Comparison of cognitive behavioral therapy and third-wave-mindfulness-based therapies for patients suffering from depression measured using the Beck-Depression-Inventory (BDI): A systematic literature review and network-meta-analysis

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY Journal of affective disorders Pub Date : 2025-06-15 Epub Date: 2025-03-05 DOI:10.1016/j.jad.2025.02.104

Alexander Buschner , Christian Makiol , Jue Huang , Nicole Mauche , Maria Strauß

{"title":"Comparison of cognitive behavioral therapy and third-wave-mindfulness-based therapies for patients suffering from depression measured using the Beck-Depression-Inventory (BDI): A systematic literature review and network-meta-analysis","authors":"Alexander Buschner , Christian Makiol , Jue Huang , Nicole Mauche , Maria Strauß","doi":"10.1016/j.jad.2025.02.104","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Mindfulness-based therapies (MBT) are proposed as a “third wave” of cognitive-behavioral therapy (CBT). This network meta-analysis investigated this hypothesis by comparing the effectiveness of MBT and CBT for treating depression, measured by the Beck Depression Inventory–II (BDI-II).</div></div><div><h3>Methods</h3><div>An indirect comparison was made. Relevant databases were searched for studies comparing either CBT or MBT with treatment as usual (TAU). Mean differences (MD) between intervention and TAU were calculated using changes from baseline from both intervention (Me) and TAU-group (Mc). MDs of CBT and MBT were compared in a network meta-analysis. Results were reported for both the common-effects-model (CEM) and the random-effects-model (REM). Risk of Bias (RoB) was measured using the RoB-2-tool. Quality of evidence was investigated based on GRADE.</div></div><div><h3>Results</h3><div>Eight MBT and ten CBT studies, meeting eligibility since 2006, were included. MBT studies included behavioral activation with mindfulness, mindfulness-based cognitive therapy, person-based cognitive therapy, and a newly developed meditation-based lifestyle modification program. Both CBT and MBT differed significantly from TAU. In the unweighted CEM network meta-analysis, MBT showed significantly better treatment effect, but this was below the clinically relevant threshold (MD:-1.81). For REM and weighted analysis, there were no significant differences between CBT and MBT.</div></div><div><h3>Limitations</h3><div>Heterogeneity, high RoB, and low evidence quality were notable, with indirectness limiting this analysis.</div></div><div><h3>Conclusions</h3><div>CBT and MBT both showed significant and clinically important treatment effects for depression. However, an outstanding benefit of MBT in comparison to CBT could not be found in this analysis. Further research could include a direct comparison.</div></div>","PeriodicalId":14963,"journal":{"name":"Journal of affective disorders","volume":"379 ","pages":"Pages 88-99"},"PeriodicalIF":4.9000,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of affective disorders","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0165032725003209","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Mindfulness-based therapies (MBT) are proposed as a “third wave” of cognitive-behavioral therapy (CBT). This network meta-analysis investigated this hypothesis by comparing the effectiveness of MBT and CBT for treating depression, measured by the Beck Depression Inventory–II (BDI-II).

Methods

An indirect comparison was made. Relevant databases were searched for studies comparing either CBT or MBT with treatment as usual (TAU). Mean differences (MD) between intervention and TAU were calculated using changes from baseline from both intervention (Me) and TAU-group (Mc). MDs of CBT and MBT were compared in a network meta-analysis. Results were reported for both the common-effects-model (CEM) and the random-effects-model (REM). Risk of Bias (RoB) was measured using the RoB-2-tool. Quality of evidence was investigated based on GRADE.

Results

Eight MBT and ten CBT studies, meeting eligibility since 2006, were included. MBT studies included behavioral activation with mindfulness, mindfulness-based cognitive therapy, person-based cognitive therapy, and a newly developed meditation-based lifestyle modification program. Both CBT and MBT differed significantly from TAU. In the unweighted CEM network meta-analysis, MBT showed significantly better treatment effect, but this was below the clinically relevant threshold (MD:-1.81). For REM and weighted analysis, there were no significant differences between CBT and MBT.

Limitations

Heterogeneity, high RoB, and low evidence quality were notable, with indirectness limiting this analysis.

Conclusions

CBT and MBT both showed significant and clinically important treatment effects for depression. However, an outstanding benefit of MBT in comparison to CBT could not be found in this analysis. Further research could include a direct comparison.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

认知行为疗法与第三波正念疗法对贝克抑郁量表（BDI）抑郁症患者的比较：系统文献综述和网络荟萃分析

正念疗法（MBT）被认为是认知行为疗法（CBT）的“第三波”。本网络meta分析通过比较MBT和CBT治疗抑郁症的有效性，通过贝克抑郁量表ii （BDI-II）来调查这一假设。方法进行间接比较。检索相关数据库，比较CBT或MBT与常规治疗（TAU）的研究。通过干预组（Me）和TAU组（Mc）的基线变化计算干预组和TAU组之间的平均差异（MD）。在网络荟萃分析中比较CBT和MBT的MDs。报告了共同效应模型（CEM）和随机效应模型（REM）的结果。使用rob2工具测量偏倚风险（Risk of Bias, RoB）。依据GRADE评价证据质量。结果纳入2006年以来符合入选条件的8项MBT和10项CBT研究。MBT研究包括正念的行为激活，基于正念的认知疗法，基于个人的认知疗法，以及新开发的基于冥想的生活方式改变计划。CBT和MBT均与TAU有显著差异。在未加权的CEM网络荟萃分析中，MBT的治疗效果明显更好，但低于临床相关阈值（MD:-1.81）。对于REM和加权分析，CBT和MBT之间无显著差异。异质性、高RoB和低证据质量显著，间接性限制了本分析。结论scbt与MBT治疗抑郁症疗效显著，具有重要的临床意义。然而，与CBT相比，MBT的显著益处在本分析中未被发现。进一步的研究可以包括直接比较。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.