Online mindfulness-based vs. cognitive-behavioural stress reduction for medical students: A randomized controlled trial.

Both online mindfulness-based stress reduction (MBSR) and cognitive behavioural stress reduction (CBSR) reduced depression, anxiety, and perceived stress in medical students. In an analysis of all randomized participants, MBSR showed small to moderate effects (depression d=0.50, anxiety d=0.73, stress d=0.48) and CBSR showed similar effects (depression d=0.40, anxiety d=0.52, stress d=0.42), with no significant differences between the two. Among those who completed the program, improvements were moderate to strong, and MBSR was superior to CBSR for reducing anxiety. Greater adherence to the programs enhanced outcomes, particularly for MBSR's effect on anxiety.

Study at a glance

Abstract

This study evaluated the effects of Mindfulness-based stress reduction(MBSR) and cognitive behavioural stress reduction(CBSR) on depression, anxiety, and perceived stress in medical students. A total of 323 medical students studying in Ankara, Turkey, applied to participate and were assessed using the Mini International Neuropsychiatric Interview. Medical students with a psychotic disorder, manic episode, major depressive disorder with suicidal ideation, or previous experience with MBSR or cognitive-behavioural treatment were excluded from the study. After randomization, 253 students were allocated to either online MBSR (n = 127) or CBSR (n = 126). Symptoms of anxiety, depression, and perceived stress were assessed at baseline and post-intervention (week 8). Both intention-to-treat (ITT) and per-protocol (PP) analyses were conducted. Multiple imputation was used to address missing data. All interventions and assessments were conducted online, making this one of the few studies to evaluate digital mental health interventions in this population. In the ITT analysis, both interventions had small to moderate effects on improving depression (MBSR: d = 0.50; CBSR: d = 0.40), anxiety (MBSR: d = 0.73; CBSR: d = 0.52), and perceived stress (MBSR: d = 0.48; CBSR: d = 0.42), with no significant differences between them. The PP analysis revealed moderate to strong improvements in depression (MBSR: d = 1.03; CBSR: d = 0.74), anxiety (MBSR: r=-0.74; CBSR: r=-0.72), and perceived stress (MBSR: r=-0.80; CBSR: r=-0.68). While both interventions were comparable in reducing depressive symptoms and perceived stress, MBSR demonstrated superior efficacy in reducing anxiety. The findings indicate that both MBSR and CBSR may be effective in reducing anxiety, depression, and perceived stress in medical students. Greater adherence appears to enhance outcomes, particularly for MBSR in alleviating anxiety symptoms.