Efficacy of mindfulness- and acceptance-based cognitive-behavioral therapies for bodily distress in adults: a meta-analysis.
Frederic Maas Genannt Bermpohl, Lea Hülsmann, Alexandra Martin
Frontiers in Psychiatry 2023 DOI: 10.3389/fpsyt.2023.1160908 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 1,288 |
| Population | Adults with bodily distress, including fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, and medically unexplained symptoms |
| Topics | Meditation |
| Keywords | Efficacy Persistent physical symptoms Somatoform disorders mesh Treatment evaluation |
| Key findings | Across 16 randomized trials, third-wave psychotherapies (MBCT, MBSR, ACT) reduced somatic symptom severity more than control conditions, with a moderate pooled effect (g = -0.51, 95% CI -0.69 to -0.32). Secondary outcomes showed small to moderate effects. The authors report no differences between mindfulness- and acceptance-based therapies, and neither total therapy duration nor number of sessions moderated efficacy. |
Abstract
Bodily distress, i.e., somatoform disorders and associated functional somatic syndromes, is highly prevalent, often persistent and highly disabling. It has been proposed that "third wave" therapies may be beneficial variants of cognitive behavioral treatments. However, evidence on their efficacy is scarce. This meta-analysis examines the efficacy of "third wave" psychotherapies (mindfulness-based cognitive therapy [MBCT], mindfulness-based stress reduction [MBSR], and acceptance and commitment therapy [ACT]) in adults with bodily distress. We included randomized controlled trials (RCTs) treating adults with bodily distress using MBCT, MBSR, and ACT compared to inactive and non-specific control groups. A random effects model was used. The primary outcome was somatic symptom severity. Secondary outcomes were degrees of depression and of anxiety, health anxiety, perceived health status, mindfulness, psychological inflexibility, and pain acceptance. Sixteen RCTs with 1,288 participants were included in the analysis (k = 4 MBCT, k = 7 MBSR, k = 5 ACT; k = 7 fibromyalgia, k = 5 irritable bowel syndrome, k = 1 chronic fatigue syndrome, k = 2 bodily distress, k = 1 medically unexplained symptoms). However, not all studies provided data for each of the relevant outcomes. The analyses revealed that "third wave" therapies were more effective than control conditions in reducing somatic symptom severity (k = 15, n = 1,100, g = -0.51, 95%CI -0.69; -0.32). Heterogeneity was moderate (I 2 = 52.8%, 95%CI 15.1 to 73.8). Effects for secondary outcomes were small to moderate with varying degrees of heterogeneity. We did not find differences between the different therapy approaches (mindfulness- vs. acceptance-based therapies); neither therapy dosis (i.e., total duration of therapy sessions) nor number of sessions were significant moderators of efficacy. The therapies addressing mindfulness and acceptance proved to be more effective than control conditions. Hence, they are promising treatment approaches for bodily distress. However, there is still need for research on which patient groups may benefit from these psychological approaches. https://osf.io/g7hby, identifier: 10.17605/OSF.IO/4RZGC.
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 2
Cites 9
- Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse Psychotherapy Research March 1, 2003
- Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: Results of a randomized clinical trial Arthritis Care & Research January 31, 2007
- A randomized clinical trial of mindfulness-based cognitive therapy for women with irritable bowel syndrome-Effects and mechanisms. Journal of Consulting and Clinical Psychology February 7, 2020
- A randomized controlled efficacy trial of Mindfulness-Based Stress Reduction compared to an active control group and usual care for fibromyalgia: the EUDAIMON study. Pain August 13, 2019
- Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up. Journal of Psychosomatic Research January 2013
and 4 more in the library