Original Title: Eficacia de los tratamientos psicológicos basados en la Atención Plena en el tratamiento de la depresión y la ansiedad

Authors' objectives: 1. To systematically review the empirical literature investigating the effectiveness of psychological treatments based on Mindfulness Meditation to treat anxiety and depression. 2. To study the effectiveness of psychological approaches based on Mindfulness in the maintenance of the gains.

Authors' results and conclusions: RESULTS: A total of 2650 references were found in the electronic databases. Once the duplicates were discarded, 1450 references were reviewed. We retrieved 86, of which 14 were included. In addition, we included 1 extra reference found in a free research. A total of 15 studies were included: 1 SR (Baer 2003), 8 RCTs (Lee 2007, Lynch 2003, Lynch 2007, Ma 2004, Teasdale 2000, Teasdale 2002, Williams 2000, Williams 2008) and 6 NRCTs (Kabat-Zinn 1992, Katz 2004, Kingston 2007, Miller 1995, Ramel 2004, Weiss 2005). According to the Jadad Scale, the total quality of RCTs was 2.38 points out of 5. According to the Estabrooks Scale, the total quality of the NRCTs was 23.17 points out of 35. According to the Oxman Scale, the mean score for the global quality of the SRs was 8 points out of 10. The goal of the SR (Baer 2003) was to summarize the empirical research on the utility of mindfulness based interventions in the treatment of physical and psychological disorders. In the studies included in this revision, MBSR was used to treat anxiety disorders, physical problems, psychotherapy and medical patients and nonclinical populations. MBCT was applied on patients with depression. MBCT was more effective than the waiting-list or the usual treatment and MBCT showed to be more effective than the usual treatment in preventing relapse in depressed patients. General findings suggest that mindfulness based interventions may improve the psychological functioning. Regarding the RCTs included in this revision, in seven out of eight studies the participants were diagnosed with major depression and only one study (Lee, 2007) included participants with anxiety disorders. Recovered depressed patients with two or more episodes and patients with unipolar and bipolar depression with suicidal ideation received MBCT. MBSR was used for treating patients with anxiety disorders and DBT for depressed older adults. We identified six outcome measures. The most common was “depressed symptoms” (Lee 2007; Lynch 2003, 2007; Williams 2000, 2008) followed by “depression relapse” (Ma 2004; Teasdale 2000, 2002), “autonomous ruminative processes” (Ma 2004, Teasdale 2000) and “anxiety levels” (Lee 2007, Williams 2008), “metacognition” (Teasdale 2002) and “memory changes” (Williams 2000). Six NRCTs were included. Four studies used MBSR (Kabat-Zinn 1992, Miller 1995, Kamel 2004, Weiss 2005), two of which included participants with anxiety disorders and two of which included patients with anxiety and depression. In the study of Kingston (2007), subjects diagnosed with major depression with at least three episodes received MBCT. In the study of Katz (2004), adolescents with suicide attempts or suicidal ideation were treated with DBT. The most frequent outcomes assessed were “depressive symptoms” and “anxiety levels”, followed by “rumination”. The least common outcome measures were “suicidal attempt” and “ideation”, “goal achievement” and “psychological wellbeing”. CONCLUSIONS: In relation to the treatment of anxiety, the MBSR model has been the most used. Studies show some evidence for the efficacy of this training, but this is not conclusive. In the treatment of depression, the MBCT model has the most scientific evidence, showing to be effective in preventing relapses. It also has some favourable evidence in the treatment of residual affective symptoms in depressive patients resistant to treatment. These data do that the MBCT model not to be recommended in dealing with a first episode of major depression, nor in the treatment of depression in acute phase; for these cases, there are other psychological or pharmacological treatments more indicated.

Project Status: Completed

Year Published: 2009

URL for published report: https://sescs.es/eficacia-de-los-tratamientos-psicologicos-basados-en-la-atencion-plena-para-depresion-y-ansiedad/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es