Mindfulness strategies for obsessive-compulsive disorder. A systematic review and meta-analysis

Mindfulness has been explored in obsessive-compulsive disorder (OCD) treatment, but its efficacy remains unclear. To evaluate the efficacy of mindfulness-based interventions (MBIs) for adults with OCD. A systematic review and meta-analysis were conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. Two independent reviewers selected randomized controlled trials (RCTs) comparing MBIs with active control interventions, including cognitive/behavioral techniques and psychoeducation. Primary outcomes were obsessive-compulsive symptoms, dropout rates, anxiety, depressive symptoms, mindfulness skills, and quality of life. Six RCTs (n = 499; mean age = 32.8 years; mean disorder duration = 9.83 years) were included. Interventions lasted from 2 to 48 weeks. The certainty of evidence ranged from low to high. Mindfulness did not significantly differ from other strategies for reducing obsessive-compulsive symptoms (SMD = -0.08; 95% CI: -0.35 to 0.18), dropout rates (RR = 1.00; 95% CI: 0.69 to 1.43), anxiety (SMD = -0.28; 95% CI: -0.57 to 0.00), or depression (SMD = -0.07; 95% CI: -0.26 to 0.11). A small improvement in mindfulness skills was observed (SMD = 0.24; 95% CI: 0.01 to 0.48), though not clinically relevant. Quality of life findings were inconsistent and could not be pooled in analysis. Mindfulness-based interventions were not significantly different from the group "other interventions", which included well-established OCD treatments such as exposure with response prevention (ERP), psychoeducation, and cognitive restructuring.