A systematic review and meta-analysis of mindfulness based interventions and yoga in inflammatory bowel disease

Abstract

Background Mindfulness interventions are increasingly used as a part of integrated treatment in inflammatory bowel disease (IBD) but there are limited data and a lack of consensus regarding effectiveness.

Objectives We explored the efficacy of mindfulness interventions compared to treatment as usual (TAU), or other psychotherapeutic interventions, in treating physical and psychosocial symptoms associated with IBD.

Methods We conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs). We included a broad range of mindfulness interventions including mindfulness-based interventions and yoga, with no restrictions on date of publication, participants' age, language or publication type. We searched the following electronic databases: MEDLINE, EMBASE, PsycINFO, CINAHL and WHO ICTRP database. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines in conducting the review.

Results We included eight studies in the meta-analysis. Mindfulness interventions showed a statistically significant effect on stress in both the short(SMD = −0.48; 95%CI:–0.97, 0.00; P = .05), and long term(SMD = −0.55; 95%CI:-0.78, −0.32; P < .00001), significant long term effects on depression (SMD = −0.36; 95%CI:–0.66, −0.07; P = .02) and quality of life (SMD = 0.38; 95%CI:0.08, 0.68; P = .01),and small but not statistically significant improvements in anxiety (SMD = −0.27; 95%CI:-0.65, 0.11; P = .16).Effects on physical outcomes were equivocal and not statistically significant.

Conclusions Mindfulness interventions are effective in reducing stress and depression and improving quality of life and anxiety, but do not lead to significant improvements in the physical symptoms of IBD. Further research involving IBD-tailored interventions and more rigorously designed trials is warranted.