Patients with clinically significant symptoms of depression who do not meet the criteria for major depressive disorder or dysthymic disorder are considered to have sub-threshold depression.
According to the researchers from The Jockey Club School of Public Health and Primary Care in Hong Kong, sub-threshold depression can cause functional impairment and considerable economic costs, and it is a strong risk factor for developing major depressive disorder.
The study, published in the journal Annals of Family Medicine, undertook a randomised controlled trial to assess the efficacy of group-based behavioural activation with mindfulness (BAM) for treating sub-threshold depression.
The researchers recruited adult patients aged 18 and above with sub-threshold depression from public primary care clinics and randomly assigned them to a BAM intervention group or a usual care group.
They randomly allocated 115 patients to the BAM intervention and 116 patients to usual care.
The BAM group was provided with eight two-hour weekly BAM sessions by trained allied health care workers. Patients in the usual care group received usual medical care with no additional psychological interventions.
The primary outcome was depressive symptoms measured by the Beck Depression Inventory-II at 12 months. Secondary outcomes included incidence of major depressive disorder at 12 months.
We assessed quality of life, activity and circumstances change, functional impairment, and anxiety at baseline, end of intervention, 5 months, and 12 months, the researchers said.
At 12 months, compared with usual care peers, BAM patients had a slightly more favourable change in levels of depressive symptoms on the Beck Depression Inventory-II.
Incidence of major depressive disorder was lower with BAM, whereas groups did not differ significantly on other secondary outcomes at 12 months.
The researchers, including Samuel Y. S. Wong, suggested that BAM group appears to be efficacious for decreasing depressive symptoms and reducing the incidence of major depression among patients with sub-threshold depression in primary care.
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