The efficacy of mindfulness-based interventions on mental health among university students: a systematic review and meta-analysis.
Xinyi Zuo, Yong Tang, Yifang Chen, Zhimiao Zhou
Frontiers in Public Health 2023 DOI: 10.3389/fpubh.2023.1259250 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 1,824 |
| Population | Participants in randomized controlled trials of mindfulness therapy for mental health |
| Intervention | Mindfulness therapy |
| Topics | Anxiety Depression Meditation |
| Keywords | Meta-analysis Sleep quality Stress University students |
| Citations | 56 |
| Key findings | Mindfulness therapy produced small but significant improvements in depression, anxiety, stress, and sleep quality, but did not significantly change mindfulness scores compared to control conditions. |
Abstract
We aimed to estimate the effect of mindfulness therapy on mental health. Two researchers searched 12 databases to identify relevant trials that were published from 1 January 2018 to 1 May 2023. We performed a meta-analysis to determine the effect of mindfulness therapy on depression, which was measured by the Beck Depression Inventory (BDI), Patient Health Questionnaire-9 (PHQ-9), Quick Inventory of Depressive Symptomatology (QIDS), Hamilton Depression Rating Scale (HDRS), Patient-Reported Outcomes Measurement Information System (PROMIS), Hospital Anxiety and Depression Scale (HADS), and Depression Anxiety Stress Scales (DASS); anxiety, which was measured by the Beck Anxiety Inventory (BAI), PROMIS, and DASS, Generalized Anxiety Disorder-7 (GAD-7); stress, which was measured by the Perceived Stress Scale (PSS), DASS, and GAD-7; mindfulness, which was measured by the GAD-7, Five Facet Mindfulness Questionnaire (FFMQ), Mindful Attention Awareness Scale (MAAS), Short Form-12 Mental Component Score (SF-12 MCS) and Short Form-12 Physical Component Score (SF-12 PCS); and sleep quality, which was measured by the Pittsburgh Sleep Quality Index (PSQI). After screening studies based on the inclusion and exclusion criteria, 11 randomized controlled trials (RCTs) involving 1,824 participants were ultimately included. All these studies demonstrated positive effects of mindfulness therapy on depression (SMD = -0.33, 95% CI: [-0.44, -0.22], p < 0.00001, I2 = 29%), anxiety (SMD = -0.35, 95% CI: [-0.46, -0.25], p < 0.00001, I2 = 40%), stress (SMD = -0.39, 95% CI: [-0.48, -0.29], p < 0.00001, I2 = 69%) and sleep quality scores (SMD = -0.81, 95% CI: [-1.54, -0.09], p = 0.03, I2 = 0%). However, there was no significant difference in mindfulness (SMD = -0.12, 95% CI: [-0.36, -0.12], p = 0.34, I2 = 34%) between the mindfulness therapy group and the control group. In future studies, it is necessary to consider the investigation on whether the strategies of improving the mindfulness therapy in adherence and fidelity can work on the improvement of the outcomes in mental health. https://www.crd.york.ac.uk/PROSPERO/, https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42023469301].
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 |
Citations in the library
Cited by 25
- Effect of a mindfulness program on stress, anxiety, depression, sleep quality, social support, and life satisfaction: a quasi-experimental study in college students. Frontiers in Psychology 2025
- The mental health of nursing students during the COVID-19 pandemic: Beneficial effects of mindfulness-based stress reduction. Heliyon June 30, 2024
- Impacts of the Mindfulness Meditation Mobile App Calm on Undergraduate Students' Sleep and Emotional State: Pilot Randomized Controlled Trial. JMIR Formative Research June 11, 2025
- The effects of mindfulness‐based interventions on emotion regulation/dysregulation in people with mental health conditions: A systematic review and meta‐analysis JCPP Advances February 12, 2026
- Psychological trajectories following brief mindfulness training: a longitudinal comparison of active and passive controls Frontiers in Psychology August 26, 2026
and 20 more in the library
Cites 33
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- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Mindfulness-based interventions: an overall review British Medical Bulletin April 21, 2021
- The effect of mindfulness meditation on sleep quality: a systematic review and meta‐analysis of randomized controlled trials Annals of the New York Academy of Sciences December 21, 2018
- The mindfulness‐based cognitive therapy adherence scale: inter‐rater reliability, adherence to protocol and treatment distinctiveness Clinical Psychology & Psychotherapy March 1, 2002
and 28 more in the library