Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up.
Tianran Zhang, Lu Lu, Fabrizio Didonna, Zhen Wang, Haiyin Zhang, Qing Fan
Frontiers in Psychiatry 2021 DOI: 10.3389/fpsyt.2021.661807 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 123 |
| Population | Unmedicated patients with mild to moderate obsessive-compulsive disorder |
| Intervention | Mindfulness-based cognitive therapy (MBCT) |
| Duration | 10-week intervention, with follow-up at 14, 22, and 34 weeks (up to 6 months) |
| Measures | Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Depression Scale-24 (HAMD-24), Hamilton Anxiety Scale (HAMA), Five Facet Mindfulness Questionnaire (FFMQ), Sheehan Disability Scale (SDS) |
| Topics | Meditation |
| Keywords | Obsessive-compulsive disorder Psychotherapy Randomized controlled trial |
| Key findings | MBCT produced treatment responses comparable to SSRIs and significantly better than psychoeducation during the 10-week intervention, with no significant between-group differences at 6-month follow-up. No adverse events were recorded in the MBCT group, and the authors conclude MBCT is effective, safe, and well tolerated for unmedicated mild to moderate OCD. |
Abstract
Background: This was the first randomized controlled trial (RCT) designed to compare the efficacy of mindfulness-based cognitive therapy (MBCT) on unmedicated obsessive-compulsive disorder with that of the first-line treatment for OCD (SSRIs) or a placebo, as well as to analyze the treatment acceptability and safety of MBCT.
Methods: A total of 123 unmedicated OCD patients with mild to moderate symptoms were randomly assigned into selective serotonin reuptake inhibitors group (SSRIs group), MBCT group or psycho-education group (PE group), respectively. They were intervened for 10 weeks. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) grade was the primary outcome, and Hamilton Depression Scale-24 (HAMD-24) and Hamilton Anxiety Scale (HAMA) grades were secondary outcomes to be measured at baseline, mid-intervention, post-intervention and 14, 22, and 34 weeks of follow-up. The Five Facet Mindfulness Questionnaire (FFMQ) and Sheehan Disability Scale (SDS) were used to assess mindfulness and social functions, respectively. In addition, treatment acceptability (dropout rate and frequency of occurrence) and safety [adverse event (AE)] of MBCT were investigated.
Results: Significant differences were detected in the treatment responses among SSRIs group, MBCT group and PE group. Notably, treatment responses were significantly better in the former two groups than that of PE group (χ2 = 6.448, p = 0.04), although we did not identify significant differences between SSRIs group and MBCT group (χ2 = 1.220, p = 0.543). Observed until 6 months of follow-up, there were no significant differences in treatment response among three groups. No AE was recorded in MBCT group.
Conclusion: MBCT is effective in the treatment of unmedicated OCD with mild to moderate symptoms comparable to that of SSRIs, which contributes to maintain the treatment outcomes at follow-up. Besides, MBCT is safe with a good clinical compliance.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 6
- Effectiveness of mindfulness based interventions in reducing depressive symptoms across mental disorders: A meta-analysis of randomized controlled trials. Psychiatry Research June 1, 2025
- Mindfulness- and acceptance-based programmes for obsessive-compulsive disorder: A systematic review and meta-analysis. Journal of Anxiety Disorders March 1, 2025
- Effectiveness of Mindfulness-Based Cognitive Therapy in Managing Chronic Tinnitus Korean Journal of Otorhinolaryngology - Head and Neck Surgery May 14, 2025
- Clinical and Neuroimaging Effects of Mindfulness-Based Cognitive Therapy for Symptomatic Obsessive-Compulsive Disorder Patients after First-Line Treatments: A Randomised Controlled Trial. Psychotherapy and Psychosomatics 2026
- Pallidum volume as a predictor for the effectiveness of mindfulness-based cognitive therapy and psycho-education in unmedicated patients with obsessive-compulsive disorder. Comprehensive Psychiatry May 1, 2024
and 1 more in the library
Cites 14
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- Mindfulness-based cognitive therapy for depression August 21, 2006
- Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials Acta Psychiatrica Scandinavica April 28, 2011
- Standardised Mindfulness-Based Interventions in Healthcare: An Overview of Systematic Reviews and Meta-Analyses of RCTs PLoS One April 16, 2015
- Mindfulness-based cognitive therapy for obsessive-compulsive disorder: Study protocol for a randomized controlled trial with functional magnetic resonance imaging and a 6-month follow-up Journal of Health Psychology July 5, 2018
and 9 more in the library