Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder: Systematic Review and Meta-Analysis
Vinicius Vieira Neves, Nana Amma O. O. Larbi, Rebecca L. Acabchuk, Laura N. Haygood, Vedhalakshmi Rajasankar, Simon Benjamin Goldberg, Shufang Sun, Elizabeth A Hoge, Judson A. Brewer, Chen Li, Blair T Johnson, Eric B Loucks
medRxiv October 24, 2026 preprint DOI: 10.64898/2026.10.21.26366048 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized |
|---|---|
| Sample size | 1,012 |
| Population | Adults with generalized anxiety disorder |
| Intervention | Mindfulness-Based Stress Reduction (MBSR) |
| Topics | Anxiety Meditation |
| Key findings | MBSR significantly reduced anxiety symptoms versus waitlist (Hedges' g=−0.88) and general active comparators (g=−0.85), and showed no significant difference versus escitalopram (g=0.09) in two linked trials. The only in-person trial reporting adverse events found fewer with MBSR (15% vs 79%; number needed to treat to avoid harm=2). The authors conclude MBSR is a well-tolerated nonpharmacologic option, though independent replication is needed. |
Abstract
Objective: To evaluate the efficacy and safety of Mindfulness-Based Stress Reduction (MBSR) for anxiety symptoms in adults with generalized anxiety disorder (GAD).
Design: Systematic review and meta-analysis. Data Sources: CINAHL, Embase, MEDLINE, PsycINFO, Scopus, SocINDEX, ERIC (EBSCO), and ProQuest Dissertations & Theses Global were searched from inception to October 2025; identified trial protocols were hand-searched for subsequent reports through February 2026. Eligibility criteria for selecting studies: Randomized, non-randomized, and single-arm trials evaluating the effects of MBSR on anxiety in adults with GAD. Data extraction and synthesis: Two authors independently screened records, extracted data, and assessed risk of bias. The primary outcome was anxiety symptoms; the secondary outcome was adverse events. Random-effects meta-analyses were conducted, and certainty of evidence was assessed.
Results: Of 19 included reports (16 independent samples), 8 randomized controlled trials (n=1,012) were included in the primary meta-analysis. MBSR significantly reduced anxiety symptoms vs. waitlist (Hedges' g=−0.88; 95% CI −1.57 to −0.19) and general active comparators (g=−0.85; 95% CI −1.15 to −0.54), and showed no significant difference vs. escitalopram in two linked trials (g=0.09; 95% CI −0.11 to 0.29), with fewer adverse events in the in-person trial, the only one reporting them (15% vs. 79%; number needed to treat to avoid harm=2). GRADE certainty of evidence was high for the escitalopram comparison and very low for waitlist.
Conclusions: MBSR is a well-tolerated, nonpharmacologic treatment option for adults with GAD. Anxiety reductions were similar to escitalopram, with fewer adverse events; independent replication is needed. MBSR may be a viable option for patients who prefer non-pharmacological management or who cannot tolerate medication. Systematic review
Registration: PROSPERO CRD420251140213.
Comparable studies
Other systematic reviews and meta-analyses on anxiety, most cited first.