Mindfulness in Mental Health and Psychiatric Disorders of Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Mindfulness-Based Interventions (MBIs) are important tools to address mental health issues in children and adolescents. However, previous studies provided variable results that suggest that the effectiveness of those third-wave Cognitive Behavioral Therapies remains uncertain. OBJECTIVES: The main objective is to assess the impact of MBIs on anxiety, depression, and stress in children and adolescents. The secondary objective is to examine the modalities of MBIs used, the duration of interventions, and potential confounding factors, such as age. METHODS: A comprehensive search of multiple databases was conducted to identify randomized clinical trials (RCTs) evaluating the effects of MBIs on mental health outcomes in children and adolescents. The research was registered in PROSPERO, adhered to PRISMA guidelines, employed the Cochrane Risk of Bias 2 tool, and calculated the effect sizes using mean differences. RESULTS: Thirteen RCTs were included; ten were identified as having some concerns, while three were classified as having a low risk of bias. Mindfulness-Based Stress Reduction (MBSR) demonstrated a small positive effect on depression and anxiety, while non-specific MBIs showed a moderate positive effect both on depression and anxiety. Mindfulness-Based Cognitive Therapy (MBCT) was effective in reducing anxiety, depression (moderate positive effects on both), and stress symptoms. In one study, no significant improvements were seen on both anxiety and depression (for MBCT) and in another study on anxiety (for MBCT/MBSR). The meta-analysis did not identify a significant effect of mindfulness interventions on depression or anxiety. The high heterogeneity suggests varying outcomes, requiring further study of moderating factors. CONCLUSIONS: While some studies suggest benefits from MBIs, mainly MBCT's ability to improve mental health outcomes in children and adolescents, their overall efficacy remains uncertain due to the high heterogeneity. The findings underscore the importance of considering the intervention type, duration, and moderating factors, such as age, when implementing MBIs.