Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and -survivors: a systematic review and meta-analysis of randomized controlled trials.

Author: Cillessen L1,2, Johannsen M3, Speckens AEM1,2, Zachariae R3
Author Information:
1Center for Mindfulness, Department of Psychiatry, Radboud university medical center, Nijmegen, The Netherlands.
2Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.
3Unit for Psychooncology and Health Psychology, Aarhus University Hospital and Aarhus University, Aarhus C, Denmark.
Conference/Journal: Psychooncology.
Date published: 2019 Aug 29
Other: Special Notes: doi: 10.1002/pon.5214. [Epub ahead of print] , Word Count: 270

OBJECTIVE: Mindfulness-based interventions (MBIs) are increasingly used within psycho-oncology. Since the publication of the most recent comprehensive meta-analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and -survivors.

METHODS: Two authors conducted independent literature searches in electronic databases from first available date to October 10th, 2018, selected eligible studies, extracted data for meta-analysis, evaluated risk of bias.

RESULTS: 29 independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post-intervention (Hedges's g=0.32; 95%CI:0.22-0.41;p<0.001) and follow-up (g=0.19; 95%CI:0.07-0.30;p<0.002). Statistically significant effects were also found at either post-intervention or follow-up for a range of self-reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p:<0.001 to 0.047). Larger effects of MBIs on psychological distress were found in studies 1) adhering to the original MBI manuals, 2) with younger patients, 3) with passive control conditions, and 4) shorter time to follow-up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post-intervention.

CONCLUSIONS: MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and -survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

This article is protected by copyright. All rights reserved.

KEYWORDS: Cancer; Meta-analysis; Mindfulness; Mindfulness-Based Cognitive Therapy; Mindfulness-Based Stress Reduction; Oncology; Systematic Review

PMID: 31464026 DOI: 10.1002/pon.5214