Treatment for Depression: Mindfulness Therapy Is Still Unproven Because of Flimsy Research

Meditation mayan calendar
People meditate as they count down to the end of the 13th bak'tun in the Maya Long Calendar near the base of the Uritorco hill in the Argentine city of Capilla del Monte, Cordoba province, December 21, 2012. A new analysis has shown that much of the scientific literature around mindfulness-based treatments for medical conditions has serious problems that have persisted for the last 16 years. REUTERS/Mariano Paiz

Mindfulness-based therapies might effectively treat a wide range of conditions, we're told, including anxiety, depression and addiction. And yet, despite an influx of funding, a new analysis has found methodological issues have continued to plague the science around the field for more than a decade.

Researchers analyzed 142 randomized, controlled clinical trials—the gold standard for evidence in medicine—involving mindfulness-based interventions. Depression was the most commonly studied condition; about 30 percent of the papers included in the researchers' analysis focused on this condition.

The group looked at six different indicators of quality, which included having a so-called "active control" group and a large pool of subjects. They published their results in the open-access journal PLoS One on Tuesday.

Though many of the studies had many of these indicators, the authors noted that the quality of studies hasn't been increasing over time in a statistically significant way.

That's discouraging, they wrote. "Considerable scientific efforts (and financial resources) have been spent conducting research on mindfulness [...] yet the body of literature is, on average, not becoming more rigorous with time."

Without rigorous research, it's impossible to say definitively whether mindfulness could be a useful tool to treat anything. And given that people have been critiquing the methodological issues since at least 2002—and as recently as last month—that indicates that there are still major issues with the literature around mindfulness.

"There is quite a bit of discussion about mindfulness and mindfulness research these days," Simon Goldberg told Newsweek. Goldberg is one of the authors of the PLoS One paper and conducted the study while a PhD student at the University of Wisconsin—Madison's Center for Healthy Minds. (He's since received his doctorate.) "Our hope ultimately is that the results from our study can help encourage researchers to implement some of these recommended practices in future studies."

Well-done studies have showed some promising results for mindfulness-based treatments efficacy. "In fact, for studies that compared mindfulness to an evidence-based treatment, mindfulness performed comparably well," Goldberg said. "The difference between mindfulness and evidence-based treatments was essentially zero."

However, he noted, "it remains an open question what kind of mindfulness-based intervention should be recommended for a given clinical condition."

Ironically, because one study from 2000 was so well done, it may have made it difficult for Goldberg and his colleagues to find a meaningful improvement over time. When the researchers took that study out of the equation, it did seem as though progress had been made; more recent research was better done in some ways than studies done further in the past. In particular, recent studies had larger sample sizes and more reported using an intention-to-treat analysis. This kind of statistical analysis is considered to be more conservative than others, which means any results observed may be considered more reliable.

So all is not lost when it comes to establishing mindfulness-based treatments' efficacy, Goldberg said. To continue moving in the right direction, scientists would need to commit to following the best methodological practices in future studies and include only the ones that do in larger analyses.

"I would say there is still plenty of work to be done, but I certainly wouldn't say that there is no evidence for the efficacy of mindfulness-based interventions."