Mindfulness-based cognitive therapy for bipolar disorder: A systematic review and meta-analysis.
Study Goal
The researchers aimed to assess the general efficacy of Mindfulness-Based Cognitive Therapy (MBCT) for bipolar disorder (BD), focusing on its effects on depression, anxiety, mania, stress, mindfulness ability, and emotional regulation.
Results Summary
MBCT significantly reduced symptoms of depression, anxiety, and stress, and improved mindfulness ability and emotional regulation in BD patients, but did not alleviate mania. Effects on depression and anxiety were sustained at 3 months but not at 12 months post-intervention.
Population
Patients with bipolar disorder (BD).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-based cognitive therapy (MBCT) | decrease | depression | patients with bipolar disorder (BD) | g = 0.37, 95%CI = 0.09-0.64, P = 0.009 | reduction in symptoms | #1 |
Mindfulness-based cognitive therapy (MBCT) | decrease | anxiety | patients with bipolar disorder (BD) | g = 0.45, 95%CI = 0.16-0.75, P = 0.002 | reduction in symptoms | #2 |
Mindfulness-based cognitive therapy (MBCT) | decrease | stress symptoms | patients with bipolar disorder (BD) | g = 0.39, 95%CI = 0.09-0.69, P = 0.01 | significantly reduced | #3 |
Mindfulness-based cognitive therapy (MBCT) | increase | mindfulness ability | patients with bipolar disorder (BD) | g = 0.63, 95%CI = 0.39-0.87, P < 0.00001 | significantly improved | #4 |
Mindfulness-based cognitive therapy (MBCT) | increase | emotion regulation | patients with bipolar disorder (BD) | g = 0.62, 95%CI = 0.14-1.10, P = 0.01 | significantly improved | #5 |
Mindfulness-based cognitive therapy (MBCT) | no change | symptoms of mania | patients with bipolar disorder (BD) | g = -0.26, 95%CI = -1.43-0.91, P = 0.66 | not alleviated | #6 |
Mindfulness-based cognitive therapy (MBCT) | decrease | symptoms of depression | patients with bipolar disorder (BD) | g = 0.46, 95%CI = 0.13-0.80, P = 0.006 | significantly improved | #7 |
Mindfulness-based cognitive therapy (MBCT) | decrease | symptoms of anxiety | patients with bipolar disorder (BD) | g = 0.57, 95%CI = 0.21-0.94, P = 0.002 | significantly improved | #8 |
Mindfulness-based cognitive therapy (MBCT) | no change | symptoms of depression | patients with bipolar disorder (BD) | g = 0.04, 95%CI = -0.29-0.37, P = 0.82 | not significantly improved | #9 |
Mindfulness-based cognitive therapy (MBCT) | no change | symptoms of anxiety | patients with bipolar disorder (BD) | g = 0.17, 95%CI = -0.16-0.50, P = 0.31 | not significantly improved | #10 |
Mindfulness-based cognitive therapy (MBCT) | decrease | depressive symptoms | patients with bipolar disorder (BD) | g = 0.3, 95%CI = -0.05-0.65, P = 0.09 | significantly reduced | #11 |
Mindfulness-based cognitive therapy (MBCT) | no change | anxiety symptoms | patients with bipolar disorder (BD) | g = 0.51, 95%CI = -0.20-1.22, P = 0.16 | not significantly reduced | #12 |
BACKGROUND: Mindfulness-based cognitive therapy (MBCT) is an increasingly popular treatment for major depression and anxiety disorder, but has shown inconsistent efficacy for bipolar disorder (BD). Therefore, we conducted a meta-analysis to assess the general efficacy of MBCT for BD. METHODS: Ten studies were identified that fulfilled the current inclusion criteria, including three controlled and seven uncontrolled studies. The effects of MBCT on depression, anxiety, mania, stress, mindfulness ability, and emotional regulation were assessed by comparing psychometric scale scores within groups (pre- vs. post-intervention) across trials as well as between groups (control vs. MBCT) across controlled trials. RESULTS: Within-group comparison revealed a reduction in symptoms of depression (g = 0.37, 95%CI = 0.09-0.64, P = 0.009) and anxiety (g = 0.45, 95%CI =0.16-0.75, P = 0.002) following treatment compared to baseline. Stress symptoms were also significantly reduced (g = 0.39, 95%CI = 0.09-0.69, P = 0.01), mindfulness ability (g = 0.63, 95%CI = 0.39-0.87, P<0.00001) and emotion regulation (g = 0.62, 95%CI=0.14-1.10, P = 0.01) were significantly improved compared to baseline. However, symptoms of mania were not alleviated (g=-0.26, 95%CI=-1.43-0.91, P = 0.66). Subgroup analysis indicated that symptoms of depression and anxiety were still significantly improved at 3 months post-intervention (g = 0.46, 95%CI = 0.13-0.80, P = 0.006 and g = 0.57, 95%CI = 0.21-0.94, P = 0.002, respectively) but not at 12 months (g = 0.04, 95%CI = -0.29-0.37, P = 0.82 and g = 0.17, 95%CI =-0.16-0.50, P = 0.31). In between-groups analysis of controlled studies, MBCT significantly reduced depressive symptoms (g = 0.3, 95%CI =-0.05-0.65, P = 0.09) but not anxiety symptoms (g = 0.51, 95%CI = -0.20-1.22, P = 0.16). CONCLUSION: Mindfulness-based cognitive therapy appears effective for alleviation of depression and anxiety among BD patients, possibly by improving emotional regulation and mindfulness abilities. However, efficacy appears time-limited and inconsistent, necessitating additional larger-scale studies and the development of post-intervention programs for sustained efficacy.