Ghanizadeh, Abotorabi-Zarchi, mohammadi et al Iranian J Psychiatry 11:3, July 2016 ijps.tums.ac.ir 166 The Effect of Combining Mindfulness-Based Cognitive Therapy with Pharmacotherapy on Depression and Emotion Regulation of Patients with Dysthymia: A Clinical Study Sajedeh Hamidian, MSc 1 Abdollah Omidi, PhD 2 Seyyed Masoud Mousavinasab, MD 3 Ghasem Naziri, PhD 4 1. Master of Clinical Psychology, Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran. 2. Associate Professor, Department of Clinical Psychology, Kashan University of Medical Sciences, Kashan, Iran. 3. Professor, Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran. 4. Assistant Professor, Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran. Corresponding author: Ghasem Naziri, PhD Assistant Professor, Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran. Tel: 07136472570 Fax: 07136472570 Email: Naziryy@yahoo.com Objective: Mindfulness skills are assumed to be related with emotions. Deficits in emotion regulation could lead to development and persistence of mood disorders. Dysthymia and double depression are two chronic types of depression. This chronicity can be attributed to the one’s inability to regulate his/ her mood. In this study, we aimed to evaluate the effect of mindfulness-based cognitive therapy (MBCT), which is one of the proposed methods for emotion regulation, on depression and the ability of emotion regulation of patients with dysthymia. Method: This clinical trial was conducted on 50 dysthymic and double depressed patients. They were selected through convenience sampling and assigned into intervention and control groups. The control group received only medication, while the MBCT group participated in an eight- session program once a week with each session lasting for two to two and half hours in addition to receiving medication. All the participants filled out Beck Depression Inventory II and Difficulties in Emotion Regulation Scale before and after the program. Data were analyzed using the SPSS statistical software (Version 16) and univariate covariance statistical method. Results: While there were no statistically significant differences between the two groups with respect to the demographic characteristics, we observed a statistically significant improvement in the defined variables in post-test of the MBCT group compared to the case group. Conclusion: The results of this study revealed that combining MBCT and pharmacotherapy could cause significant improvement in depression symptoms and increase the patient’s ability to regulate emotion compared to pharmacotherapy alone. Key words: Dysthymia, Emotion Regulation, Mindfulness-Based Cognitive Therapy The concept of depression has been recognized among the physicians. Avicenna, in his book Canon of Medicine, referred to depression as “melancholy” and defined it as a disorder in which the thought deviates from the natural path leading to destruction and fear. He believes that this disorder is caused by ill-tempered dry and cold humor. In his opinion, dry and cold humor is opposed to and hurts the spirit (1). Dysthymia can be initially differentiated from major depression by its chronic nature and less severe symptoms. Among the signs considered for major depression in DSM-IV, only psychomotor disorder and suicide thoughts cannot be observed in dysthymia. This is somewhat in line with the studies conducted by Beck et al. (1987) who reported suicide thoughts and loss of appetite not to be the features of dysthymia (2). A high rate of comorbid disorders are observed in this disorder, which is usually accompanied by other psychological disorders such as anxiety disorders, drug abuse, and alcohol abuse. In addition, more than 75% of individuals with dysthymia experience exacerbations in their symptoms in the form of major depressive disorder (3-7), which is defined as “double depression” (7, 8). Following the signs of dysthymia predicts strong risk factors for major depression for both children and adults (7). Emotion regulation or control has been a central concept for many Asian and European philosophers. For instance, Spinoza, a 17th century philosopher, was highly interested in emotions; he differentiated the negative emotions and positive ones and emphasized the regulation of the passions. Studies by Block and Block (1980) on ego resilience directly affected the present works on emotion regulation. Block emphasized the inefficient nature of over-controlling and importance of flexible, optimum control for more compatibility (9). Mood disorders are accompanied by disorders in perception and processing of the emotional information Original Article Iran J Psychiatry 2016; 11:3: 166-172