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The empirical support for mindfulness-based interventions for common psychiatric disorders: a systematic review and meta-analysis

  • Maria Hedman-Lagerlöf (a1), Erik Hedman-Lagerlöf (a1) and Lars-Göran Öst (a2)
Abstract

Mindfulness-based interventions (MBIs) have become widely used for common mental disorders (CMDs) but the state of the evidence has not been sufficiently investigated. The aims for this study were: (1) to quantify the effect size of MBIs for CMDs in the acute phase; (2) to explore moderator variables; and (3) to evaluate the evidence status of MBIs for the CMDs it has been tried for. A comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted. RCTs that evaluated MBI and included patients with a primary manifest CMD was included. Methodological quality, the risk of bias, publication bias and evidence status were assessed. Literature searches gave 2448 hits and 19 studies were included. MBIs were more effective than no treatment (g = 1.07) and treatment-as-usual (g = 0.40) but not in comparison to placebo (g = 0.17) or other active treatments (g = −0.01). Methodological quality was negatively correlated with outcome. For all psychiatric disorders it has been tested, MBIs were judged to have weak or no empirical support. The conclusion of the study is that the evidence-base for MBIs for CMDs in the acute phase is weak.

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Corresponding author
Author for correspondence: Maria Hedman-Lagerlöf, E-mail: maria.hedman-lagerlof@ki.se
References
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American Psychological Association, S. o. c. p. (2016) Research-Supported Psychological Treatments. American Psychological Association, Society of Clinical Psychology. Available at http://www.div12.org/psychological-treatments/.
Asmaee Majid, S, Seghatoleslam, T, Homan, H, Akhvast, A and Habil, H (2012) Effect of mindfulness based stress management on reduction of generalized anxiety disorder. Iranian Journal of Public Health 41, 2428.
Baer, RA (2003) Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice 10, 125143.
Balshem, H, Helfand, M, Schünemann, HJ, Oxman, AD, Kunz, R, Brozek, J et al. (2011) GRADE guidelines: 3. Rating the quality of evidence. Journal of Clinical Epidemiology 64, 401406.
Barnhofer, T, Crane, C, Hargus, E, Amarasinghe, M, Winder, R and Williams, JM (2009) Mindfulness-based cognitive therapy as a treatment for chronic depression: a preliminary study. Behaviour Research and Therapy 47, 366373.
Biegel, GM, Brown, KW, Shapiro, SL and Schubert, CM (2009) Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. Journal of Consulting and Clinical Psychology 77, 855866.
Black, DS, O'Reilly, GA, Olmstead, R, Breen, EC and Irwin, MR (2015) Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Internal Medicine 175, 494501.
Bower, JE, Crosswell, AD, Stanton, AL, Crespi, CM, Winston, D, Arevalo, J et al. (2015) Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer 121, 12311240.
Bränström, R, Kvillemo, P and Moskowitz, JT (2012) A randomized study of the effects of mindfulness training on psychological well-being and symptoms of stress in patients treated for cancer at 6-month follow-up. International Journal of Behavioral Medicine 19, 535542.
Brown, KW, Ryan, RM and Creswell, JD (2007) Mindfulness: theoretical foundations and evidence for its salutary effects. Psychological Inquiry 18, 211237.
Chambless, DL, Baker, MJ, Baucom, DH, Beutler, LE, Calhoun, KS, Crits-Christoph, P et al. (1998) Update on empirically validated therapies, II. The Clinical Psychologist 51, 316.
Chiesa, A, Castagner, V, Andrisano, C, Serretti, A, Mandelli, L, Porcelli, S et al. (2015) Mindfulness-based cognitive therapy vs. psycho-education for patients with major depression who did not achieve remission following antidepressant treatment. Psychiatry Research 226, 474483.
Chiesa, A and Serretti, A (2011) Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Research 187, 441453.
Degenhardt, L, Whiteford, HA, Ferrari, AJ, Baxter, AJ, Charlson, FJ, Hall, WD et al. (2013) Global burden of disease attributable to illicit drug use and dependence: findings from the global burden of disease study 2010. The Lancet 382, 15641574.
Delgado, LC, Guerra, P, Perakakis, P, Vera, MN, Reyes del Paso, G and Vila, J (2010) Treating chronic worry: psychological and physiological effects of a training programme based on mindfulness. Behaviour Research and Therapy 48, 873882.
Demarzo, MM, Cebolla, A and Garcia-Campayo, J (2015 a) The implementation of mindfulness in healthcare systems: a theoretical analysis. General Hospital Psychiatry 37, 166171.
Demarzo, MM, Montero-Marin, J, Cuijpers, P, Zabaleta-del-Olmo, E, Mahtani, KR, Vellinga, A et al. (2015 b) The efficacy of mindfulness-based interventions in primary care: a meta-analytic review. Annals of Family Medicine 13, 573582.
Dimidjian, S and Segal, ZV (2015) Prospects for a clinical science of mindfulness-based intervention. American Psychologist 70, 593620.
Duval, S and Tweedie, R (2000) Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56, 455463.
Egger, M, Davey Smith, G, Schneider, M and Minder, C (1997) Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 315, 629634.
Eisendrath, SJ, Gillung, E, Delucchi, KL, Segal, ZV, Nelson, JC, McInnes, LA et al. (2016) A randomized controlled trial of mindfulness-based cognitive therapy for treatment-resistant depression. Psychotherapy and Psychosomatics 85, 99110.
Galante, J, Iribarren, SJ and Pearce, PF (2013) Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. Journal of Research in Nursing 18, 133155.
Goyal, M, Singh, S, Sibinga, EM, Gould, NF, Rowland-Seymour, A, Sharma, R et al. (2014) Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine 174, 357368.
Gross, CR, Kreitzer, MJ, Thomas, W, Reilly-Spong, M, Cramer-Bornemann, M, Nyman, JA et al. (2010) Mindfulness-based stress reduction for solid organ transplant recipients: a randomized controlled trial. Alternative Therapies in Health and Medicine 16, 3038.
Grossman, P, Niemann, L, Schmidt, S and Walach, H (2004) Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research 57, 3543.
Guardino, CM, Dunkel Schetter, C, Bower, JE, Lu, MC and Smalley, SL (2014) Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy. Psychology & Health 29, 334349.
Hamidian, S, Omidi, A, Mousavinasab, SM and Naziri, G (2013) Comparison of the effect of mindfulness-based cognitive therapy accompanied by pharmacotherapy with pharmacotherapy alone in treating dysthymic patients. Iranian Red Crescent Medical Journal 15, 239244.
Hedges, LV (1982) Estimation of effect size from a series of independent experiments. Psychological Bulletin 92, 490499.
Higgins, JP, Altman, DG, Gotzsche, PC, Juni, P, Moher, D, Oxman, AD et al. Cochrane Bias Methods, G., Cochrane Statistical Methods, G. (2011) The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. British Medical Journal 343, d5928.
Hofmann, SG, Sawyer, AT, Witt, AA and Oh, D (2010) The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology 78, 169183.
Hoge, EA, Bui, E, Marques, L, Metcalf, CA, Morris, LK, Robinaugh, DJ et al. (2013) Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. The Journal of Clinical Psychiatry 74, 786792.
Jadad, AR, Moore, A, Carroll, D, Jenkinson, C, Reynolds, JM, Gavaghan, DJ et al. (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Controlled Clinical Trials 17, 112.
Jazaieri, H, Goldin, PR, Werner, K, Ziv, M and Gross, JJ (2012) A randomized trial of MBSR versus aerobic exercise for social anxiety disorder. Journal of Clinical Psychology 68, 715731.
Kabat-Zinn, J (1996) Full Catastrophe Living : How to Cope with Stress, Pain and Illness Using Mindfulness Meditation. London: Piatkus.
Kearney, DJ, McDermott, K, Malte, C, Martinez, M and Simpson, TL (2013) Effects of participation in a mindfulness program for veterans with posttraumatic stress disorder: a randomized controlled pilot study. Journal of Clinical Psychology 69, 1427.
Khoury, B, Lecomte, T, Fortin, G, Masse, M, Therien, P, Bouchard, V et al. (2013) Mindfulness-based therapy: a comprehensive meta-analysis. Clinical Psychology Review 33, 763771.
Koszycki, D, Benger, M, Shlik, J and Bradwejn, J (2007) Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder. Behaviour Research and Therapy 45, 25182526.
Lengacher, CA, Johnson-Mallard, V, Post-White, J, Moscoso, MS, Jacobsen, PB, Klein, TW et al. (2009) Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psycho-oncology 18, 12611272.
Lenz, AS, Hall, J and Bailey Smith, L (2016) Meta-analysis of group mindfulness-based cognitive therapy for decreasing symptoms of acute depression. Journal for Specialists in Group Work 41, 4470.
Lipsey, MW and Wilson, D (2001) Practical Meta-Analysis. London: SAGE.
Ludwig, DS and Kabat-Zinn, J (2008) Mindfulness in medicine. JAMA 300, 13501352.
McManus, F, Surawy, C, Muse, K, Vazquez-Montes, M and Williams, JM (2012) A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of Consulting and Clinical Psychology 80, 817828.
Michalak, J, Schultze, M, Heidenreich, T and Schramm, E (2015) A randomized controlled trial on the efficacy of mindfulness-based cognitive therapy and a group version of cognitive behavioral analysis system of psychotherapy for chronically depressed patients. Journal of Consulting and Clinical Psychology 83, 951963.
Moher, D, Liberati, A, Tetzlaff, J and Altman, DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLOS Medicine 151, 264269, W64.
National Institute for Clinical Excellence (2011) Generalised Anxiety Disorder and Panic Disorder (with or without Agoraphobia) in Adults: Management in Primary, Secondary and Community Care. London: National Collaborating Centre for Mental Health.
National Institutes of Health (2017) U.S. Department of Health & Human Services. Bethesda, MD: National Institutes of Health, USA.gov.
Ong, JC, Manber, R, Segal, Z, Xia, Y, Shapiro, S and Wyatt, JK (2014) A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep 37, 15531563.
Öst, L-G (2008) Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis. Behaviour Research and Therapy 46, 296321.
Öst, L-G (2014) The efficacy of acceptance and commitment therapy: an updated systematic review and meta-analysis. Behaviour Research and Therapy 61, 105121.
Öst, L-G, Havnen, A, Hansen, B and Kvale, G (2015) Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014. Clinical Psychology Review 40, 156169.
Öst, L-G, Riise, EN, Wergeland, GJ, Hansen, B and Kvale, G (2016) Cognitive behavioral and pharmacological treatments of OCD in children: a systematic review and meta-analysis. Journal of Anxiety Disorders 43, 5869.
Owens, DK, Lohr, KN, Atkins, D, Treadwell, JR, Reston, JT, Bass, EB et al. (2010) AHRQ series paper 5: grading the strength of a body of evidence when comparing medical interventions – agency for healthcare research and quality and the effective health-care program. Journal of Clinical Epidemiology 63, 513523.
Piet, J and Hougaard, E (2011) The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clinical Psychology Review 31, 10321040.
Piet, J, Hougaard, E, Hecksher, MS and Rosenberg, NK (2010) A randomized pilot study of mindfulness-based cognitive therapy and group cognitive-behavioral therapy for young adults with social phobia. Scandinavian Journal of Psychology 51, 403410.
Plank, K (2010) Mindful medicine: the growing trend of mindfulness-based therapies in the Swedish health care system. Finnish Journal of Ethnicity and Migration 5, 4755.
Polusny, MA, Erbes, CR, Thuras, P, Moran, A, Lamberty, GJ, Collins, RC et al. (2015) Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: a randomized clinical trial. JAMA 314, 456465.
Possemato, K, Bergen-Cico, D, Treatman, S, Allen, C, Wade, M and Pigeon, W (2015) A randomized clinical trial of primary care brief mindfulness training for veterans With PTSD. Journal of Clinical Psychology 72, 179193.
Segal, ZV, Bieling, P, Young, T, MacQueen, G, Cooke, R, Martin, L et al. (2010) Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression. Archives of General Psychiatry 67, 12561264.
Shapiro, DA and Shapiro, D (1982) Meta-analysis of comparative therapy outcome studies: A replication and refinement. Psychological Bulletin 92, 581604.
Southam-Gerow, MA and Prinstein, MJ (2014) Evidence base updates: the evolution of the evaluation of psychological treatments for children and adolescents. Journal of Clinical Child & Adolescent Psychology 43, 16.
Strauss, C, Cavanagh, K, Oliver, A and Pettman, D (2014) Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLoS ONE 9, e96110.
Sundquist, J, Lilja, A, Palmer, K, Memon, AA, Wang, X, Johansson, LM et al. (2015) Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: randomised controlled trial. The British Journal of Psychiatry 206, 128135.
Teasdale, JD, Segal, ZV, Williams, JM, Ridgeway, VA, Soulsby, JM and Lau, MA (2000) Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 68, 615623.
van Aalderen, JR, Donders, AR, Giommi, F, Spinhoven, P, Barendregt, HP and Speckens, AE (2012) The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: a randomized controlled trial. Psychological Medicine 42, 9891001.
Vollestad, J, Nielsen, MB and Nielsen, GH (2012) Mindfulness- and acceptance-based interventions for anxiety disorders: a systematic review and meta-analysis. British Journal of Clinical Psychology 51, 239260.
Wahbeh, H, Goodrich, E, Goy, E and Oken, BS (2016) Mechanistic pathways of mindfulness meditation in combat veterans With posttraumatic stress disorder. Journal of Clinical Psychology 72, 365383.
Wampold, BE, Mondin, GW, Moody, M, Stich, F, Benson, K and Ahn, H-n (1997) A meta-analysis of outcome studies comparing bona fide psychotherapies: Empiricially, “all must have prizes.” Psychological Bulletin 122, 203215.
Weisz, JR, Weiss, B, Han, SS, Granger, DA and Morton, T (1995) Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin 117, 450468.
Williams, JM, Crane, C, Barnhofer, T, Brennan, K, Duggan, DS, Fennell, MJ et al. (2014) Mindfulness-based cognitive therapy for preventing relapse in recurrent depression: a randomized dismantling trial. Journal of Consulting and Clinical Psychology 82, 275286.
Zhang, JX, Liu, XH, Xie, XH, Zhao, D, Shan, MS, Zhang, XL et al. (2015) Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial. Explore (NY) 11, 180185.
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