Effects of Mindfulness-Based Interventions on Depression in Patients With Breast Cancer: A Systematic Review and
Chuntana Reangsing1,2, Sasinun Punsuwun3, Kristine Keller4
1Mae Fah Luang University, Chiangrai, Thailand.
Objective:
We examined the effects of Mindfulness-based interventions (MBIs) on depressive symptoms in women with breast cancer and examined the moderating effects of participant characteristics, research methodologies, and features of interventions.
Methods:
We systematically searched 12 databases through November 2022 without date restrictions using the following search terms: (mindful* or meditation) AND (cancer OR neoplasm) AND (depress*). Studies included were primary studies evaluating MBIs in women with breast cancer who also had depression. Studies were included if they used a control group and were written in English. We used a random-effects model to compute effect sizes (ESs) using Hedges' g, forest plot, and Q and I2 statistics as measure of heterogeneity. We also requested moderator analyses.
Results:
We found 19 studies with 2139 participants (49.4 ± 8.3 years old) that met inclusion criteria for this meta-analysis and systematic review. Overall, women in MBI groups demonstrated significantly lower levels of depression (g = 0.48, 95% CI:0.159, 0.792, P < .001) compared to women in control groups. Regarding moderators, providing MBIs with a home assignment component showed a significantly greater effect on decreasing depressive symptoms (g = 1.75) compared to MBIs without a home assignment component (g = 0.20). When researchers used concealed allocation technique, the interventions demonstrated lower effects on depression than when concealed allocation (g = 0.11vs g = 1.33, P ≤ .001) was not reported. Additionally, when researchers reported high rates of sample attrition, they found a lower effect size on depression (β = -.019, Q = 3.97, P = .046) indicating that attrition moderates the effect.
Conclusion:
MBIs are moderately effective interventions to reduce depressive symptoms among women with breast cancer. Clinicians might consider encouraging MBIs as adjunct/alternative treatments for women with breast cancer to manage symptoms of depression. Interventions that incorporat home assignments for practicing mindfulness are likely to have a greater effect on reducing depressive symptoms. Additionally, methods including concealed allocation and attrition rate were moderators of the effects of MBIs on depression in women with breast cancer.
Insights
Mindfulness-based interventions (MBIs) significantly reduce depressive symptoms in women with breast cancer. Interventions incorporating home assignments and robust methodologies show greater effectiveness.
Area of Science:
- Oncology
- Psychiatry
- Behavioral Science
Background:
- Breast cancer diagnosis frequently leads to depressive symptoms.
- Mindfulness-based interventions (MBIs) show promise in managing psychological distress.
- Evidence on the efficacy and moderators of MBIs for depression in breast cancer patients requires synthesis.
Conclusions:
- MBIs are moderately effective in reducing depressive symptoms among women with breast cancer.
- Clinicians may consider MBIs as adjunct treatments for depression management in this population.
- Intervention design, specifically the inclusion of home assignments, and methodological rigor, such as concealed allocation and attrition management, influence MBI effectiveness.
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