Mindfulness for obsessive-compulsive disorder: a systematic review and meta-analysis.

Abstract

To evaluate the efficacy of mindfulness-based interventions for adults with obsessivecompulsive disorder. A systematic review and meta-analysis were conducted according to Cochrane Handbook guidelines. Two independent reviewers selected randomized controlled trials (RCTs) comparing mindfulness-based interventions with active control interventions, including cognitive/behavioral techniques and psychoeducation. The outcomes were obsessive-compulsive symptoms, dropout rates, anxiety, depressive symptoms, mindfulness skills, and quality of life. A total of 6 RCTs (n = 499; mean age = 32.8 years; mean disorder duration = 9.83 years) were included, with interventions lasting from 2 to 48 weeks. The certainty of evidence ranged from low to high. Mindfulness did not significantly differ from cognitive-behavioral techniques (CBT) regarding reduced obsessive-compulsive symptoms (standardized mean difference [SMD] = -0.08; 95%CI -0.35-0.18), dropout rates (risk ratio = 1.00; 95%CI 0.69-1.43), anxiety (SMD = -0.28; 95%CI -0.57-0.00), or depression (SMD = -0.07; 95%CI -0.26-0.11). A small but clinically non-relevant improvement in mindfulness skills was observed (SMD = 0.24; 95%CI 0.01 to 0.48), although quality of life findings were inconsistent and could not be pooled for analysis. Mindfulness-based interventions did not differ significantly from CBT, which included well-established obsessive-compulsive disorder treatments such as exposure with response prevention, psychoeducation, and cognitive restructuring.