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Mindfulness- and acceptance-based programmes for obsessive-compulsive disorder: A systematic review and meta-analysis.

Johannes J Bürkle, Stefan Schmidt, Johannes C Fendel

Journal of Anxiety Disorders March 1, 2025 DOI: 10.1016/j.janxdis.2025.102977 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Systematic review and meta-analysis Randomized Peer reviewed
Sample size 2,221
Population Patients with obsessive-compulsive disorder
Intervention Mindfulness- and acceptance-based programmes
Topics Meditation
Keywords Meta-analysis Mindfulness interventions Mindfulness-based cognitive therapy Obsessive-compulsive disorder Systematic review Treatment
Citations 7
Key findings Mindfulness- and acceptance-based programmes are associated with large reductions in OCD severity and are superior to medication and waitlist but not to cognitive behavioral therapy or exposure and response prevention.

Abstract

Mindfulness- and acceptance-based programmes (MABPs) in the treatment of obsessive-compulsive disorder (OCD) are increasingly gaining research interest, yet a comprehensive systematic review and meta-analysis is missing. To fill this gap, we analysed 46 trials involving 2221 patients. Two independent reviewers screened records, extracted data, assessed risk of bias, and rated overall quality of evidence. MABPs were associated with large reductions in OCD-severity in between-group analysis in randomised controlled trials (k = 33; g = -.87; CI = -1.13,-.60) and within-group pre-post analysis in all MABPs (k = 49; g = -1.72; CI = -2.00,-1.44). Depressive symptoms decreased between- and within-group with a small to moderate effect, with maintained reductions at follow-up for both OCD and depression. Moderate to large pre-post improvements were also observed in anxiety, obsessive beliefs, and quality of life. MABPs did not differ from cognitive behavioural therapy and exposure and response prevention (k = 9; g=.02; CI = -.23,.26) but were superior to medication (k = 5; g = -.77; CI = -1.44,-.11) and waitlist (k = 16; g = -1.66; CI = -2.1,-1.24). Symptom reductions were observed across world regions, but to varying degrees. When combined, increases in mindfulness and psychological flexibility predicted reductions in OCD symptoms. Outcomes were not moderated by treatment duration, samples', and therapists' characteristics. MABPs can reduce OCD-severity, but further high-quality trials with long-term follow-ups are needed to confirm results.

Comparable studies

Other systematic reviews and meta-analyses on meditation, most cited first.

Study Year Design Participants
Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations 2014 Meta-analysis n = 3,515
Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects 2009 Systematic review and meta-analysis
The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators 2012 Meta-analysis n = 163
Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission 2016 Meta-analysis of individual patient data from randomized controlled trials n = 1,258
Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials 2011 Systematic review

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Meditation Anxiety Depression