The efficacy of mindfulness-based interventions on mental health among university students: a systematic review and meta-analysis.

A meta-analysis of 11 randomized controlled trials with 1,824 participants found that mindfulness therapy had small but significant positive effects on depression, anxiety, stress, and sleep quality. Depression scores improved moderately (standardized mean difference -0.33), anxiety improved similarly (-0.35), stress showed a slightly larger effect (-0.39), and sleep quality improved substantially (-0.81). However, mindfulness therapy did not significantly change mindfulness itself compared to control groups. The authors suggest future research should investigate whether improving adherence and fidelity to mindfulness therapy can further enhance mental health outcomes.

Study at a glance

Abstract

We aimed to estimate the effect of mindfulness therapy on mental health. Two researchers searched 12 databases to identify relevant trials that were published from 1 January 2018 to 1 May 2023. We performed a meta-analysis to determine the effect of mindfulness therapy on depression, which was measured by the Beck Depression Inventory (BDI), Patient Health Questionnaire-9 (PHQ-9), Quick Inventory of Depressive Symptomatology (QIDS), Hamilton Depression Rating Scale (HDRS), Patient-Reported Outcomes Measurement Information System (PROMIS), Hospital Anxiety and Depression Scale (HADS), and Depression Anxiety Stress Scales (DASS); anxiety, which was measured by the Beck Anxiety Inventory (BAI), PROMIS, and DASS, Generalized Anxiety Disorder-7 (GAD-7); stress, which was measured by the Perceived Stress Scale (PSS), DASS, and GAD-7; mindfulness, which was measured by the GAD-7, Five Facet Mindfulness Questionnaire (FFMQ), Mindful Attention Awareness Scale (MAAS), Short Form-12 Mental Component Score (SF-12 MCS) and Short Form-12 Physical Component Score (SF-12 PCS); and sleep quality, which was measured by the Pittsburgh Sleep Quality Index (PSQI). After screening studies based on the inclusion and exclusion criteria, 11 randomized controlled trials (RCTs) involving 1,824 participants were ultimately included. All these studies demonstrated positive effects of mindfulness therapy on depression (SMD = -0.33, 95% CI: [-0.44, -0.22], p < 0.00001, I2 = 29%), anxiety (SMD = -0.35, 95% CI: [-0.46, -0.25], p < 0.00001, I2 = 40%), stress (SMD = -0.39, 95% CI: [-0.48, -0.29], p < 0.00001, I2 = 69%) and sleep quality scores (SMD = -0.81, 95% CI: [-1.54, -0.09], p = 0.03, I2 = 0%). However, there was no significant difference in mindfulness (SMD = -0.12, 95% CI: [-0.36, -0.12], p = 0.34, I2 = 34%) between the mindfulness therapy group and the control group. In future studies, it is necessary to consider the investigation on whether the strategies of improving the mindfulness therapy in adherence and fidelity can work on the improvement of the outcomes in mental health. https://www.crd.york.ac.uk/PROSPERO/, https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42023469301].