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Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective: To systematically evaluate the effectiveness of mindfulness-based interventions (MBIs) on rumination among patients with depression and their efficacy across countries and year of publication and control conditions. Methods: Web of Science Core Collection, Medline, BIOSIS Citation Index,...

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Autores principales: Li, Pan, Mao, Lingyun, Hu, Maorong, Lu, Zihang, Yuan, Xin, Zhang, Yanyan, Hu, Zhizhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737922/
https://www.ncbi.nlm.nih.gov/pubmed/36498174
http://dx.doi.org/10.3390/ijerph192316101
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author Li, Pan
Mao, Lingyun
Hu, Maorong
Lu, Zihang
Yuan, Xin
Zhang, Yanyan
Hu, Zhizhong
author_facet Li, Pan
Mao, Lingyun
Hu, Maorong
Lu, Zihang
Yuan, Xin
Zhang, Yanyan
Hu, Zhizhong
author_sort Li, Pan
collection PubMed
description Objective: To systematically evaluate the effectiveness of mindfulness-based interventions (MBIs) on rumination among patients with depression and their efficacy across countries and year of publication and control conditions. Methods: Web of Science Core Collection, Medline, BIOSIS Citation Index, KCI-Korean Journal Database, SciELO Citation Index, PubMed, Cochrane Library, and Embase were searched to include randomized controlled trials of MBIs for depressive rumination that met the criteria. The Rumination Scale was used as the primary outcome indicator; Depression, mindfulness, and anxiety indexes were selected as the secondary outcome indicators. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors. RevMan5.3 software was used to perform a meta-analysis of the extracted data. Results: Nineteen studies with 1138 patients were included. Meta-analysis showed that MBIs could significantly reduce rumination levels in patients with depression (standardized mean difference (SMD) = −0.46; 95% confidence interval (CI): −0.58, −0.34; p < 0.001), notably improve depression (SMD = −0.58; 95% CI: −0.83, −0.32; p < 0.001), enhance mindfulness ability (SMD = 0.95; 95% CI: 0.57, 1.32; p < 0.001), and reduce the anxiety of patients with depression (SMD = −0.45, 95% CI: −0.62, −0.27; p < 0.001). MBIs conducted in Asia improved rumination better than studies in Europe and North America (SMD = −2.05 95% CI: −4.08, −0.01; p < 0.001) but had no greater effect than behavior activation on depression. The interventions carried out in the past 5 years were significantly better than earlier studies in improving mindfulness levels (SMD = 2.74; 95% CI: 0.81, 4.66; p = 0.005). Conclusions: MBIs are effective in the treatment of depression as they produce pleasant improvement in rumination and depression, decrease the degree of anxiety, and enhance mindfulness levels compared to controls. In newer forms of MBIs, regional differences need to be considered when designing the intervention program. More large, high-quality randomized controlled studies are needed to confirm the conclusion that the effectiveness of MBIs has differences in terms of the trial area and year of publication.
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spelling pubmed-97379222022-12-11 Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Li, Pan Mao, Lingyun Hu, Maorong Lu, Zihang Yuan, Xin Zhang, Yanyan Hu, Zhizhong Int J Environ Res Public Health Review Objective: To systematically evaluate the effectiveness of mindfulness-based interventions (MBIs) on rumination among patients with depression and their efficacy across countries and year of publication and control conditions. Methods: Web of Science Core Collection, Medline, BIOSIS Citation Index, KCI-Korean Journal Database, SciELO Citation Index, PubMed, Cochrane Library, and Embase were searched to include randomized controlled trials of MBIs for depressive rumination that met the criteria. The Rumination Scale was used as the primary outcome indicator; Depression, mindfulness, and anxiety indexes were selected as the secondary outcome indicators. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors. RevMan5.3 software was used to perform a meta-analysis of the extracted data. Results: Nineteen studies with 1138 patients were included. Meta-analysis showed that MBIs could significantly reduce rumination levels in patients with depression (standardized mean difference (SMD) = −0.46; 95% confidence interval (CI): −0.58, −0.34; p < 0.001), notably improve depression (SMD = −0.58; 95% CI: −0.83, −0.32; p < 0.001), enhance mindfulness ability (SMD = 0.95; 95% CI: 0.57, 1.32; p < 0.001), and reduce the anxiety of patients with depression (SMD = −0.45, 95% CI: −0.62, −0.27; p < 0.001). MBIs conducted in Asia improved rumination better than studies in Europe and North America (SMD = −2.05 95% CI: −4.08, −0.01; p < 0.001) but had no greater effect than behavior activation on depression. The interventions carried out in the past 5 years were significantly better than earlier studies in improving mindfulness levels (SMD = 2.74; 95% CI: 0.81, 4.66; p = 0.005). Conclusions: MBIs are effective in the treatment of depression as they produce pleasant improvement in rumination and depression, decrease the degree of anxiety, and enhance mindfulness levels compared to controls. In newer forms of MBIs, regional differences need to be considered when designing the intervention program. More large, high-quality randomized controlled studies are needed to confirm the conclusion that the effectiveness of MBIs has differences in terms of the trial area and year of publication. MDPI 2022-12-01 /pmc/articles/PMC9737922/ /pubmed/36498174 http://dx.doi.org/10.3390/ijerph192316101 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Li, Pan
Mao, Lingyun
Hu, Maorong
Lu, Zihang
Yuan, Xin
Zhang, Yanyan
Hu, Zhizhong
Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_fullStr Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_short Mindfulness on Rumination in Patients with Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_sort mindfulness on rumination in patients with depressive disorder: a systematic review and meta-analysis of randomized controlled trials
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737922/
https://www.ncbi.nlm.nih.gov/pubmed/36498174
http://dx.doi.org/10.3390/ijerph192316101
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