Principal Investigator: Jan Sundquist
The treatment of anxiety and depression places a great burden on primary care services in Sweden. There is an urgent need to develop more cost-effective treatments. The National Board of Health and Welfare advocates the use of cognitive behavioral therapy (CBT) according to the principles of mindfulness—a meditative technique that teaches patients to manage their thoughts and feelings—in the treatment of anxiety and depression. However, there is a shortage of trained CBT instructors, and the treatment of patients with these disorders on an individual basis is very expensive.
Although mindfulness-based methods are today used in Sweden to treat anxiety and depression, their effectiveness is less well documented than that of conventional techniques and there remains a gap in the evidence for clinicians, especially in primary care. To address this, in 2012 we initiated a multi-center randomized controlled trial to assess whether group mindfulness-based therapy improves mental health and quality of life in a group of primary care patients with anxiety and depression. Eligible patients were enrolled at 16 primary care centers in Skåne and randomized to one of two treatment groups: an intervention group that received group mindfulness-based therapy and a control group that received treatment as usual.
All participants were assessed at baseline and immediately post-intervention, and will be followed up at 6, 12, and 24 months after completion of the intervention, for (1) symptoms of depression, anxiety, stress, and burnout; (2) functioning; (3) self-rated health; (4) sense of coherence; and (5) quality of life. Since increased systemic inflammation has been linked to depression and anxiety we will also measure serum levels of a range of inflammatory factors/markers, including high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor (TNF)-α. The cost-effectiveness of the intervention will also be assessed.