Mindfulness based cognitive therapy versus group psycho-education for people with generalized anxiety disorder: a randomized controlled trial

Background: Research suggests that a course of eight-week mindfulness based cognitive therapy (MBCT) may be effective in the treatment of generalized anxiety disorder (GAD) although few randomized controlled studies have been conducted. Aims: To compare changes in anxiety and worry levels among participants with GAD randomly assigned to MBCT, psycho-education (PEG) using cognitive behavioural therapy principles and usual care (UC). Methods: One hundred and eighty-two participants with GAD were recruited. Both the MBCT and PEG received 8 week intervention while the control group received usual care and were followed over 5 months after baseline assessment (3 months post intervention). The MBCT and PEG were further followed for additional 6 months. Primary outcomes were anxiety and worry levels while secondary outcomes included depressive symptoms, quality of life and level of mindfulness. Results: Linear mixed models demonstrated significant group-time interaction (F(4, 148) = 5.10, p = 0.001) effects for decrease in anxiety measured by BAI for both MBCT and PEG participants relative to UC. Significant group-time interaction effect was observed in worry symptoms, depressive symptoms and mental health related quality of life for PEG only although both MBCT and PEG improved in level of mindfulness. At eight and eleven months, no significant difference in outcome measures were observed between PEG and MBCT although the study was not powered as an equivalence trial to compare PEG and MBCT. Conclusion: These results suggest that although both MBCT and PEG appear to be superior to usual care for the reduction of anxiety symptoms, although PEG has the additional benefits of reducing worry and depressive symptoms among people with GAD.