A systematic review on mindfulness-based immersive interventions in depressive disorders

Depressive disorders are characterized by persistent negative affect, rumination, and impaired emotion regulation, contributing substantially to global disease burden. As recurrent rumination and negative attentional biases are central cognitive mechanisms of depression, interventions targeting these processes have gained increasing attention. Mindfulness-based interventions (MBIs) effectively treat depressive disorders but face adherence challenges, which immersive technology may resolve through multi-sensory stimulation and real-time feedback. This systematic review assesses the therapeutic potential of mindfulness-based immersive interventions (MBIIs, which combine immersive technologies with MBIs) for depressive disorders. Following PRISMA guidelines, we identified 37 eligible studies from 670 screened records. Across the included studies, a proportion of studies (69%) reported greater improvements in depressive and anxiety-related symptoms in MBII conditions compared with conventional therapies, while 78% of the trials reported improvements in psychological processes. A subset of trials reported greater feasibility and acceptance for immersive implementations compared with non-immersive approaches (67%), and 89% reported improvements in physiological outcomes. However, significant gaps remain, including substantial variability in sessions and VR configurations, insufficient active controls, and limited long-term validation. Future research is recommended to prioritize mechanistic studies to clarify neurocognitive pathways, standardize sessions, and evaluate cost-effectiveness.