Table 1.

Characteristics and findings of included studies

Study and method	Participants	Recruitment	Intervention/conditions	Measures utilised	Key findings
Bondolfi et al. (2010) RCT Country: Switzerland	60 randomised, 43 females; 17 males MBCT + TAU median age = 46 years TAU median age = 49 years	History of major depressive disorder ≥ 3 episodes In remission and not taking medication	MBCT + TAU: 8 weekly × 2 h sessions, French translation MBCT manual utilised 4 MBCT booster sessions provided over 3 months follow-up TAU: seek treatment as normal	Outcome: SCID	Time to relapse was significantly longer for MBCT + TAU compared to TAU alone
Cash et al. (2015) RCT Country: USA	91 randomised, all female 18 years+	Diagnosis of fibromyalgia Females Available to attend weekly groups	MBSR: 8 weekly × 2.5 h sessions Wait-list control: offered the MBSR programme following study	Outcome: BDI CTQ PSS SSQ FSI FIQ	MBSR significantly reduced perceived stress, sleep disturbance and symptom severity, gains maintained at follow-up MBSR did not significantly alter pain, physical functioning or cortisol
Crane et al. (2014) RCT Country: UK	274 randomised, 198 females; 76 males Mean age of sample = 43 years, range 18–68 years	History of major depressive disorder ≥ 3 episodes Remission for the previous 8 weeks Informed consent from primary care physicians	MBCT: 8 weekly × 2 h session and 2 follow-up sessions at 6 weeks and 6 months post-treatment Cognitive Psychological Education (CPE): 8 weekly × 2 h session and 2 follow-up sessions provided at 6 weeks and 6 months post-treatment TAU: seek treatment as normal	Outcome: SCID CTQ HAMD Process: MBI-TAC	See home-practice findings
Day et al. (2016) Secondary analysis of a RCT Country: USA	36 randomised, 32 females, 4 males Mean age of total sample = 41.7 years	19+ years old ≥ 3 pain days per month due to a primary headache pain If using medication, must have begun ≥ 4 weeks before baseline assessment	MBCT: 8 weekly × 2 h session and 2 follow-up sessions at 6 weeks and 6 months post-treatment, continued medical treatment as usual Delayed treatment (DT): medical treatment as usual, then completed MBCT	Outcome: CSQ WAI-SF BPI CPEG Process: MBCT-AAQS	Therapists’ adherence and quality were both significant predictors of post-treatment client satisfaction Baseline pain intensity was positively associated with pre-treatment expectations, motivations and working alliance
Davidson et al. (2003) RCT Country: USA	41 randomised, 29 females, 12 males Average age of sample = 36 years, range = 23–56 years	Employees of Biotechnological Corporation in Madison, Wisconsin Right-handed	MBSR: 8 weekly × 2.5–3 h sessions, 7 h silent retreat Wait-list control: offered the MBSR programme following the study	Outcome: PANAS STAI	Meditation can produce increases in relative left-sided anterior activation that are associated with reductions in anxiety and negative affect and increases in positive affect
Dimidjian et al. (2016) Pilot RCT Country: USA	86 randomised MBCT-PD mean age = 31 years TAU mean age = 29 years	Pregnant adult women up to 32 weeks gestation History of major depressive disorder Available to attend weekly groups	MBCT-PD: adapted MBCT for peri-natal depression, 8 weekly × 2 h sessions, 1 monthly follow-up class TAU: free to continue or initiate mental health care	Outcome: SCID SCID-II CSQ LIFE EPDS	Significantly lower rates of relapse and depressive symptoms through 6 months post-partum in MBCT-PD compared to TAU MBCT-PD for at-risk pregnant women was acceptable based on rates of attendance and at-home-practice assignments
Gross et al. (2011) Pilot RCT Country: USA	30 randomised, 22 females, 8 males MBSR median age = 47 years PCT median age = 53.50 years	Diagnosis of primary insomnia Not taking sleep medication Adults English speaking	MBSR: 8 weekly × 2.5 h sessions and a day-long retreat (6 h) Pharmacotherapy (PCT): 3 mg of eszopiclone nightly for 8 weeks and as needed for 3 months follow-up Plus 10 min presentation on sleep hygiene	Outcome: ISI PSQI DBAS-16 SSES STAI CES-D SF-12 Other: sleep diary	MBSR achieved reductions in insomnia symptoms and improvements in sleep quality comparable to PCT Higher treatment satisfaction in MBSR compared to PCT
Johns et al. (2015) Pilot RCT Country: USA	35 randomised, 33 females, 2 males MBSR-CRF mean age = 58.80 years Wait-list control mean age = 55.70 years	Diagnosis of cancer and clinically significant cancer-related fatigue (CRF) for 8 weeks 18+ years old	MBSR-CRF: 7 weekly × 2 h sessions and brief psycho-education on CRF, adapted MBSR for cancer-related fatigue Wait-list control: offered the MBSR programme following the study	Outcome: FSI SF-36 SDS PHQ-9 ISI PHQGADS	MBSR demonstrated significantly greater improvements in fatigue interference than controls and significant improvements in depression and sleep disturbance, improvements in symptoms maintained at 6-month follow-up MBSR proved acceptable to fatigued cancer survivors
King et al. (2013) Pilot non-randomised controlled trial Country: USA	37 participants MBCT mean age = 60.10 years TAU mean age = 58.30 years	Long-term >10 years PTSD or PTSD in partial remission All experienced combat-related traumas from military services	MBCT: adapted for combat-related PTSD, 8 weekly × 2 h sessions TAU: 8 × 1 h sessions of Psychoed: PTSD psycho-education and skills and IRT: 6 × 1.5 h sessions, of imagery rehearsal therapy	Outcome: PDS PTCI	MBCT proved an acceptable intervention for PTSD symptoms evidenced by engagement in programme and resulted in significant improvement in PTSD symptoms pre- vs post-MBCT compared to TAU and clinically meaningful improvement in PTSD symptom severity and cognitions
MacCoon et al. (2012) RCT Country: USA	63 randomised, 47 females, 16 males MBSR mean age = 44.50 years HEP mean age = 47.50 years	18–65 years Right-handed No previous experience of meditation English speaking In good general health	MBSR: 8 weekly × 2.5 h sessions, 7 h/day retreat Health Enhancement Programme (HEP): 8 weekly × 2.5 h sessions, 7 hr day retreat, programme to match MBSR, activities valid active therapeutic ingredients but no mindfulness	Outcome: SCL-90-R MSC	Significant improvements for general distress, anxiety, hostility and medical symptoms but no differences between interventions, MBSR pain rating decrease compared to HEP HEP is an active control condition for MBCT
Perich et al. (2013) RCT Country: Australia	95 participants randomised, 62 females, 33 males No information on age provided	Diagnosis of bipolar I or II disorder, experienced 1+ episode over the past 18 months and lifetime of 3+ episodes Symptoms controlled on a mood stabiliser 18+ years of age, English speaking	MBCT: 8 weekly sessions, duration of each session not given. Followed Segal et al. (2002) protocol TAU: treatment as usual Both conditions received weekly psycho-educational material on bipolar disorder	Outcome: DASS STAI YMRS MADRS CIDI SCID Process: MAAS TMS	See home-practice findings
Speca et al. (2000) RCT Country: Canada	90 randomised, 73 females, 17 males Mean age of sample = 51 years, age range = 27–75 years	Diagnosis of cancer at any time point were eligible to participate	MBSR: 7 weekly × 1.5 h sessions, adapted version of Kabat-Zinn MBSR programme Wait-list control: offered the MBSR programme following the study	Outcome: POMS SOSI	MBSR effectively reduced mood disturbance, fatigue and a broad spectrum of stress-related symptoms
Wells et al. (2014) Pilot RCT Country: USA	19 randomised, 17 females, 2 males MBSR mean age = 45.90 years TAU mean age = 45.20 years	Diagnosis of migraine, ≥ 1 year history of migraines Available to attend weekly sessions 18+ years old English speaking	MBSR: 8 weekly × 2 h sessions plus 1-day (6 h) retreat. Utilised Kabat-Zinn protocol TAU: continue with care as usual and asked not to start a yoga or meditation during study. Offered MBSR following the study	Outcome: HIT-6 MIDAS MSQ PHQ-9 STAI PSS-10 HMSES Process: FFMQ	MBSR is safe and feasible for adults with migraines Secondary outcomes demonstrated that MBSR had a beneficial effect on headache duration, disability, self-efficacy and mindfulness
Whitebird et al. (2012) RCT Country: USA	78 randomised, 69 females, 9 males MBSR mean age = 56.40 years CCES mean age = 57.20 years	Self-identified as primary caregiver of family member with dementia 21+ years old English speaking	MBSR: 8 weekly × 2.5 h sessions, 5-h day retreat Community Caregiver Education Support (CCES): 8 weekly × 2.5 h sessions, 5-h retreat day. Education on issues affecting family caregivers and group social and emotional support	Outcome: PSS CES-D STAI SF-12 MBCBS MOSSSS	MBSR is a feasible and acceptable intervention for dementia caregivers, MBSR improved overall mental health, reduced stress and decreased depression at post-intervention compared to CCES Both interventions improved caregiver mental health, anxiety, social support and burden

SCID Structured Clinical Interview for DSM-IV (First et al. 1996), SSQ Stanford Sleep Questionnaire (Douglass et al. 1994), BDI Beck Depression Inventory (Beck et al. 1961), FSI The Fatigue Symptom Inventory (Hann et al. 1998), CTQ Childhood Trauma Questionnaire (Bernstein and Fink 1998), FIQ Fibromyalgia Impact Questionnaire (Burckhardt et al. 1991), PSS Perceived Stress Scale (Cohen et al. 1983), CSQ Client Satisfaction Questionnaire (Attkisson and Zwick 1982), WAI-SF Working Alliance Inventory-Short Form (Hatcher and Gillaspy 2006), HAMD Hamilton Rating Scale for Depression (Hamilton 1960), BPI Wisconsin Brief Pain Inventory (Cleeland and Ryan 1991), MBI-TAC Mindfulness-Based Interventions-Teaching Assessment Criteria Scale (Crane et al. 2013), MBCT-AAQS MBCT Adherence, Appropriateness and Quality Scale (Day et al. 2014), CPEG Checklist of Patient Engagement in Group Form (Mignogna et al. 2007), PANAS Positive and Negative Affect Schedule (Watson et al. 1988), EPDS Edinburgh Post-partum Depression Scale (Cox et al. 1987), STAI State-Trait Anxiety Inventory (Spielberger et al. 1970), ISI Insomnia Severity Index (Bastien et al. 2001), PSQI Pittsburgh Sleep Quality Index (Buysse et al. 1989), SCID-II Structured Clinical Interview for DSM-IV Axis II Personality Disorders (First et al. 1997), DBAS-16 Dysfunctional Beliefs and Attitudes about Sleep (Morin et al. 2007), SSES Sleep Self-Efficacy Scale (Lacks 1987), LIFE Longitudinal Interval Follow-up Evaluation (Keller et al. 1987), CES-D Centre for Epidemiological Studies Depression Scale (Radloff 1977), SF-12 Short-Form 12 Item Health Survey (Ware et al. 1996), PDS PTSD Diagnostic Scale (Foa et al. 1997), SF-36 Medical Outcomes Study 36-item Health Survey (Ware & Sherbourne, 1992), PTCI Post-traumatic Cognitions Inventory (Foa et al. 1999), SDS Sheehan Disability Scale (Sheehan et al. 1996), PHQ-9 Patient Health Questionnaire (Kroenke and Spitzer 2002), PHQGADS Patient Health Questionnaire Generalised Anxiety Disorder (Spitzer et al. 2006), SCL-90-R Symptom Checklist-90-Revised (Derogatis 1996), MADRS Montgomery-Asberg Depression Rating Scale (Montgomery and Asberg 1979), MSC Medical Symptoms Checklist (Travis and Ryan 1977), CIDI Composite International Diagnostic Interview (Kessler et al. 1998), SCID Structured Clinical Interview for DSM-IV (First et al. 1996), MASS Mindfulness Attention Awareness Scale (Brown and Ryan 2003), DASS Depression Anxiety Stress Scale (Lovibond and Lovibond 1993), TMS Toronto Mindfulness Scale (Lau et al. 2006), POMS Profile of Mood States (McNair et al. 1992), YMRS Young Mania Rating Scale (Young et al. 1978), SOSI Symptoms of Stress Inventory (Leckie and Thompson 1979), HIT-6 Headache Impact Test-6 (Kosinski et al. 2003), FFMQ Five Facets Mindfulness Questionnaire (Baer et al. 2006), MIDAS Migraine Disability Assessment (Stewart et al. 1999), MSQ Migraine Specific Quality of Life Questionnaire (Jhingran et al. 1998), SF-12 Short-Form 12 Item Health Survey (Ware et al. 1996), PSS-10 Perceived Stress Scale (Cohen et al. 1983), MBCBS Montgomery Borgatta Caregiver Burden Scale (Montgomery et al. 2000), HMSES Headache Management Self-Efficacy Scale (French et al. 2000), MOSSSS Medical Outcomes Study Social Support Survey (Sherbourne and Stewart 1991)