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

Electronic mindfulness-based cognitive therapy (eMBCT) reduces anxiety and depression in adults with small but significant effects that are sustained over time. A meta-analysis of 12 randomized controlled trials with 2,588 participants found that eMBCT lowered anxiety (standardized mean difference -0.33) and depression (-0.34) compared to usual care, waitlist, or active interventions. Greater baseline symptom severity was linked to larger improvements. Short- and long-term benefits were observed, but medium-term effects were not significant. The findings suggest eMBCT is an effective scalable treatment, though further research is needed to enhance medium- and long-term outcomes and tailor interventions for flexible patient care.

Study at a glance

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).