Comparing the efficacy of mindfulness-based therapy and cognitive-behavioral therapy for depression in head-to-head randomized controlled trials: A systematic review and meta-analysis of equivalence.
Kristine Trettø Sverre, E. Nissen, I. Farver-Vestergaard, M. Johannsen, R. Zachariae
Clinical Psychology Review December 1, 2022 DOI: 10.1016/j.cpr.2022.102234 (opens in new tab) via Semantic Scholar
Summary
AI-generated from the abstractA meta-analysis of 30 randomized controlled trials with 2,750 participants found that mindfulness-based therapies (MBT) and cognitive behavioral therapy (CBT) are equally effective for treating current depression in adults. At both post-intervention and follow-up, the difference in outcomes was statistically negligible, and Bayesian analyses supported equivalence. Subgroup analysis suggested that at follow-up, mindfulness-based cognitive therapy (MBCT) was more similar to CBT than was mindfulness-based stress reduction (MBSR). The authors conclude that MBT and CBT are equally efficacious, but it remains unclear whether they work through different mechanisms or shared factors.
Study at a glance
| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 2,750 |
| Population | Adults with current depression |
| Keywords | Medicine Psychology |
| Key finding | MBT and CBT are statistically equivalent in treating current adult depression at post-intervention and follow-up. |
Abstract
BACKGROUND While Cognitive Behavioral Therapy (CBT) is recommended as first-line treatment for depression, a significant minority do not show an adequate treatment response. Despite evidence for the efficacy of Mindfulness-Based Therapies (MBT) both in treating current depression and preventing relapse, it remains unknown whether MBT and CBT are equivalent in the treatment of current depression. METHODS Five databases were searched for randomized controlled trials (RCTs) directly comparing MBT with CBT and including depression as primary or secondary outcome. RESULTS When pooling the results of 30 independent RCTs with a total of 2750 participants, MBT and CBT were statistically significantly equivalent at both post-intervention (Hedges's g = -0.009; p < .001) and follow-up (g = -0.033; p = .001). Supplementary Bayesian analyses provided further support for the alternative hypothesis of no difference between MBT and CBT. When exploring possible sources of heterogeneity, the differences at follow-up were smaller between CBT and mindfulness-based cognitive therapy (MBCT) than between CBT and mindfulness-based stress-reduction (MBSR) (Slope = 0.37;p = .022). CONCLUSION The currently available evidence suggests that that MBT and CBT are equally efficacious in treating current adult depression. It remains unclear whether the similar effects of the two intervention types are due to different mechanisms or common factors.