Mindfulness-based cognitive therapy can prevent recurrent depression

McDonald, S. The Mental Elf Blog. Published online 28 April 2016

Mindfulness-Based Cognitive Therapy (MBCT) has gained traction as a therapy for the many people whose lives are blighted by recurrent depression. As a potential alternative to antidepressants or other proven talking therapies, MBCT has the dual attractions of apparent clinical efficacy and cost effectiveness (Kuyken et al, 2015).

As a therapy that has really developed over the last twenty years or so, a time during which momentum has gathered behind proving through research the evidence base for therapies, MBCT has a considerable number of research papers (especially well-conducted randomised trials) behind it in comparison to other models of therapy.

Commentary of: Kuyken W. et al. Efficacy and moderators of mindfulness-based cognitive therapy (MBCT) in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. JAMA Psychiatry. Published online April 27, 2016

Summary

  • This meta-analysis adds further impetus to the drive to make MBCT a therapy of choice for relapsing depression.
  • It certainly presents a strong case for clinicians to provide MBCT for individuals with a substantial history of relapsing depression.
  • The finding that MBCT was more therapeutic for people with higher levels of depression but still conferred some benefit and did not appear to have adverse effects on people with less severe symptoms is helpful for those planning mental health services or considering national guidance.

Read full commentary here

Read original research abstract here

 

 

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Statistics on Obesity, Physical Activity and Diet

Overall, 58% of women and 65% of men were overweight or obese

This statistical report presents a range of information on obesity, physical activity and diet, drawn together from a variety of sources.

The topics covered include:

Part 1: Overweight and obesity prevalence among adults and children

Part 2: Health Outcomes; presents a range of information about the health outcomes of being obese or overweight which includes information on health risks, hospital admissions and prescription drugs used for treatment of obesity

Part 3: Physical activity levels among adults and children

Part 4: Diet among adults and children, including trends in purchases, and consumption of food and drink and energy intake

Each section provides an overview of the key findings from these sources, as well as providing sources of further information and links to relevant documents and sources.

E cigarettes as substitute for smoking

GPs  advised to promote e-cigarettes ‘as widely as possible as a substitute for smoking’ by the Royal College of Physicians (RCP), following a comprehensive review of available evidence

E-cigarettes should be used as a viable harm reduction strategy to help patients give up on the ‘addictive and lethal’ habit of tobacco smoking, according to the RCP’s Nicotine without smoke report.

Assessing the scientific evidence, public policy, regulation and ethics of e-cigarettes, the RCP concluded that they are not a gateway to smoking and do not result in the normalisation of smoking.

The report does warn that any long-term or rare side effects of vaping will not become apparent until e-cigarettes have been in widespread use for several decades, but states the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.

Read the full report, Nicotine without smoke: Tobacco harm reduction

See also:

Yoga for Asthma

Yoga for asthma – Yang – 2016 – Cochrane Database of Systematic Reviews – Wiley Online Library

The Cochrane Database of Systematic Reviews has published a new report ‘Yoga for Asthma’.

Yoga for Asthma

Image source: http://www.cochranelibrary.com/

Asthma is a common chronic inflammatory disorder affecting about 300 million people worldwide. As a holistic therapy, yoga has the potential to relieve both the physical and psychological suffering of people with asthma, and its popularity has expanded globally. A number of clinical trials have been carried out to evaluate the effects of yoga practice, with inconsistent results.

The researchers found found moderate-quality evidence that yoga probably leads to small improvements in quality of life and symptoms in people with asthma. There is more uncertainty about potential adverse effects of yoga and its impact on lung function and medication usage. RCTs with a large sample size and high methodological and reporting quality are needed to confirm the effects of yoga for asthma.

Read more here

Living positively with dementia

Aging & Mental Health Volume 20, Issue 7, 2016

Objective: Little is known about how and to what extent people with dementia live positively with their condition. This study aimed to review and carry out a synthesis of qualitative studies where accounts of the subjective experiences of people with dementia contained evidence of positive states, experiences or attributes.

B0003527 Alzheimer's disease - digital artwork

image source: Adrian Cousins,  Wellcome images//CC BY-NC-ND 4.0

Methods: A meta-synthesis was undertaken to generate an integrated and interpretive account of the ability of people with dementia to have positive experiences. A methodological quality assessment was undertaken to maximize the reliability and validity of this synthesis and to contextualize the findings with regard to methodological constraints and epistemological concepts.

Findings: Twenty-seven papers were included. Three super-ordinate themes relating to positive experiences and attributes were identified, each with varying and complementing sub-themes. The first super-ordinate theme related to the experience of engaging with life in ageing rather than explicitly to living with dementia. The second theme related to engaging with dementia itself and comprised the strengths that people can utilize in facing and fighting the condition. The third theme captured how people with dementia might transcend the condition and seek ways to maintain identity and even achieve personal growth.

Conclusions: This review provides a first step towards understanding what conceptual domains might be important in defining positive outcomes for people who live with dementia. Highlighting the potential for people to have positive experiences in spite of or even because of their dementia has important implications for de-stigmatizing dementia and will enhance person-centred approaches to care.

Full reference:  Wolverson, E.L. et al. Living positively with dementia: a systematic review and synthesis of the qualitative literature  Aging & Mental Health. Volume 20, Issue 7, 2016 p. 676-699

Destitution in the UK

This report published by the Joseph Rowntree Foundation defines destitution in the UK, looking at how many people are affected, who they are, and the main pathways in and out of destitution. It looks at the impact and experience of those people directly affected.

The report considers:

  • how ‘destitution’ should be defined in the contemporary UK context;
  • how much destitution there is in the UK;
  • who is affected by destitution;
  • how this has changed over time;
  • the main pathways into and out of destitution;
  • the experiences and impacts of destitution for the people directly affected.

Full reference: Destitution in the UK. Fitzpatrick, S et al. 

Drinking in the UK

IPSOS Mori has published the results of a survey Drinkaware Monitor 2015: UK adults’ experience of and views on cutting down.

The key findings provide an overview of drinking in the UK, alcohol consumption patterns, perceptions around drinking, experiences of cutting down and opportunities for cutting down and moderating.

Key findings are highlighted in the press release.