Mindfulness-Based Interventions for Mental Health Outcomes in Frontline Healthcare Workers During the COVID-19 Pandemic: A Randomized Controlled Trial.
Marieke Arts-De Jong, Dirk E. M. Geurts, Philip Spinhoven, Henricus G. Ruhé, Anne E. M. Speckens
Journal of General Internal Medicine May 19, 2025 DOI: 10.1007/s11606-025-09529-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 201 |
| Population | Frontline healthcare workers (physicians, nurses, supporting staff) |
| Interventions | adjusted therapist-assisted Mindfulness-based Stress Reduction group intervention minimal self-guided mindfulness-based intervention |
| Duration | 4-week intervention, 6-month follow-up |
| Topics | Anxiety Depression Meditation |
| Keywords | Covid-19 pandemic Frontline healthcare workers Mental health Mindfulness-based intervention Emotional health Stress reduction Mindfulness meditation Contemplative practices Stress management Medical professionals Clinicians Nurses Doctors |
| Citations | 2 |
| Registration | NCT04720404 |
| Key findings | The therapist-assisted MBSR was not superior to the self-guided MBI; both interventions were accompanied by significant reductions in depressive, anxiety, and somatic symptoms sustained at 6-month follow-up. |
Abstract
The COVID-19 pandemic significantly impacted the mental health of frontline healthcare workers (HCWs), but solid evidence on psychological interventions for HCWs remains limited. Whether an adjusted therapist-assisted Mindfulness-based Stress Reduction group intervention (adjusted MBSR) is superior to a minimal self-guided mindfulness-based intervention (self-guided MBI) in improving mental health of HCWs during the COVID-19 pandemic. Randomized controlled trial. 201 frontline HCWs (47 physicians, 120 nurses, 34 supporting staff); enrollment between June 2020 and September 2021. A 4-week adjusted MBSR with eight biweekly 1.5-h sessions; or a 4-week self-guided MBI with 24 mindfulness/compassion exercises. Primary outcome was the Patient Health Questionnaire - Somatic, Anxiety and Depressive Symptom Scales (PHQ-SADS) at 6-month follow-up. Secondary outcomes included posttraumatic symptoms, insomnia, alcohol use, repetitive negative thinking, mental well-being, posttraumatic growth, mindfulness, and self-compassion at post-intervention and 3- and 6-month follow-up. At 6-month follow-up, the adjusted MBSR was not superior to the self-guided MBI (mean difference (SE) PHQ-SADS, 0.23 (1.03), P=0.82). Both interventions showed similar within-group improvement in PHQ-SADS (Cohen's d between baseline and 6-month follow-up: adjusted MBSR -0.78 (95% CI -1.07; -0.48), self-guided MBI -0.72 (95% CI -1.01; -0.43)). Secondary outcomes showed that symptom trajectories differed between groups for PHQ-SADS (intervention*time F(3, 420)=3.99, P=0.008), with greater reduction at post-intervention for adjusted MBSR, and posttraumatic growth (intervention*time F(3, 350)=5.32, P=0.001), with exclusive increase post-intervention in adjusted MBSR. Both interventions showed comparable significant within-group improvements on posttraumatic symptoms, insomnia, repetitive negative thinking, mental well-being, mindfulness, and self-compassion. The adjusted MSBR was not superior to the self-guided MBI; both were accompanied by significant reductions of depressive, anxiety, and somatic symptoms after 4 weeks of treatment which was sustained at 6-month follow-up. Further research is needed to investigate the possible role of MBIs to support HCWs involved in future healthcare crises. ClinicalTrials.gov NCT04720404; onderzoekmetmensen.nl/en NL73793.091.20.
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
Cites 8
- Association of an Educational Program in Mindful Communication With Burnout, Empathy, and Attitudes Among Primary Care Physicians JAMA September 22, 2009
- The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials Perspectives on Psychological Science February 16, 2021
- Individual participant data systematic review and meta-analysis of randomised controlled trials assessing adult mindfulness-based programmes for mental health promotion in non-clinical settings. Nature Mental Health July 10, 2023
- Effects of Web-Based Mindfulness-Based Interventions on Anxiety, Depression, and Stress Among Frontline Health Care Workers During the COVID-19 Pandemic: Systematic Review and Meta-Analysis. Journal of Medical Internet Research August 29, 2023
- Effects of Mobile App-Based Mindfulness Practice on Healthcare Workers: a Randomized Active Controlled Trial Mindfulness September 16, 2022
and 3 more in the library