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      Baseline imbalance about depressive symptoms may overestimate the effectiveness of mindfulness-based cognitive therapy for anxiety disorders.

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        , 1 , 2 , 3

      ScienceOpen Preprints

      ScienceOpen

      mindfulness-based cognitive therapy, anxiety disorder, psychotherapy

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          Abstract

          We read the article by Ninomiya et al. with great interest and appreciate the author's efforts to analyze the effect of primary mindfulness-based cognitive therapy (MBCT) in patients with anxiety disorder in secondary-care settings, compared with a waiting-list group. However, we have concerns about baseline imbalance of depressive symptoms that may influence the conclusion of the trial.

          Comorbid major depressive disorder can have caused an underestimation of anxiety symptoms in the waiting-list group and distort effectiveness of MBCT. The wait-list group had more severe depressive symptoms than the intervention group, about 7 points more in the Center for Epidemiologic Studies Depression Scale (CES-D) scores, and that group might have more major depressive disorder. Indeed, the rate of antidepressant use in the wait-list group was 25% higher than the intervention group.

          It is well known that major depressive disorder is associated with cognitive errors and underestimation of self-report outcomes. Baseline imbalance of depressive symptoms may therefore weaken the conclusion of the study, because all outcome measures were self-report questionnaires.

          The authors should acknowledge the limitation and provide information about the diagnosis of major depressive disorder.

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          Author and article information

          Journal
          ScienceOpen Preprints
          ScienceOpen
          17 March 2020
          Affiliations
          [1 ] Autism and Developmental Disorders Clinic
          [2 ] Department of Surgery, Tottori Prefectural Central Hospital
          [3 ] Department of Nephrology and Dialysis, Kyoritsu Hospital
          Article
          10.14293/S2199-1006.1.SOR-.PPBPG7K.v1

          This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

          All data generated or analysed during this study are included in this published article (and its supplementary information files).

          Medicine

          mindfulness-based cognitive therapy, psychotherapy, anxiety disorder

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