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The effectiveness of mindfulness-based interventions in inflammatory bowel disease: A Systematic Review & Meta-Analysis.

Colette Naude, David Skvarc, Simon R Knowles, Lahiru Russell, Subhadra Evans, Antonina Mikocka-Walus

Journal of Psychosomatic Research June 2023 DOI: 10.1016/j.jpsychores.2023.111232 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Systematic review and meta-analysis Peer reviewed
Sample size 575
Population Individuals living with inflammatory bowel disease
Intervention Mindfulness-Based Interventions (MBI)
Topics Meditation
Keywords Crohn's disease Inflammatory bowel disease Mbi Mbsr mindfulness Ulcerative colitis
Key findings Mindfulness-based interventions outperformed control groups in the short term for stress (SMD = -0.38), mindfulness (SMD = 0.59), C-reactive protein (SMD = -0.25), and health-related quality of life (SMD = 0.45). Stress and mindfulness benefits persisted at longer follow-up (SMD = -0.44 and 0.52), but quality-of-life gains did not, and no long-term CRP data were available. The authors suggest these interventions may be a useful adjuvant in holistic IBD care, with further trials warranted.

Abstract

Mental health has been identified as contributing to the pathogenesis of Inflammatory Bowel Disease (IBD). Resultingly, psychotherapeutic interventions, such as Mindfulness-Based Interventions (MBI), have been increasingly investigated for improving IBD outcomes. To systematically review the current state of evidence of MBI's for individuals living with IBD. We performed a systematic review searching Medline, PsychINFO, CINAHL, Embase, Cochrane and Scopus, to identify controlled clinical trials, investigating MBI's for various IBD biopsychosocial outcomes. Data was pooled using the inverse-variance random effects model, with restricted maximum likelihood estimation, providing the standardized mean difference (SMD) between control and experimental groups, at both short and long-term follow up. We identified 8 studies with 575 participants. Meta-analytic results found that MBI's were more efficacious than control groups in the short-term improvement of stress (SMD = -0.38, 95% CI [-0.65, -0.10], p = 0.007), mindfulness (SMD = 0.59, 95% CI [0.36, 0.83], p = 0.00001), C-Reactive Protein (CRP) (SMD = -0.25, 95% CI [-0.49, -0.01], p = 0.04) and health-related quality of life (HRQoL) (SMD = 0.45, 95% CI [0.24, 0.66], p = 0.0001) (including all emotional, bowel, social and systemic subscales). This was maintained in the long-term for stress (SMD = -0.44, 95% CI [-0.88, -0.01], p < 0.05) and mindfulness (SMD = 0.52, 95% CI [0.14, 0.90], p = 0.008), but not for HRQoL, with no long-term data available for CRP. Given that MBI's appear to be effective in improving several IBD outcomes, they may be a useful adjuvant therapy in wholistic IBD care, with further trials warranted.

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

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