Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs

Mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) modestly improve depressive symptoms, anxiety, stress, quality of life, and physical functioning across a range of chronic conditions. A systematic review and meta-analysis of 23 reviews covering 115 randomized controlled trials and 8,683 individuals found that, compared with waitlist or treatment as usual, these programs yielded small to moderate benefits: depressive symptoms (Cohen's d=0.37), anxiety (d=0.49), stress (d=0.51), quality of life (d=0.39), and physical functioning (d=0.27). The evidence supports their use as adjunct treatments for cancer, cardiovascular disease, chronic pain, depression, anxiety disorders, and prevention in healthy adults and children, though heterogeneity, possible publication bias, and limited long-term follow-up temper confidence.

Study at a glance

Abstract

BACKGROUND: Mindfulness-based therapies are being used in a wide range of common chronic conditions in both treatment and prevention despite lack of consensus about their effectiveness in different patient categories. OBJECTIVE: To systematically review the evidence of effectiveness MBSR and MBCT in different patient categories. METHODS: A systematic review and meta-analysis of systematic reviews of RCTs, using the standardized MBSR or MBCT programs. We used PRISMA guidelines to assess the quality of the included reviews and performed a random effects meta-analysis with main outcome measure Cohen's d. All types of participants were considered. RESULTS: The search produced 187 reviews: 23 were included, covering 115 unique RCTs and 8,683 unique individuals with various conditions. Compared to wait list control and compared to treatment as usual, MBSR and MBCT significantly improved depressive symptoms (d=0.37; 95%CI 0.28 to 0.45, based on 5 reviews, N=2814), anxiety (d=0.49; 95%CI 0.37 to 0.61, based on 4 reviews, N=2525), stress (d=0.51; 95%CI 0.36 to 0.67, based on 2 reviews, N=1570), quality of life (d=0.39; 95%CI 0.08 to 0.70, based on 2 reviews, N=511) and physical functioning (d=0.27; 95%CI 0.12 to 0.42, based on 3 reviews, N=1015). Limitations include heterogeneity within patient categories, risk of publication bias and limited long-term follow-up in several studies. CONCLUSION: The evidence supports the use of MBSR and MBCT to alleviate symptoms, both mental and physical, in the adjunct treatment of cancer, cardiovascular disease, chronic pain, depression, anxiety disorders and in prevention in healthy adults and children.