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MBCT for Relapse Prevention — MRCPsych Paper B MCQ

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ModeratePsychotherapyMBCT for Relapse PreventionMRCPsych Paper B

A 40-year-old woman has remitted from her latest episode of recurrent depression following treatment with an antidepressant alone. She has had frequent recent episodes, continues to experience prominent rumination and is assessed as being at higher risk of relapse. She would prefer not to continue antidepressant medication. According to NICE NG222, what is the most appropriate role for mindfulness-based cognitive therapy (MBCT)?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — As a psychological intervention focused on relapse-prevention skills after remission in a person at higher risk

Explanation lettering: E = shown as B · D = shown as C · B = shown as D · C = shown as E

C is correct. NICE NG222 recommends considering group CBT or MBCT for relapse prevention when a person has remitted after antidepressant treatment alone, is assessed as being at higher risk of relapse and does not wish to continue antidepressants. MBCT should explicitly develop relapse-prevention skills and is usually delivered over eight sessions. Current NG222 does not restrict MBCT to people with three or more previous episodes; relapse risk is assessed using factors such as frequent or recent episodes, residual symptoms, rumination, previous severity and continuing psychosocial adversity. MBCT is therefore not automatically indicated after every first episode (A), is not a rapid acute treatment for severe depression (B), and does not treat the psychotic features of psychotic depression (D). It is one shared-decision relapse-prevention option rather than a universal replacement for maintenance medication or other therapies (E).

Reference: National Institute for Health and Care Excellence. Depression in adults: treatment and management (NG222), section 1.8, recommendations 1.8.1–1.8.8. 2022; last reviewed 30 January 2026. https://www.nice.org.uk/guidance/ng222/chapter/recommendations