Comparison of cognitive behavioral therapy and third-wave-mindfulness-based therapies for patients suffering from depression measured using the Beck-Depression-Inventory (BDI): A systematic literature review and network-meta-analysis.
Alexander Buschner, Christian Makiol, Jue Huang, Nicole Mauche, Maria Strauß
Journal of Affective Disorders June 15, 2025 DOI: 10.1016/j.jad.2025.02.104 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Network meta-analysis Peer reviewed |
|---|---|
| Population | Adults with depression |
| Interventions | Mindfulness-based therapies Cognitive-behavioral therapy |
| Topics | Depression Meditation |
| Keywords | Cognitive behavioral therapy Meta-analysis Mindfulness-based-cognitive-therapy Systematic literature review Third-wave therapies |
| Citations | 5 |
| Key findings | Mindfulness-based therapies and cognitive-behavioral therapy both significantly reduce depression symptoms, but mindfulness-based therapies do not show a clinically meaningful advantage over CBT. |
Abstract
Mindfulness-based therapies (MBT) are proposed as a "third wave" of cognitive-behavioral therapy (CBT). This network meta-analysis investigated this hypothesis by comparing the effectiveness of MBT and CBT for treating depression, measured by the Beck Depression Inventory-II (BDI-II). An indirect comparison was made. Relevant databases were searched for studies comparing either CBT or MBT with treatment as usual (TAU). Mean differences (MD) between intervention and TAU were calculated using changes from baseline from both intervention (Me) and TAU-group (Mc). MDs of CBT and MBT were compared in a network meta-analysis. Results were reported for both the common-effects-model (CEM) and the random-effects-model (REM). Risk of Bias (RoB) was measured using the RoB-2-tool. Quality of evidence was investigated based on GRADE. Eight MBT and ten CBT studies, meeting eligibility since 2006, were included. MBT studies included behavioral activation with mindfulness, mindfulness-based cognitive therapy, person-based cognitive therapy, and a newly developed meditation-based lifestyle modification program. Both CBT and MBT differed significantly from TAU. In the unweighted CEM network meta-analysis, MBT showed significantly better treatment effect, but this was below the clinically relevant threshold (MD:-1.81). For REM and weighted analysis, there were no significant differences between CBT and MBT. Heterogeneity, high RoB, and low evidence quality were notable, with indirectness limiting this analysis. CBT and MBT both showed significant and clinically important treatment effects for depression. However, an outstanding benefit of MBT in comparison to CBT could not be found in this analysis. Further research could include a direct comparison.
Comparable studies
Other systematic reviews and meta-analyses on depression, most cited first.
Citations in the library
Cites 12
- What defines mindfulness-based programs? The warp and the weft Psychological Medicine December 29, 2016
- Mindfulness: diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma Contemporary Buddhism May 1, 2011
- Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis Cognitive Behaviour Therapy February 8, 2019
- Foreword: Seeds of a necessary global renaissance in the making: the refining of psychology’s understanding of the nature of mind, self, and embodiment through the lens of mindfulness and its origins at a key inflection point for the species Current Opinion in Psychology February 23, 2019
- Comparing the efficacy of mindfulness-based therapy and cognitive-behavioral therapy for depression in head-to-head randomized controlled trials: A systematic review and meta-analysis of equivalence. Clinical Psychology Review December 1, 2022
and 7 more in the library