กลุ่มบำบัดความคิดบนพื้นฐานการฝึกสติเพื่อป้องกันโรคซึมเศร้าในวัยรุ่นและผู้ใหญ่ตอนต้น: การศึกษานำร่อง

บทคัดย่อ

Objective  To develop and evaluate the efficacy of group mindfulness-based cognitive therapy (MBCT) in targeted prevention of depressive disorder in adolescents and young adults with an elevated risk of depression.

Materials and methods  Mindfulness practice in Thailand and standard MBCT programs were reviewed. Then discussion with experts in mindfulness practice in adolescence were done before developing the mindfulness-based cognitive therapy for young people aged 15-24 years old with sub-syndromal depression and anxiety. Forty-four participants were recruited in the study and received group intervention for MBCT. Measurements evaluated pre- and post- intervention included: 1) the Anxiety Rating Scale, 2) Beck Depressive Inventory-II (BDI-II), Thai version, and 3) the Philadelphia Mindfulness Scale (PHLMS), Thai version. Descriptive statistics and paired t-test were used in data analysis.

Results  Data analysis indicated post-intervention advantage for prevention program. Anxiety and depressive scale score decreased significantly after the intervention and 3 months later. However, the Mindfulness Scale score did not show significant improvement at the end of group session but increased significantly after 3 months. Qualitatively, almost all participants reported positive effects of the program towards their internal mindfulness experience. ‘Mismatch between the  content measured in the PHLMS and the content in the program’ and ‘misunderstanding of what is mindfulness’ are suspected causes of this contrary. Moreover, proportion of risk group decreased to 25.0% and 11.4% at 0 and 3 months after the end of the program, respectively.

Conclusion The MBCT showed efficacy in reducing anxiety and sub-syndromal depressive symptoms and therefore decrease risk of developing depressive disorder. Change in the mindfulness score was controversial and need further investigation.