. Strong evidence for positive effects for MBCT in areas closely related to depression prevention i.e….. • Current depression episode • Residual depression • Treatment resistant depression • Anxiety • Bi-polar • Suicidality

  6. MBCT beyond depression: Adolescents with ADHD Health anxiety Psoriasis Respiratory conditions Mental health professionals Insomnia Cancer OCD Binge eating Headache pain Tinnitus Veterans with PTSD etc

  7. Summary • Evidence for depression prevention is compelling – particularly in those who have heighted relapse vulnerability • More episodes • Earlier onset • History of adversity and trauma • Unstable remission • MBCT does no harm when (carefully) offered to people with current depression, anxiety, PTSD

  8. National Institute for Health and Clinical Excellence (NICE) Recommendation for Depression Relapse Prevention (2009)

  9. Implementation Guidancewww.implementing-mbct.com/

  10. Health careEducationCriminal JusticeWork place

  11. Thank you! Rebecca Crane r.crane@bangor.ac.uk www.bangor.ac.uk/mindfulness

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