The Effectiveness of Mindfulness-Based Interventions for Depressive Symptoms and Their Relationship to Interoceptive Awareness: A Systematic Review.

Mindfulness-based interventions (MBIs) derived from established programs such as Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, and Mindfulness-Integrated Cognitive Behavioural Therapy significantly reduce depressive symptoms and improve interoceptive awareness (IA) in adults. Across six studies with 646 participants, IA partially mediated the relationship between MBI participation and depression relief, though only one study directly tested mediation. Effect sizes varied. The review notes limitations including a small number of eligible studies, heterogeneity, and mixed evidence quality. Future research should standardize IA measurement and explore its mediating role further.

Study at a glance

Abstract

This systematic review aimed to investigate the effectiveness of mindfulness-based interventions (MBIs) in treating depression, enhancing interoceptive awareness (IA), and whether IA mediates this relationship. In August 2024, a comprehensive literature search was conducted in web-based medical and psychological databases, including PsycINFO, MEDLINE, and Scopus, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they were quantitative, peer-reviewed, in English, used MBIs derived from Mindfulness-based Stress Reduction (MBSR), Mindfulness-based Cognitive Therapy (MBCT), or Mindfulness-integrated Cognitive Behavioural Therapy (MiCBT), included a control/comparison group, pre- and post-intervention measures, assessed depressive symptoms and IA in adults over 18, and had at least 20 participants. Exclusion criteria included non-English publications, dissertations, case studies, qualitative research, therapies not derived from the specified MBIs, and studies with under 20 participants or individuals under 18. Methodological quality and risk of bias were assessed. Six studies involving 646 participants met the inclusion criteria. All MBIs (MBCT, MBSR, MiCBT, Mindfulness-based Cancer Recovery, and Mindful Awareness in Body-Oriented Therapy) significantly reduced depressive symptomology and improved IA across varying effect sizes, with IA identified as a partial mediator. MBIs appear to alleviate depressive symptoms and improve IA, with one study finding IA as a mediator. Limitations included limited literature, search term specificity, heterogeneity and mixed evidence quality. Future research should explore IA's mediating role, develop a standardised IA measure, and integrate IA into broader treatment modalities to enhance outcomes. CRD42023457300, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023457300.