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Mindfulness-based interventions (MBIs) are increasingly suggested as therapeutic approaches for effecting substance use and misuse (SUM). The aim of this article is to review current evidence on the therapeutic efficacy of MBIs for SUM. A literature search was undertaken using four electronic databases and references of retrieved articles. The search included articles written in English published up to December 2011. Quality of included trials was assessed. In total, 24 studies were included, three of which were based on secondary analyses of previously investigated samples. Current evidence suggests that MBIs can reduce the consumption of several substances including alcohol, cocaine, amphetamines, marijuana, cigarettes, and opiates to a significantly greater extent than waitlist controls, non-specific educational support groups, and some specific control groups. Some preliminary evidence also suggests that MBIs are associated with a reduction in craving as well as increased mindfulness. The limited generalizability of the reviewed findings is noted (i.e., small sample size, lack of methodological details, and the lack of consistently replicated findings). More rigorous and larger randomized controlled studies are warranted.
Mindfulness meditation practices (MMPs) are a subgroup of meditation practices which are receiving growing attention. The present paper reviews current evidence about the effects of MMPs on objective measures of cognitive functions. Five databases were searched. Twenty three studies providing measures of attention, memory, executive functions and further miscellaneous measures of cognition were included. Fifteen were controlled or randomized controlled studies and 8 were case–control studies. Overall, reviewed studies suggested that early phases of mindfulness training, which are more concerned with the development of focused attention, could be associated with significant improvements in selective and executive attention whereas the following phases, which are characterized by an open monitoring of internal and external stimuli, could be mainly associated with improved unfocused sustained attention abilities. Additionally, MMPs could enhance working memory capacity and some executive functions. However, many of the included studies show methodological limitations and negative results have been reported as well, plausibly reflecting differences in study design, study duration and patients' populations. Accordingly, even though findings here reviewed provided preliminary evidence suggesting that MMPs could enhance cognitive functions, available evidence should be considered with caution and further high quality studies investigating more standardized mindfulness meditation programs are needed.
Mindfulness- based Cognitive Therapy (MBCT) is a meditation program based on an integration of Cognitive behavioural therapy and Mindfulness-based stress reduction. The aim of the present work is to review and conduct a meta-analysis of the current findings about the efficacy of MBCT for psychiatric patients. A literature search was undertaken using five electronic databases and references of retrieved articles. Main findings included the following: 1) MBCT in adjunct to usual care was significantly better than usual care alone for reducing major depression (MD) relapses in patients with three or more prior depressive episodes (4 studies), 2) MBCT plus gradual discontinuation of maintenance ADs was associated to similar relapse rates at 1 year as compared with continuation of maintenance antidepressants (1 study), 3) the augmentation of MBCT could be useful for reducing residual depressive symptoms in patients with MD (2 studies) and for reducing anxiety symptoms in patients with bipolar disorder in remission (1 study) and in patients with some anxiety disorders (2 studies). However, several methodological shortcomings including small sample sizes, non-randomized design of some studies and the absence of studies comparing MBCT to control groups designed to distinguish specific from non-specific effects of such practice underscore the necessity for further research
Objectives: The objective of this study was to compare mindfulness-based cognitive therapy (MBCT) with a psycho-educational control group designed to be structurally equivalent to the MBCT program but excluding the claimed “active ingredient” of MBCT (i.e., mindfulness meditation practice) for the treatment of patients with major depression (MD).Design: This was a randomized controlled trial.
Location: The study was conducted at the Institute of Psychiatry, University of Bologna, Italy.
Subjects: Patients who had MD and who did not achieve remission following at least 8 weeks of antidepressant treatment were considered for inclusion. Eligible subjects were randomized to receive MBCT or psycho-education and were prospectively followed for 8 weeks.
Outcome measures: MD severity was assessed with the Hamilton Rating Scale for Depression (HAMD). Measures of anxiety, mindfulness, and quality of life, as measured with the Beck Anxiety Inventory, Mindfulness Attention and Awareness Scale, and the Psychological General Well-being Index (PGWBI), respectively, were also included. All assessments were performed at baseline, 4 weeks, and 8 weeks. Changes of psychologic variables over the study period were analyzed by means of the repeated-measures analysis of variance.
Results: Of 29 screened subjects, 16 received MBCT or psycho-education. Both HAMD and PGWBI scores improved to a significantly higher extent in the MBCT group than in the psycho-educational control group.
Conclusions: Although limited by a small sample size and the lack of follow-up measures, the results of this preliminary study suggest the superiority of MBCT over psycho-education for subjects who had MD and who did not achieve remission following antidepressant treatment.
Mindfulness-based cognitive therapy (MBCT) showed efficacy for currently depressed patients. However, most of the available studies suffer from important methodological shortcomings, including the lack of adequate control groups. The present study aims to compare MBCT with a psycho-educational control group designed to be structurally equivalent to the MBCT program but excluding the main putative “active ingredient” of MBCT (i.e., mindfulness meditation practice) for the treatment of patients with major depression (MD) who did not achieve remission following at least 8 weeks of antidepressant treatment. Out of 106 screened subjects, 43 were randomized to receive MBCT or psycho-education and were prospectively followed for 26 weeks. MD severity was assessed with the Hamilton Rating Scale for Depression (HAM-D) and the Beck Depression Inventory-II (BDI-II). Measures of anxiety, mindfulness, and quality of life were also included. All assessments were performed at baseline, 4, 8, 17 and 26-weeks. Both HAM-D and BDI scores, as well as quality of life and mindfulness scores, showed higher improvements, which were particularly evident over the long-term period, in the MBCT group than in the psycho-education group. Although limited by a small sample size, the results of this study suggest the superiority of MBCT over psycho-education for non-remitted MD subjects.
Background: Mindfulness-based stress reduction (MBSR) is a clinically standardized meditation that has shown consistent efficacy for many mental and physical disorders. Less attention has been given to the possible benefits that it may have in healthy subjects. The aim of the present review and meta-analysis is to better investigate current evidence about the efficacy of MBSR in healthy subjects, with a particular focus on its benefits for stress reduction.Materials and methods: A literature search was conducted using MEDLINE (PubMed), the ISI Web of Knowledge, the Cochrane database, and the references of retrieved articles. The search included articles written in English published prior to September 2008, and identified ten, mainly low-quality, studies. Cohen's d effect size between meditators and controls on stress reduction and spirituality enhancement values were calculated.Results: MBSR showed a nonspecific effect on stress reduction in comparison to an inactive control, both in reducing stress and in enhancing spirituality values, and a possible specific effect compared to an intervention designed to be structurally equivalent to the meditation program. A direct comparison study between MBSR and standard relaxation training found that both treatments were equally able to reduce stress. Furthermore, MBSR was able to reduce ruminative thinking and trait anxiety, as well as to increase empathy and self-compassion.Conclusions: MBSR is able to reduce stress levels in healthy people. However, important limitations of the included studies as well as the paucity of evidence about possible specific effects of MBSR in comparison to other nonspecific treatments underline the necessity of further research.