TRANS-DIAGNOSTIC EFFICACY OF MINDFULNESS-BASED PROGRAMS: AN UMBRELLA REVIEW OF META-ANALYSES OF RANDOMIZED CONTROLLED TRIALS

To comprehensively evaluate meta-analyses (MAs) of randomized controlled trials (RCTs) that investigated associations between mindfulness-based programs (MBPs) and a wide range of health outcomes. Three electronic databases (PubMed, Embase, and Cochrane Library) were systematically searched from inception to April 2022 for meta-analyses of RCTs investigating associations between mindfulness and health outcomes. We included 59 MAs (421 RCT), reporting on 21 mental disorders or medical conditions. Methodological quality of individual primary studies was evaluated using the GRADE (Grading of Recommendations, Asssessment, Development and Evaluation) assessment. Each MA has been re-analyzed using the random-effects model. Summary effect sizes and their confidence interval for each outcome were estimated, along with prediction interval. We also calculated I2, small study effects, and excess significance that are associated with heterogeneity and bias. Treatments show moderate to medium efficacy for many outcomes in di#erent clinical populations. However, the quality of RCTs included by MAs is very poor. Considering the economic interests that revolve around the mindfulness industry (estimated at around $4 billion), high-quality RCT studies and longer follow-up period are needed.