title: Standardised mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs.
abstract: BACKGROUND
  Mindfulness-based therapies are being used in a wide range of common chronic conditions in both treatment and prevention despite lack of consensus about their effectiveness in different patient categories.
  
  
  OBJECTIVE
  To systematically review the evidence of effectiveness MBSR and MBCT in different patient categories.
  
  
  METHODS
  A systematic review and meta-analysis of systematic reviews of RCTs, using the standardized MBSR or MBCT programs. We used PRISMA guidelines to assess the quality of the included reviews and performed a random effects meta-analysis with main outcome measure Cohen's d. All types of participants were considered.
  
  
  RESULTS
  The search produced 187 reviews: 23 were included, covering 115 unique RCTs and 8,683 unique individuals with various conditions. Compared to wait list control and compared to treatment as usual, MBSR and MBCT significantly improved depressive symptoms (d=0.37; 95%CI 0.28 to 0.45, based on 5 reviews, N=2814), anxiety (d=0.49; 95%CI 0.37 to 0.61, based on 4 reviews, N=2525), stress (d=0.51; 95%CI 0.36 to 0.67, based on 2 reviews, N=1570), quality of life (d=0.39; 95%CI 0.08 to 0.70, based on 2 reviews, N=511) and physical functioning (d=0.27; 95%CI 0.12 to 0.42, based on 3 reviews, N=1015). Limitations include heterogeneity within patient categories, risk of publication bias and limited long-term follow-up in several studies.
  
  
  CONCLUSIONS
  The evidence supports the use of MBSR and MBCT to alleviate symptoms, both mental and physical, in the adjunct treatment of cancer, cardiovascular disease, chronic pain, depression, anxiety disorders and in prevention in healthy adults and children.
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands; Department of Radiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Rinske A
authors.initials: RA
authors.lastname: Gotink
authors.affiliation: Department of Health Policy, Harvard University, Cambridge, United States of America.
authors.forename: Paula
authors.initials: P
authors.lastname: Chu
authors.affiliation: Department of Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Jan J V
authors.initials: JJ
authors.lastname: Busschbach
authors.affiliation: Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
authors.forename: Herbert
authors.initials: H
authors.lastname: Benson
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, United States of America.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Fricchione
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Radiology, Erasmus MC, Rotterdam, the Netherlands; Department of Health Policy and Management, Harvard School of Public Health, Boston, United States of America.
authors.forename: M G Myriam
authors.initials: MG
authors.lastname: Hunink
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000379:methods*; D006801:Humans; D064866:Mindfulness