Digital Mindfulness-Based Interventions for Psychiatric Disorders: A Systematic Review and Meta-Analysis (Preprint)

BACKGROUND Mindfulness has been defined as the ability to observe thoughts, bodily sensations, and emotions in the present moment with openness and acceptance. Decades of research have shown that MBI’s are efficacious across many conditions. There are a variety of factors that may preclude individuals from accessing in-person MBIs, and digital MBIs offer a viable solution to difficulties accessing care. Internet-based treatments have the potential to increase accessibility, thus reaching a wider audience and reducing barriers to access. OBJECTIVE The emergence of digital mindfulness-based interventions (MBIs) represents a significant advancement in the accessibility of treatments for psychiatric disorders. We conducted a systematic review and meta-analysis to estimate the effects of digital MBIs on reducing symptoms in psychiatric disorders. METHODS A comprehensive systematic search was conducted encompassing studies published up to July 2024. The R package metafor was then used to conduct multilevel mixed effects models to estimate between-group effect sizes and moderator effects. RESULTS A total of 135 between-group effect sizes were reported in twenty-one studies with 20 independent study samples. Meta-analysis findings indicate a small-to-moderate between-group effect of digital MBIs on psychological outcomes as compared to control interventions (d = 0.36). Between-group effects of MBIs were smaller in studies that used active controls compared to studies that used treatment as usual controls. Type of digital MBI was also a significant moderator such that MBCT had significantly larger effects on outcomes compared to other digital MBIs (p = .05) and MBSR (p = .05). Study design was also a significant moderator (p = .004), such that effects of MBIs were smaller in studies with quasi-experimental designs compared to studies with a randomized controlled trial design. CONCLUSIONS Overall, digital MBIs are transdiagnositcally efficacious compared to passive controls and have similar efficacy to active controls. Future research should prioritize examining effects on disorders where no RCTs have yet evaluated digital MBIs, including eating disorders, personality disorders, and bipolar disorder. Additionally, the field would benefit from more rigorous RCTs with larger sample sizes.