Is mindfulness for anxiety an effective treatment? A new study of 276 patients says yes.
Specifically, it found that a guided mindfulness-based stress reduction program (in this case “mindfulness-based stress reduction,” or MBSR) was as effective as a common antidepressant drug (escitalopram) for patients with anxiety disorders.
The study, conducted by researchers at Georgetown University Medical Center, was published in JAMA Psychiatry on November 9, 2022.
Prior studies had already shown that standardized mindfulness-based interventions can decrease anxiety, but they had not previously been studied in comparison to anti-anxiety drugs.
Mindfulness vs antidepressants
The clinicians recruited 276 patients between June 2018 and February 2020 from three hospitals in Boston, New York City and Washington, D.C., and randomly assigned each to either the mindfulness program (MBSR) or escitalopram.
MBSR was offered weekly for eight weeks via in-person classes of 2.5 hours, plus a day-long retreat weekend during the 5th or 6th week, and 45-minute daily home practice exercises.
Patients’ anxiety symptoms were assessed upon enrollment, and again at completion of the intervention at 8 weeks, along with post-treatment assessments at 12 and 24 weeks after enrollment.
The evaluators did not know whether the patients they were assessing received the drug or MBSR.
At the end of the trial, 102 patients had completed MBSR and 106 had completed their medication course.
The patients were relatively young, with a mean age of 33 and included 156 women, which comprised 75% of the enrollees, mirroring the disease prevalence in the U.S.
Results: mindfulness program just as effective as the antidepressant
The researchers used an assessment measure to rate the severity of symptoms of anxiety across all of the disorders on a scale of 1 to 7 (with 7 being severe anxiety).
Both groups saw a reduction in their anxiety symptoms.
Participants in the MBSR program experienced an average 1.35-point reduction in their anxiety symptoms, while patients who had been assigned to the antidepressant experienced a 1.43-point average reduction.
Though the antidepressant reduction was slightly higher, it was not statistically significant.
The average scores of both groups dropped from about 4.5 to 3.1, which translates to a significant 30% or so drop in the severity of peoples’ anxiety.
Getting insurance companies to recognize the effectiveness of mindfulness for anxiety
“Our study provides evidence for clinicians, insurers, and healthcare systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders,” said lead author Elizabeth Hoge.
That is especially imortant, she points out, because mindfulness meditation is currently reimbursed by only a few providers.
A major advantage of mindfulness meditation, she added, is that it doesn’t require a clinical degree to train someone to become a mindfulness facilitator.
Likewise, sessions can be done outside of a medical setting, such as at a school or community center.
Finding good treatments for anxiety is important
Anxiety disorders can be highly distressing; they include generalized anxiety, social anxiety, panic disorder and fear of certain places or situations, including crowds and public transportation.
Drugs that are currently prescribed for the disorders can be very effective, but many patients either have difficulty getting them, do not respond to them, or find the side effects as a barrier to consistent treatment.
Of note, approximately 15% of the U.S. population tried some form of meditation in 2017.
Online mindfulness training also an option
“It is important to note that although mindfulness meditation works, not everyone is willing to invest the time and effort to successfully complete all of the necessary sessions and do regular home practice which enhances the effect,” Hoge said.
“Also, virtual delivery via videoconference is likely to be effective, so long as the ‘live’ components are retained, such as question-and-answer periods and group discussion.”
Hoge points out that there are many phone apps that offer guided meditation, though researchers don’t know how apps compare with the full in-person, weekly group class experience.
In the future, the researchers also hope to explore the effects of MBSR on sleep and depression.
Study: “Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial”
Authors: Elizabeth A. Hoge, Eric Bui, Mihriye Mete, Mary Ann Dutton, Amanda W. Baker, and Naomi M. Simon
Published in: JAMA Psychiatry
Publication date: November 9, 2022
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