Table 2.
Study characteristics of MBTs
| Reference | Study design | Intervention | Study sample | Findings |
|---|---|---|---|---|
| Depression | ||||
| Wang et al. 2018 | Meta-analysis | MBIs, including MBCT, MBSR, on depression | 11 RCTs, N = 764, adults ages 18 and older |
MBIs (MBCT, MBSR) were associated with reduction of depression severity immediately after MBIs but not at follow-up endpoint. Compared to the control group, MDD subjects receiving MBIs showed significant reduction in depressive symptoms (n = 722; SMD − 0.59, 95% CI − 1.01 to − 0.17, I2 = 85%, p = 0.006) at post-MBI assessment, but the significance disappeared by the end of post-treatment follow-up. |
| Strauss et al. 2014 | Meta-analysis | MBIs on depression and anxiety | 12 RCTs, N = 578, adults ages 18 and older |
Significant effect on post-intervention between-group benefits of MBIs on depression but not on anxiety. Significant post-intervention between-group benefits of MBIs relative to control conditions on primary symptom severity (Hedges g = 20.59, 95% CI = 20.12 to 21.06). Effects were demonstrated for depressive symptom severity (Hedges g = 20.73, 95% CI = 20.09 to 21.36), but not for anxiety symptom severity (Hedges g = 20.55, 95% CI = 0.09 to 21.18), for RCTs with an inactive control (Hedges g = 21.03, 95% CI = 20.40 to 21.66), but not where there was an active control (Hedges g = 0.03, 95% CI = 0.54 to 20.48) and effects were found for MBCT (Hedges g = 20.39, 95% CI = 20.15 to 20.63) but not for MBSR (Hedges g = 20.75, 95% CI = 0.31 to 21.81). |
| Kuyken et al. 2019 | Meta-analysis | MBCT on depression relapse | 9 RCTs; N = 1258, adults ages 18 and older |
Significant effect of MBCT with reduction in risk of depressive relapse/recurrence over 60 weeks compared with usual care. Patients receiving MBCT had a reduced risk of depressive relapse within a 60-week follow-up period compared with those who did not receive MBCT (hazard ratio, 0.69; 95% CI, 0.58–0.82). Comparisons with active treatments suggest a reduced risk of depressive relapse within a 60-week follow-up period (hazard ratio, 0.79; 95% CI, 0.64–0.97). |
| Khoury et al. 2013 | Meta-analysis | MBT for depression, anxiety | 209 studies; N = 12,145, adults ages 18 and older |
MBT effective in reducing anxiety and depression and did not differ from traditional CBT, behavioral therapies, and pharmacological treatments. Effect-size estimates suggested that MBT is moderately effective in pre-post comparisons (n = 72; Hedge’s g = 0.55), in comparisons with waitlist controls (n = 67; Hedge’s g = 0.53), and when compared with other active treatments (n = 68; Hedge’s g = 0.33), including other psychological treatments (n = 35; Hedge’s g = 0.22). MBT did not differ from traditional CBT or behavioral therapies (n = 9; Hedge’s g = − 0.07) or pharmacological treatments (n = 3; Hedge’s g = 0.13). |
| Cramer et al. 2013 | Meta-analysis | Yoga for depression | 12 RCTs; N = 619, adults ages 18 and older |
Moderate short-term effects of yoga on depression compared to usual care, relaxation, and aerobic exercise. Regarding severity of depression, there was moderate evidence for short-term effects of yoga compared to usual care (SMD = − 0.69; 95% CI − 0.99, − 0.39; p < 0.001), and limited evidence compared to relaxation (SMD = − 0.62; 95%CI − 1.03, − 0.22; p = 0.003), and aerobic exercise (SMD = − 0.59; 95% CI − 0.99, − 0.18; p = 0.004). Limited evidence was found for short-term effects of yoga on anxiety compared to relaxation (SMD = − 0.79; 95% CI − 1.3, − 0.26; p = 0.004). |
| Liu et al. 2015 | Meta-analysis | Tai chi and qigong on depression | 30 studies; N = 2328, adults ages 18 and older |
Significant effect of Qigong interventions but no effect of Tai Chi for depression. A significant effect was found for the Qigong interventions (Cohen’s d − 0.48 95% CI − 0.48 to − 0.12; SMG − 0.52, 95% CI − 0.79 to − 0.26). There was no significant effect seen for tai chi (d − 0.07, 95% CI − 0.44 to 0.31). |
| Zou et al. 2018 | Meta-analysis | Meditative movement (tai chi, qigong, and yoga) on depression | 15 RCTs; N = 844, adults ages 18 and older |
Significant effect of meditative movement on reducing depression severity compared to passive controls. Significant benefit in favor of meditative movement on depression severity (SMD = − 0.56, 95% CI − 0.76 to − 0.37, p < 0.001, I2 = 35.76%) and on anxiety severity (SMD = − 0.46, 95% CI − 0.71 to − 0.21, p < 0.001, I2 = 1.17%). Meditative movement interventions showed significantly improved treatment remission rate (OR = 6.7, 95% CI 2.38 to 18.86, p < 0.001) and response rate (OR = 5.2, 95% CI 1.73 to 15.59, p < 0.001) over passive controls. |
| Anxiety | ||||
| Hilton et al. 2017 | Meta-analysis | Meditation interventions (MBSR, meditation, and yoga) on PTSD | 10 RCTs; N = 643, adults ages 18 and older |
Significant effect of meditative interventions on reducing PTSD symptoms. PTSD symptoms for adjunctive meditation interventions were statistically significantly different compared with all comparators (SMD 0.41; CI [0.81, 0.01]; 8 RCTs; I2 67%) in favor of meditation. |
| Gallegos et al. 2017 | Meta-analysis | Meditation and yoga on PTSD | 19 RCTs; N = 1173, adults ages 18 and older |
Possible small effect size of meditation and yoga on PTSD. A random effects model yielded a statistically significant ES in the small to medium range (ES = − 0.39, p < 0.001, 95% CI [− 0.57, − 0.22]). |
| Cramer et al. 2018 | Meta-analysis | Yoga on PTSD | 7 RCTs; N = 289, adults ages 18 and older |
Low evidence for short term yoga on PTSD. Low quality evidence for clinically relevant effects of yoga on PTSD symptoms compared to no treatment (SMD = − 1.10, 95% CI [− 1.72, − 0.47], p < 0.001, I2 = 72%; MD = − 13.11, 95% CI [− 17.95, − 8.27]) |
| Cognition | ||||
| Berk et al. 2017 | Systematic review | MBSR and MBCT for cognition | 6 total studies with 3 RCTs; N = 409, adults ages 55 and older | Inconclusive differences of MBSR and active control group on several cognitive measures due to small sample size and studies |
| Wong et al. 2017 | Longitudinal mixed-methods observational study | Mindfulness training program on MCI | N = 13, adults ages 60 and older | Long-term mindfulness practice associated with cognitive and functional improvements for older adults with MCI after 1 year follow-up |
| Farhang et al. 2019 | Systematic review | MBIs (MBSR, MBCT, yoga, tai chi, meditative movements, qigong) on cognition impairment | 9 RCTs; N = 710, adults ages 55 and older | MBIs improved cognitive function, everyday activities functioning, and mindfulness, as well as resulting in a moderate reduction in fall risk, depression and stress and lower risk of dementia at 1 year. |
| Zou et al. 2019 | Meta-analysis | MBE (tai chi, yoga, qigong) on cognition | 12 studies with 9 RCTs; N = 1298, adults ages 18 and older with MCI |
Significant effect of MBE on improved attention, short-term memory, executive function, visual-spatial/executive function, and global cognitive function. MBE significantly improved attention (SMD = 0.39, 95% CI 0.07–0.71, p = 0.02, I2 = 31.6%, n = 245), short-term memory (SMD = 0.74, 95% CI 0.57–0.90, p < 0.001, I2 = 0%, n = 861), executive function (SMD = − 0.42, 95% CI − 0.63 to − 0.21, p < 0.001, I2 = 38.54%, n = 701), visual-spatial/executive function (SMD = 0.35, 95% CI 0.07–0.64, p < 0.05, I2 = 0%, n = 285), and global cognitive function (SMD = 0.36, 95% CI 0.2–0.52, p < 0.001, I2 = 15.12%, n = 902). Positive effect on cognitive processing speed was not observed following MBE interventions (SMD = 0.31, 95% CI − 0.01 to 0.63, p = 0.054, I2 = 28.66%, n = 233). |
MBCT mindfulness-based cognitive therapy, MBSR mindfulness-based stress reduction, MBIs mindfulness-based interventions, MBT mindfulness-based therapy, CBT cognitive behavioral therapy, MCI mild cognitive impairment, PTSD post-traumatic stress disorder, MBE mind-body exercise