Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis

A systematic review of 47 randomized clinical trials with 3,515 participants found that mindfulness meditation programs produce small to moderate reductions in anxiety, depression, and pain compared to active placebo controls. At 8 weeks, anxiety improved with an effect size of 0.38 and depression with 0.30; these benefits persisted at 3–6 months with effect sizes of 0.22 and 0.23 respectively. Pain showed an effect size of 0.33. Evidence for stress/distress and mental health-related quality of life was low. Meditation programs showed no effect or insufficient evidence for positive mood, attention, substance use, eating habits, sleep, and weight, and were not better than drugs, exercise, or other behavioral therapies.

Study at a glance

Abstract

ImportanceMany people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation.ObjectiveTo determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/ distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations.Evidence reviewWe identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95 % confidence intervals.FindingsAfter reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95 % CI, 0.12–0.64] at 8 weeks and 0.22 [0.02–0.43] at 3–6 months), depression (0.30 [0.00–0.59] at 8 weeks and 0.23 [0.05– 0.42] at 3–6 months), and pain (0.33 [0.03–0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies).Conclusions and relevanceClinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.