The treatment efficacy of mindfulness-based cognitive therapy combined with medication on obsessive-compulsive disorder: evidence from effective connectivity of the triple network.
Siyi Wei, Bo Li, Weiqi Qin, Shancong Li, Jiahui Leng, Hongzhe Zhang, Weimiao Shan, Xiaoyi Luo, Songrui Wu, Ting Liu, Tinghuizi Shang, Yunhui Chen, Ping Li
Psychiatry research. Neuroimaging October 28, 2026 DOI: 10.1016/j.pscychresns.2026.112356 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Non-randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 76 |
| Population | Patients with obsessive-compulsive disorder (n=53) and healthy controls (n=23) |
| Interventions | Mindfulness-based cognitive therapy (MBCT) SSRIs |
| Duration | 10-week intervention, with assessments at baseline, week 4, and week 10 |
| Topics | Meditation |
| Keywords | Effective connectivity Mindfulness-based cognitive therapy Obsessive-compulsive disorder Triple network |
| Key findings | MBCT plus SSRIs produced greater improvements than SSRIs alone in obsessive-compulsive symptoms, depression, mindfulness, and quality of life, but not anxiety. The combination was accompanied by increased inhibitory effective connectivity within the salience network and increased excitatory connectivity from the salience to the frontoparietal network. Baseline effective connectivity showed moderate diagnostic accuracy (0.726) but did not predict treatment response. |
Abstract
To evaluate the clinical efficacy of mindfulness-based cognitive therapy (MBCT) plus SSRIs on obsessive-compulsive disorder (OCD), and explore its underlying neural mechanisms. A non-randomized controlled trial enrolled 53 OCD patients (medication group, n = 30; MBCT+medication group, n = 23) and 23 healthy controls (HCs). Patients received a 10-week intervention, with clinical assessments conducted at baseline, week 4 and 10, and fMRI acquired at baseline and week 10. Repeated-measures ANOVA, Granger causality analysis, elastic-net logistic regression and bayesian ridge regression were used for clinical efficacy, effective connectivity (EC), diagnostic classification and treatment-response prediction. The MBCT+medication group showed greater improvements in obsessive-compulsive symptoms, depression, mindfulness and quality of life than the medication group (P < 0.050), but not in anxiety (P = 0.082). At baseline, OCD showed abnormal EC within and between the frontoparietal (FPN) and salience networks (SN) versus HCs (P < 0.050). Post-intervention, the MBCT+medication group showed increased inhibitory EC within the SN (P = 0.040) and excitatory EC from the SN to the FPN (P = 0.021). Aberrant EC achieved moderate diagnostic performance (accuracy = 0.726, specificity = 0.740, sensitivity = 0.711), whereas treatment response was not predicted (cross-validated R2 = -0.100). MBCT combined with medication significantly improved clinical efficacy in OCD, accompanied by altered EC within the SN and from the SN to the FPN as concurrent neurobiological changes.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cites 8
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Mindfulness meditation increases default mode, salience, and central executive network connectivity Scientific Reports August 2, 2022
- 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
- Mindfulness-based stress reduction and mindfulness-based cognitive therapy for psychological health and well-being in nonclinical samples: A systematic review and meta-analysis. International Journal of Stress Management November 1, 2020
- Mindfulness-based cognitive therapy on bereavement grief: Alterations of resting-state network connectivity associate with changes of anxiety and mindfulness. Human Brain Mapping October 17, 2020
and 3 more in the library