Effectiveness of mindfulness-based cognitive therapy via e-health on anxiety and depression in adults: A meta-analysis.

Summary

Mindfulness-based cognitive therapy delivered through electronic health platforms (eMBCT) effectively reduces anxiety and depression, showing small effect sizes of -0.33 and -0.34 respectively, based on a meta-analysis of 12 randomized controlled trials involving 2,588 adults. Notably, eMBCT provided significant short- and long-term benefits, particularly for individuals with more severe initial symptoms. While the treatment shows promise, enhancing medium-term outcomes remains a priority for future development. This scalable approach offers a flexible option for managing mental health challenges in today's digital age.

Abstract

Anxiety and depression are highly prevalent mental health disorders, imposing significant burdens on individuals and healthcare systems. Mindfulness-based cognitive therapy (MBCT) has demonstrated effectiveness in reducing these symptoms. Electronic health MBCT (eMBCT) offers a scalable alternative, but its efficacy in alleviating anxiety and depression in adults remains unclear. To examine the treatment efficacy of eMBCT for adult anxiety and depression and identify potential moderators associated with better treatment outcomes. A systematic search was conducted across PubMed, PsycINFO, Web of Science, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials from inception to February 24, 2024. RCTs comparing eMBCT with usual care, waitlist controls, or active interventions in adults with anxiety or depression were included. Two independent reviewers conducted study selection, data extraction, and risk-of-bias assessment using the Cochrane Risk of Bias Tool. Standardized mean differences (SMDs) with 95 % confidence intervals (CIs) were calculated using Review Manager 5.3 and Stata 16.0 to estimate pooled effect sizes. Twelve RCTs (n = 2588) were included. eMBCT significantly reduced anxiety (SMD = -0.33, 95 % CI [-0.52, -0.15], P < 0.001) and depression (SMD = -0.34, 95 % CI [-0.50, -0.17], P < 0.001), with both effects representing a small effect size. Subgroup analysis showed significant short- and long-term effects, but no medium-term benefits. Greater baseline symptom severity was associated with larger improvements. eMBCT effectively alleviates anxiety and depression, with sustained benefits. Future research should enhance its medium-term and long-term effectiveness of eMBCT and explore relevant intervention features that offer patients more flexible and personalized care. CRD42024544712 (PROSPERO).

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