Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials

作者：J. Galante, C. Friedrich, Anna F Dawson, M. Modrego-Alarcón, P. Gebbing, Irene Delgado-Suárez, Radhika Gupta, L. Dean, T. Dalgleish, I. White, Peter B. Jones · 发表于：PLoS Medicine · 年份：2021 · DOI：10.1371/journal.pmed.1003481 · 被引用次数：264 · 研究领域：Medicine

Background There is an urgent need for mental health promotion in nonclinical settings. Mindfulness–based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions. Methods and findings Following a detailed preregistered protocol (PROSPERO CRD42018105213) developed with public and professional stakeholders, 13 databases were searched to August 2020 for randomised controlled trials (RCTs) examining in–person, expert–defined MBPs in nonclinical settings. Two researchers independently selected, extracted, and appraised trials using the Cochrane Risk–of–Bias Tool 2.0. Primary outcomes were psychometrically validated anxiety, depression, psychological distress, and mental well–being questionnaires at 1 to 6 months after programme completion. Multiple testing was performed using p < 0.0125 (Bonferroni) for statistical significance. Secondary outcomes, meta–regression and sensitivity analyses were prespecified. Pairwise random–effects multivariate meta–analyses and prediction intervals (PIs) were calculated. A total of 11,605 participants in 136 trials were included (29 countries, 77% women, age range 18 to 73 years). Compared with no intervention, in most but not all scenarios MBPs improved average anxiety (8 trials; standardised mean difference (SMD) = −0.56; 95% confidence interval (CI) −0.80 to −0.33; p–...