The effectiveness of mindfulness-based cognitive therapy on rumination and related psychological indicators: a systematic review and meta-analysis

The effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on rumination has been reviewed; however, the findings remain inconclusive. The present research will systematically evaluate the effectiveness of MBCT on rumination and related psychological indicators. We searched the Cochrane Library, EBSCO, Embase, LILACS, PubMed, Web of Science, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Science and Technology Journal Database (VIP) for all available records up until December 2024 to include randomized controlled trials (RCTs) examining MBCT on rumination. Rumination scores served as the primary outcome, and the mindfulness, self-compassion, decentering, depression, and anxiety scores served as the secondary outcomes. RevMan and Stata software were applied for data processing. Twenty-nine RCTs comprising 2535 subjects were ultimately selected for analysis. The results revealed that MBCT significantly reduced rumination (SMD = -0.51, 95% CI = -0.64, -0.39, z = 8.30, P < 0.001), with sustained effectiveness during the follow-up period (SMD = -0.61, 95% CI = -0.89, -0.32, z = 4.21, P < 0.001). Additionally, we also discovered that MBCT had significant effectiveness on mindfulness (SMD = 0.55, 95% CI = 0.46, 0.63, z = 12.04, P < 0.001), self-compassion (SMD = 0.59, 95% CI = 0.22, 0.96, z = 3.15, P = 0.002), decentering (SMD = 0.62, 95% CI = 0.45, 0.78, z = 7.24, P < 0.001), depressive (SMD = -0.57, 95% CI = -0.79, -0.34, z = 4.95, P < 0.001) and anxiety symptoms (SMD = -0.37, 95% CI = -0.56, -0.18, z = 3.78, P < 0.001). Funnel plot analysis and Egger's statistical test did not reveal any significant publication bias (t = -1.47, P = 0.154, 95% CI = -2.20,0.37). The present findings confirm the feasibility of MBCT in diminishing rumination and enhancing related psychological indicators. Furthermore, these effects were sustained throughout the follow-up period.