Abstract / Summary
Abstract Objectives Mindfulness-based cognitive therapy (MBCT) has rarely been tested in non-Western inpatient services or delivered by nurses. This trial evaluated a culturally adapted, nurse-led group MBCT programme for Thai inpatients. Method Ninety-four inpatients with moderate to severe ICD-10 depressive disorder at a Thai psychiatric hospital were randomised 1:1 to MBCT plus routine nursing care or routine care alone. The programme comprised six group sessions of 60–90 minutes over three weeks. Depressive symptoms (9Q), rumination (RRS) and mindfulness (MAS) were assessed before and after the intervention and at three months; readmission within three months of discharge was recorded. Sixteen completers took part in two focus groups (content analysis). Results The arms were equivalent at baseline. Time × Group interactions favoured MBCT on all three outcomes (all p < .001; partial η² = .13–.40). Both arms improved, but at three months MBCT showed lower depressive symptoms (mean difference 3.49, 95% CI [2.75, 4.23], d = 1.93), lower rumination ( d = 3.34) and higher mindfulness ( d = 2.16). Rumination gains were fully maintained after discharge ( p = 1.000) whereas controls deteriorated; mindfulness eroded partially in both arms. Minimal-symptom status was reached by 51.1% of MBCT participants versus 2.1% of controls ( p < .001), a number needed to treat of 2.0. Readmission was less frequent under MBCT (2 of 47 versus 7 of 47) but not significantly so (Fisher's exact p = .158). Three themes emerged: recognising emotions and automatic thoughts; behavioural change with self-compassion; and stress management for relapse prevention. Conclusions Brief, nurse-led, culturally adapted MBCT added clinically meaningful benefit to routine inpatient care, sustained to three months. The trial was underpowered for readmission. Partial erosion of mindfulness gains suggests booster contact may be needed. Preregistration TCTR20250927009, Registration date: September 27, 2025