To the Editor We commend Kuyken et al1 for their important contribution. An individual patient-level approach has been needed to evaluate moderators of the effect of mindfulness-based cognitive therapy (MBCT). With growing evidence that MBCT, cognitive behavioral therapy, and antidepressant medication (ADM) may all help prevent depressive relapse, clinicians and patients are grappling with the question of who does better taking which treatments. As a laudable first step, the authors reported that patients with greater baseline depressive severity may benefit more from MBCT. The authors1 acknowledged they were not able to access important moderators such as ethnicity and employment. Unfortunately, one moderator they also did not examine, but surely had access to, was patient ADM status.
Lovas DA, Lutz J, Schuman-Olivier Z. Meditation and Medication—What About a Middle Path?. JAMA Psychiatry. 2016;73(12):1294-1295. doi:10.1001/jamapsychiatry.2016.1471