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Major Depressive Disorder, Recurrent, in RemissionBECOMENCT06832605

Mindfulness-Based Cognitive Therapy (MBCT) for the Prevention of Depression Relapse or Recurrence Using Videoconference

A study testing Group Mindfulness-Based Cognitive Therapy, Mindfulness-Based Cognitive Therapy Self-Help and Treatment as Usual (TAU) in people with Major Depressive Disorder, Recurrent, in Remission and Major Depressive Disorder, Recurrent, Mild, run by Fundació Sant Joan de Déu at 5 sites in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Objectives: To evaluate the clinical- and cost-effectiveness of two delivery formats of mindfulness-based cognitive therapy (MBCT) - (i) MBCT delivered through eight videoconference group sessions (group MBCT), and (ii) MBCT delivered through a self-help manual plus three low-intensity videoconference group support… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Group Mindfulness-Based Cognitive Therapy, Mindfulness-Based Cognitive Therapy Self-Help and Treatment as Usual (TAU)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
342 participants
Where
5 sitesSpain
Study dates
10 Jun 2026to Sep 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age over 18.
  • Diagnosis of recurrent major depressive disorder, with ≥ 2 previous major depressive episodes (MDD), either in an acute mild/moderate episode or in remission.
  • Internet access (via smartphone or personal computer).
  • Spanish literacy (spoken and written).

Who cannot join

  • Current severe depressive episode (≥24 on the GRID-HAMD)
  • Current or past psychosis, bipolar 1 disorder, a history of schizophrenia, schizoaffective disorder, organic mental disorder, current severe substance abuse, organic brain damage, pervasive developmental delay, persistent antisocial behaviour, recent (in the past 6 months) self-injury requiring clinical management or therapy according to medical records and clinical judgment.
  • Formal concurrent structured psychotherapy during the intervention period.
  • No experience in the use of new technologies (smartphones or computers).
  • Having completed a mindfulness-based structured training and/or extensive meditation experience (i.e., previous participation in meditation retreats (≥1) or regular (≥ weekly) meditation practice) in the previous year, or intending to commence meditation retreats or meditation practice during the study.

Trial locations and contacts

5 sites in 1 country. Contact the study team or a site near you to ask about taking part.

5 sites in 1 country

Spain5 sites, 5 recruiting
  • Parc de Salut Mar

    Barcelona, Barcelona, 08003

    Matilde Elices, Doctor, melices@researchmar.net

    Recruiting
  • Fundacio Centre Higiene Mental Nou Barris

    Barcelona, Barcelona

    Giusi Rametti, Doctor, giusi.rametti@csm9b.com

    Recruiting
  • Hospital General Universitario de Elche

    Elche, Alicante, 03203

    Jose M Rico, Doctor, rico_josgom@gva.es

    Recruiting
  • Parc Sanitari Sant Joan de Déu (PSSJD)

    Sant Boi de Llobregat, Barcelona, 08830

    Jesus Montero, PhD, (+34) 936 615 208 ext. 12733, jesus.montero@sjd.es

    Recruiting
  • Hospital Universitario Miguel Servet

    Zaragoza, Zaragoza, 50009

    Javier Prado, Doctor, jprado@salud.aragon.es

    Recruiting

Other trials in Spain

About this study

Official title: Effectiveness and Cost-Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the Prevention of Depression Relapse or Recurrence Using Videoconference in the Spanish National Health System

Objectives: To evaluate the clinical- and cost-effectiveness of two delivery formats of mindfulness-based cognitive therapy (MBCT) - (i) MBCT delivered through eight videoconference group sessions (group MBCT), and (ii) MBCT delivered through a self-help manual plus three low-intensity videoconference group support sessions (supported MBCT self-help) - when added to treatment as usual (TAU; mental health outpatient care), compared with TAU alone, in patients with recurrent depression, either in an acute episode or in remission. We will identify potential predictors and moderators of response and examine psychological mechanisms of change. Study design: Multicentre randomised controlled trial, with pre-post, 6- and 12-months follow-ups. Centres: Parc Sanitari Sant Joan de Déu (St. Boi de Llobregat), Hospital Universitario Miguel Servet (Zaragoza), Hospital del Mar (Barcelona), Fundació Centre Higiene Mental Nou Barris (Barcelona), and Hospital General Universitario de Elche (Elche, Alicante). Participants: Adult patients (n=342) with recurrent depression, either in an acute episode or in remission, will be randomly assigned to group MBCT, supported MBCT self-help, or TAU. Primary outcome: transitions between clinically defined states of recurrent depression over the 12-month follow-up (DSM-5). The primary confirmatory transition is from remission to a major depressive episode (relapse/recurrence), whereas the transition from acute depression to remission will be examined as an exploratory objective. Secondary outcomes: depressive symptom severity, negative affect, mental well-being, quality of life, costs, and quality-adjusted life years. Process measures: mindfulness, positive affect, and self-compassion. Main statistical analyses: The primary analysis will use the intention-to-treat (ITT) principle and continuous-time multi-state modelling to estimate transition-specific hazard ratios. Secondary outcomes, predictors, and moderators will be analysed using regression-based approaches. Cost-effectiveness and cost-utility analyses will be conducted from healthcare system and societal perspectives, alongside mediation analyses. Participant experiences will be evaluated using qualitative methods. Conclusions: This study will inform the implementation of two accessible MBCT formats in Spain for preventing depressive relapse/recurrence. The comparison of two delivery formats will provide evidence on effectiveness, cost-effectiveness, scalability, and efficient resource allocation.

Read the detailed description

The BECOME trial was developed to fill an important evidence gap on whether Mindfulness-Based Cognitive Therapy (MBCT) is clinically effective and cost-effective across different stages of recurrent depression within the Spanish National Health System (NHS). While MBCT has strong evidence as an alternative to maintenance antidepressant medication (m-ADM) for people with recurrent depression, most of this research has been conducted outside Spain and has not been confirmed in a sufficiently powered, multicentre randomized controlled trial in the Spanish setting. This gap is especially relevant in the post-COVID-19 period, when depressive disorders have increased in prevalence and severity, adding pressure to already overstretched public mental health services. Recurrent depression also carries a high social and economic burden in Spain, making the identification of effective, scalable, and sustainable interventions to improve outcomes across the clinical trajectory of recurrent depression a public health priority. Most prior studies have focused on face-to-face MBCT and have given limited attention to implementation constraints in publicly funded systems. In addition, many patients report concerns about long-term antidepressant use (e.g., side effects and adherence difficulties) and often prefer psychological approaches, highlighting the need to evaluate acceptable and accessible alternatives such as MBCT. By comparing videoconference-delivered group MBCT and supported MBCT self-help against treatment as usual (TAU), this study aims to provide pragmatic evidence on whether different MBCT delivery formats can broaden access to individuals across the clinical trajectory of recurrent depression while preserving clinical benefit and good value for money in routine services. The trial will also assess outcomes from both healthcare and societal perspectives, which is important given the significant indirect costs of recurrent depression in Spain, including work disability and reduced productivity. As digitally supported care becomes more common, rigorous evaluation of its clinical and economic impact is essential to ensure that digital delivery improves outcomes and delivers measurable public health value.

Being tested
Group Mindfulness-Based Cognitive Therapy, Mindfulness-Based Cognitive Therapy Self-Help, Treatment as Usual (TAU)
Keywords
Depression, MBCT, Relapse/recurrence prevention, RCT, cost-effectiveness
Medical subject headings
Depressive Disorder, Major, Recurrence, Lymphoma, Follicular, Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Group Mindfulness-Based Cognitive TherapyBehavioural

    Also called Mindfulness Based Cognitive Therapy, Treatment as Usual (TAU)

    Videoconference-delivered group MBCT will be provided in line with the manual 'Mindfulness-Based Cognitive Therapy for Depression'. The program will be led by Spanish MBCT therapists who are trained and certified, and who will also complete a 2-day study standardisation course. After this training, therapists must demonstrate at least "competent" teaching skills, confirmed by an independent assessor using the Mindfulness-Based Interventions Teaching Assessment Criteria (MBI:TAC). Competency will be defined as a score of 4-6 based on the rating of a randomly selected recorded session. Group MBCT is a structured mindfulness meditation program designed to help participants learn skills to reduce the risk of depression relapse or recurrence. It will be delivered over 8 weeks in weekly group sessions lasting 2 hours, with approximately 12 participants per group, and includes between-session home practice.

  • Mindfulness-Based Cognitive Therapy Self-HelpBehavioural

    Also called Mindfulness Based Cognitive Therapy, Treatment as Usual (TAU)

    Participants work through the Spanish version of 'The Mindful Way Workbook: An 8-Week Program to Free Yourself from Depression and Emotional Distress' on their own, following weekly instructions and mindfulness exercises. The workbook presents the standard 8-week MBCT program in a self-guided format. It also includes reflection questions, tools to monitor progress, and feedback from people who have previously completed the program. To support engagement and manage difficulties, participants will also take part in three structured, low-intensity group support sessions with a health psychologist (at the start, mid-point, and end of the program). Each session will last 1 hour, be delivered by group videoconference, and include approximately 12 participants per group.

  • Treatment as Usual (TAU)Other

    TAU (treatment as usual) will be delivered as it is in routine clinical practice. In Spain, ongoing care for recurrent depression commonly relies on maintenance antidepressant medication (m-ADM). Spanish National Health System guidelines recommend continuing antidepressants for at least two years at the same dose that was effective during the acute treatment phase. Participants will be advised that, if they notice a worsening of symptoms or encounter difficulties during the study, they should seek help from their primary care General Practitioner or their usual mental health service provider, as they would normally do.

Study groups in NCT06832605
Study groupRoleWhat they receive
Treatment as Usual (TAU)Active comparatorTAU will be delivered as it is in routine clinical practice.
Receives: Other: Treatment as Usual (TAU)
Supported Mindfulness-Based Cognitive Therapy Self-HelpActive comparatorPatients will continue receiving TAU at the same time.
Receives: Behavioral: Mindfulness-Based Cognitive Therapy Self-Help
Group Mindfulness-Based Cognitive TherapyExperimentalPatients will continue receiving TAU at the same time.
Receives: Behavioral: Group Mindfulness-Based Cognitive Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Transition from remission to relapse/recurrence, analysed within a continuous-time multi-state model over 12 months

    The primary outcome will be transitions between clinically defined states of recurrent depression over the 12-month follow-up, assessed in a time-to-event analysis. The primary confirmatory transition is from remission to a major depressive episode (relapse/recurrence), whereas the transition from acute depression to remission will be examined as an exploratory objective. The presence of depression between assessments will be assessed retrospectively according to the Longitudinal Interval Follow-up Evaluation (LIFE), a form of the Structured Clinical Interview for DSM-5 (SCID) designed for longitudinal studies.

    Measured: 6- and 12-month follow-ups

Secondary outcomes (7)
  1. GRID-HAMD

    Depressive symptoms

    Measured: Baseline, post-treatment, and 6- and 12-month follow-ups

  2. Patient Health Questionnaire (PHQ-9)

    Depressive symptoms

    Measured: Baseline

  3. Positive and Negative Affect Schedule (PANAS)

    Negative Affect

    Measured: Baseline, post-treatment, and 6- and 12-month follow-ups

  4. Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS)

    Mental well-being

    Measured: Baseline, post-treatment, and 6- and 12-month follow-ups

  5. EuroQoL-5D (EQ-5D-5L)

    Health-related quality of life

    Measured: Baseline, post-treatment, and 6- and 12-month follow-ups

  6. Client Service Receipt Inventory (CSRI)

    Use of health and social services

    Measured: Baseline, 12-month follow-ups

  7. Self-Report Quick Inventory of Depressive Symptomatology (QIDS-SR16)

    Depressive symptom severity Score range is 0-27, lower scores indicating lower depressive symptom severity.

    Measured: Baseline, post-treatment, 6- and 12-month follow-ups

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Feb 2025
  2. Study start10 Jun 2026
  3. Primary completionDec 2027 (estimated)
  4. Study completionSep 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
342 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06832605
Sponsor's protocol ID
PI23/00021
Acronym
BECOME
Status last verified
Aug 2026
First submitted
9 Jan 2025
Last updated
3 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Questions about this trial

What is this clinical trial studying?

A study testing Group Mindfulness-Based Cognitive Therapy, Mindfulness-Based Cognitive Therapy Self-Help and Treatment as Usual (TAU) in people with Major Depressive Disorder, Recurrent, in Remission and Major Depressive Disorder, Recurrent, Mild, run by Fundació Sant Joan de Déu at 5 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 3 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jesus Montero, PhD ((34) 936 615 208 - 12733, jesus.montero@sjd.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Transition from remission to relapse/recurrence, analysed within a continuous-time multi-state model over 12 months (time frame: 6- and 12-month follow-ups). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Sep 2026.

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