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Meditation programs for psychological stress and well-being: a systematic review and meta-analysis.

JAMA internal medicine
March 1, 2014
Madhav Goyal et al. (15 authors)
Journal ArticleMeta-AnalysisResearch Support, U.S. Gov't, P.H.S.ReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the efficacy of meditation programs in improving stress-related outcomes such as anxiety, depression, and pain in diverse adult clinical populations.

Results Summary

Mindfulness meditation programs showed moderate evidence of improved anxiety, depression, and pain, with small to moderate reductions in negative psychological stress dimensions. However, there was low or insufficient evidence for effects on positive mood, attention, substance use, eating habits, sleep, and weight.

Population

Diverse adult clinical populations.

Effective Dosage

Not specified.

Duration

8 weeks to 6 months.

Interactions

None mentioned.

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
meditation programs
decrease
anxiety
diverse adult clinical populations
effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months
moderate evidence of improved
#1
meditation programs
decrease
depression
diverse adult clinical populations
0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months
moderate evidence of improved
#2
meditation programs
decrease
pain
diverse adult clinical populations
0.33 [0.03- 0.62]
moderate evidence of improved
#3
meditation programs
decrease
stress/distress
diverse adult clinical populations
-
low evidence of improved
#4
meditation programs
increase
mental health-related quality of life
diverse adult clinical populations
-
low evidence of improved
#5
meditation programs
no change
positive mood
diverse adult clinical populations
-
low evidence of no effect or insufficient evidence of any effect
#6
meditation programs
no change
attention
diverse adult clinical populations
-
low evidence of no effect or insufficient evidence of any effect
#7
meditation programs
no change
substance use
diverse adult clinical populations
-
low evidence of no effect or insufficient evidence of any effect
#8
meditation programs
no change
eating habits
diverse adult clinical populations
-
low evidence of no effect or insufficient evidence of any effect
#9
meditation programs
no change
sleep
diverse adult clinical populations
-
low evidence of no effect or insufficient evidence of any effect
#10
meditation programs
no change
weight
diverse adult clinical populations
-
low evidence of no effect or insufficient evidence of any effect
#11
meditation programs
no change
-
diverse adult clinical populations
-
no evidence that meditation programs were better than any active treatment
#12
meditation programs
decrease
multiple negative dimensions of psychological stress
patients
-
can result in small to moderate reductions
#13
Abstract

IMPORTANCE: Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation. OBJECTIVE: To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations. EVIDENCE REVIEW: We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. FINDINGS: After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies). CONCLUSIONS AND RELEVANCE: Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.

Medical Subject Headings (MeSH)
AdultAffectAnxietyDepressionHumansMeditationQuality of LifeStress, Psychological
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality85/10
Citation Metrics
Total Citations1,019
Citations/Year92.6
Relative Citation Ratio46.48
NIH Percentile99.9%
Research Impact Scores
APT Score0.95
Weight Score2.20
Normalized Score0.63
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