Symptom worsening in mindfulness-based cognitive therapy
Apollo (University of Cambridge) July 3, 2026 DOI: 10.17863/cam.131754 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of individual participant data meta-analysis of randomized controlled trials Preregistered Peer reviewed |
|---|---|
| Population | Individuals with depression in randomized trials of MBCT |
| Intervention | Mindfulness-based cognitive therapy |
| Topics | Meditation |
| Keywords | Harm Context archaeology Cognitive therapy Cognition Health care Randomized controlled trial Odds Causality physics Medline Clinical psychology Clinical trial Excellence |
| Key findings | The analysis evaluates odds of symptom worsening for MBCT versus control conditions to assess treatment-related harm. |
Abstract
Kuyken et al’s1 individual participant data (IPD) meta-analysis of mindfulness-based cognitive therapy (MBCT) for the prevention of depressive relapse/recurrence has supported MBCT’s dissemination as a frontline treatment for depression. MBCT is now recommended in multiple clinical guidelines including the National Institute for Health and Care Excellence in the United Kingdom and is widely implemented across healthcare systems. Since this meta-analysis was published, questions have been raised regarding the safety of mindfulness-based interventions. Two recent studies examined the occurrence of meditation-related harm in the context of MBCT.2,3 Although definitions and rates of harm differed across these studies, both documented cases defined as reflecting patient-reported harm. Importantly, neither study included a control condition, making it impossible to evaluate the degree to which MBCT increased the likelihood of these experiences occurring. Establishing whether MBCT increases the likelihood of poor outcomes relative to a control condition is crucial for weighing the costs relative to benefits of this treatment. IPD allows evaluation of symptom worsening following treatment relative to control conditions, which is one indicator of treatment-related harm when examined within a randomized trial context in which causality can be inferred.4,5 The present study is a preregistered secondary analysis of Kuyken et al’s1 IPD evaluating odds of symptom worsening for MBCT versus controls.
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 |