title: Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: a systematic review.
abstract: BACKGROUND
  Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, owing to a lower side-effect burden, potential reduction of polypharmacy, and theoretical considerations that such interventions may target some of the cognitive roots of depression.
  
  
  OBJECTIVE
  We aimed to determine the state of the evidence supporting this application.
  
  
  METHODS
  Randomized controlled trials of techniques meeting the Agency for Healthcare Research and Quality definition of meditation, for participants having clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e., how they were applied) components, and trial outcomes were reviewed.
  
  
  RESULTS
  18 studies meeting the inclusion criteria were identified, encompassing 7 distinct techniques and 1173 patients. Mindfulness-Based Cognitive Therapy comprised the largest proportion of studies. Studies including patients having acute major depressive episodes (n = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (n = 8), demonstrated moderate to large reductions in depression symptoms within the group, and relative to control groups. There was significant heterogeneity of techniques and trial designs.
  
  
  CONCLUSIONS
  A substantial body of evidence indicates that meditation therapies may have salutary effects on patients having clinical depressive disorders during the acute and subacute phases of treatment. Owing to methodologic deficiencies and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium.
authors.affiliation: Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA (FAJ, SC). Electronic address: fjain@mednet.ucla.edu.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Jain
authors.affiliation: Department of Psychiatry, University of California, Irvine, CA (RNW).
authors.forename: Roger N
authors.initials: RN
authors.lastname: Walsh
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA (SJE).
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Eisendrath
authors.affiliation: Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA (FAJ, SC).
authors.forename: Scott
authors.initials: S
authors.lastname: Christensen
authors.affiliation: Department of Psychiatry, University of Southern California, Los Angeles, CA (BRC); Brain and Creativity Institute, University of Southern California, Los Angeles, CA (BRC).
authors.forename: B
authors.initials: B
authors.lastname: Rael Cahn
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods; D003866:Depressive Disorder / Q000628:therapy; D003865:Major Depressive Disorder / Q000628:therapy*; D006801:Humans; D019122:Meditation / Q000379:methods*; D064866:Mindfulness / Q000379:methods*; D016896:Treatment Outcome