Rumination as a predictor of relapse in mindfulness‐based cognitive therapy for depression

OBJECTIVES: In mindfulness-based cognitive therapy (MBCT), it is proposed that training in mindfulness should reduce the tendency of formerly depressed patients to enter into ruminative thinking, thus reducing their risk of depressive relapse. However, data showing that rumination is associated with depressive relapse are lacking. METHOD: In an uncontrolled study with 24 formerly depressed patients, rumination was assessed with the Ruminative Response Scale. To assess the occurrence of relapse or recurrence, the Structured Clinical Interview for DSM-IV was administered 12 months after the end of the MBCT. RESULTS: Rumination significantly decreased during the MBCT course. Post-treatment levels of rumination predicted the risk of relapse of major depressive disorder in the 12-month follow-up period even after controlling for numbers of previous episodes and residual depressive symptoms. CONCLUSIONS: The results provide preliminary evidence that rumination is important in the process of depressive relapse.