There is a significant association between depressive episodes of bipolar disorder and non-suicidal self-injury (NSSI). Mindfulness-based cognitive therapy (MBCT) represents an evolution of cognitive Show more
There is a significant association between depressive episodes of bipolar disorder and non-suicidal self-injury (NSSI). Mindfulness-based cognitive therapy (MBCT) represents an evolution of cognitive behavioural therapy and serves as a comprehensive psychological intervention. Preliminary research suggests that MBCT may enhance cognitive flexibility and attentional adjustment in patients with depressive episodes of bipolar disorder by modulating brain activity. The aim of this study was to explore the effects of MBCT on behaviour, cognitive function, and serum precursor of brain-derived neurotrophic factor (proBDNF) levels in adolescents with depressive episodes of bipolar disorder. A total of 149 adolescent patients with bipolar disorder and depression with NSSI were randomly assigned. The Chinese version of the Adolescent Non-suicidal Self-Injury Assessment Questionnaire (ANSAQ) was used to measure NSSI symptoms. One group received MBCT in addition to treatment as usual (TAU) (n = 75), while the other group received TAU alone (n = 74). At baseline and at weeks 4 and 8 after treatment initiation, participants were assessed using the Barratt Impulsiveness Scale (BIS), the Hamilton Anxiety Scale (HAMA), the Repeatable Battery for the Assessment of Neuropsychological Status, and the Hamilton Depression Scale (HAMD). In addition, serum precursor Brain-Derived Neurotrophic Factor (proBDNF) levels were determined using an enzyme-linked immunosorbent assay. After 4 and 8 weeks of treatment, the MBCT group showed significantly greater improvement than the control group across the three BIS dimensions (motor impulsiveness, cognitive impulsiveness, and non-planning impulsiveness) (P < 0.001). HAMD scores in the MBCT group were significantly lower than those in the TAU group (4 weeks: MBCT:16.89 ± 1.45 vs TAU:17.27 ± 1.47, P < 0.05; 8 weeks: MBCT:9.24 ± 1.43 vs TAU:11.01 ± 1.84, P < 0.001). Similarly, HAMA scores were lower in the MBCT group (4 weeks: MBCT:13.14 ± 1.30 vs TAU:14.13 ± 1.65, P < 0.05; 8 weeks: MBCT:7.16 ± 1.68 vs TAU:8.17 ± 1.40, P < 0.001). Regarding cognitive function, the MBCT group demonstrated significantly higher scores in immediate memory (4 weeks: MBCT:72.31 ± 11.08 vs TAU:68.31 ± 9.36 P < 0.05; 8 weeks:MBCT:74.80 ± 13.06 vs TAU:71.87 ± 13.64, P < 0.05), delayed memory (4 weeks: MBCT:74.46 ± 11.50 vs TAU:70.20 ± 11.76, P < 0.05; 8 weeks: MBCT:76.54 ± 13.07 vs TAU:71.90 ± 12.60, P < 0.001), attention (4 weeks: MBCT:77.53 ± 11.41 vs TAU: 73.01 ± 13.21, P<0.05; 8 weeks: MBCT:84.56 ± 12.77 vs TAU:76.87 ± 11.38, P < 0.001), language ability (4weeks: MBCT:76.47 ± 12.17 vs TAU:72.13 ± 13.25 P < 0.05;8 weeks: MBCT:79.89 ± 15.02 vs TAU:74.83 ± 12.97, P < 0.05) and visuospatial ability (4 weeks:MBCT:89.04 ± 10.92 vs TAU:84.01 ± 12.67 P < 0.05;8 weeks:MBCT:90.23 ± 13.62 vs TAU:87.67 ± 12.74 P < 0.05) . In addition, serum proBDNF levels in the MBCT group were significantly lower than those in the TAU group at both 4 weeks (MBCT:1.34 ± 0.09 ng/mL vs TAU:1.40 ± 0.06 ng/mL, P < 0.05) and 8 weeks (MBCT:1.27 ± 0.07 ng/mL vs TAU:1.31 ± 0.04 ng/mL, P < 0.05). MBCT can effectively reduce impulsive behaviour, alleviate depressive and anxiety symptoms related to self-injurious behaviour in adolescents with bipolar depression, and decrease serum proBDNF levels. Additionally, immediate memory, delayed memory, attention, language, and visuospatial ability were significantly improved following treatment. Show less