Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder: Systematic Review and Meta-Analysis
Abstract
ObjectiveTo evaluate the efficacy and safety of Mindfulness-Based Stress Reduction (MBSR) for anxiety symptoms in adults with generalized anxiety disorder (GAD).
DesignSystematic review and meta-analysis.
Data SourcesCINAHL, Embase, MEDLINE, PsycINFO, Scopus, SocINDEX, ERIC (EBSCO), and ProQuest Dissertations & Theses Global were searched from inception to October 2025; identified trial protocols were hand-searched for subsequent reports through February 2026.
Eligibility criteria for selecting studiesRandomized, non-randomized, and single-arm trials evaluating the effects of MBSR on anxiety in adults with GAD.
Data extraction and synthesisTwo authors independently screened records, extracted data, and assessed risk of bias. The primary outcome was anxiety symptoms; the secondary outcome was adverse events. Random-effects meta-analyses were conducted, and certainty of evidence was assessed.
ResultsOf 19 included reports (16 independent samples), 8 randomized controlled trials (n=1,012) were included in the primary meta-analysis. MBSR significantly reduced anxiety symptoms vs. waitlist (Hedges g=-0.88; 95% CI -1.57 to -0.19) and general active comparators (g=-0.85; 95% CI -1.15 to -0.54), and showed no significant difference vs. escitalopram in two linked trials (g=0.09; 95% CI -0.11 to 0.29), with fewer adverse events in the in-person trial, the only one reporting them (15% vs. 79%; number needed to treat to avoid harm=2). GRADE certainty of evidence was high for the escitalopram comparison and very low for waitlist.
ConclusionsMBSR is a well-tolerated, nonpharmacologic treatment option for adults with GAD. Anxiety reductions were similar to escitalopram, with fewer adverse events; independent replication is needed. MBSR may be a viable option for patients who prefer non-pharmacological management or who cannot tolerate medication.
Systematic review registrationPROSPERO CRD420251140213.
SUMMARY BOXO_ST_ABSWhat is already known on this topicC_ST_ABSO_LIGeneralized anxiety disorder (GAD) is common and disabling, and pharmacotherapy is frequently discontinued because of adverse effects C_LIO_LIPrevious reviews of mindfulness-based interventions for anxiety pooled different programs and diagnoses, with inconsistent findings C_LIO_LIRecent noninferiority trials comparing Mindfulness-Based Stress Reduction (MBSR) with escitalopram had not been synthesized C_LI
What this study addsO_LIMBSR reduced anxiety symptoms compared with waitlist and general active comparators, although certainty of evidence for the waitlist comparison was very low C_LIO_LIIn two linked trials, anxiety reductions with MBSR were similar to those with escitalopram (high certainty evidence; g=0.09, 95% CI -0.11 to 0.29), with fewer adverse events in the in-person trial (15% v 79%; number needed to treat to avoid harm 2) C_LIO_LIIndependent replication and head-to-head trials against cognitive behavioral therapy are needed C_LI
Related
- The Association of a Mindfulness-Based Stress Reduction Nursing Model With Quality of Life in Patients With Chronic Tonsillitis Complicated by Anxiety Disorder: A Retrospective Study
- Effects of Information-Motivation-Behavioural Skills Model-Based Exercise and Mindfulness-Based Stress Reduction on Chronic Obstructive Pulmonary Disease With Anxiety and Depression
- Behavioral, Psychological, and Metabolic Characteristics of Adults with Co-Occurring Generalized Anxiety Disorder and Obesity: A Cross-Sectional Study
- Concerning the harm-benefit ratio of escitalopram for pediatric generalized anxiety disorder. A critical viewpoint on the evidence and approval process
- Effects of Mindfulness-Based Stress Reduction Combined With Perioperative Refined Nursing on Postoperative Sleep Disturbances, Anxiety, and Depression in Patients Undergoing Coronary Artery Bypass Grafting
BibTeX
@misc{neves2026mindfulnessbased,
title = {{Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder: Systematic Review and Meta-Analysis}},
author = {Vinicius V. Neves and Nana Amma O. O. Larbi and Rebecca L. Acabchuk and Laura N. Haygood and Vedhalakshmi Rajasankar and Simon B. Goldberg and Shufang Sun and Elizabeth A. Hoge and Judson A. Brewer and Chen Li and Blair T. Johnson and Eric B. Loucks},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.21.26366048},
url = {https://www.medrxiv.org/content/10.64898/2026.10.21.26366048v1},
note = {CC BY-ND},
}
RIS
TY - UNPB
TI - Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder: Systematic Review and Meta-Analysis
AU - Vinicius V. Neves
AU - Nana Amma O. O. Larbi
AU - Rebecca L. Acabchuk
AU - Laura N. Haygood
AU - Vedhalakshmi Rajasankar
AU - Simon B. Goldberg
AU - Shufang Sun
AU - Elizabeth A. Hoge
AU - Judson A. Brewer
AU - Chen Li
AU - Blair T. Johnson
AU - Eric B. Loucks
PY - 2026
DA - 2026/10/21
PB - medRxiv
DO - 10.64898/2026.10.21.26366048
UR - https://www.medrxiv.org/content/10.64898/2026.10.21.26366048v1
AB - ObjectiveTo evaluate the efficacy and safety of Mindfulness-Based Stress Reduction (MBSR) for anxiety symptoms in adults with generalized anxiety disorder (GAD). DesignSystematic review and meta-analysis. Data SourcesCINAHL, Embase, MEDLINE, PsycINFO, Scopus, SocINDEX, ERIC (EBSCO), and ProQuest Dissertations & Theses Global were searched from inception to October 2025; identified trial protocols were hand-searched for subsequent reports through February 2026. Eligibility criteria for selecting studiesRandomized, non-randomized, and single-arm trials evaluating the effects of MBSR on anxiety in adults with GAD. Data extraction and synthesisTwo authors independently screened records, extracted data, and assessed risk of bias. The primary outcome was anxiety symptoms; the secondary outcome was adverse events. Random-effects meta-analyses were conducted, and certainty of evidence was assessed. ResultsOf 19 included reports (16 independent samples), 8 randomized controlled trials (n=1,012) were included in the primary meta-analysis. MBSR significantly reduced anxiety symptoms vs. waitlist (Hedges g=-0.88; 95% CI -1.57 to -0.19) and general active comparators (g=-0.85; 95% CI -1.15 to -0.54), and showed no significant difference vs. escitalopram in two linked trials (g=0.09; 95% CI -0.11 to 0.29), with fewer adverse events in the in-person trial, the only one reporting them (15% vs. 79%; number needed to treat to avoid harm=2). GRADE certainty of evidence was high for the escitalopram comparison and very low for waitlist. ConclusionsMBSR is a well-tolerated, nonpharmacologic treatment option for adults with GAD. Anxiety reductions were similar to escitalopram, with fewer adverse events; independent replication is needed. MBSR may be a viable option for patients who prefer non-pharmacological management or who cannot tolerate medication. Systematic review registrationPROSPERO CRD420251140213. SUMMARY BOXO_ST_ABSWhat is already known on this topicC_ST_ABSO_LIGeneralized anxiety disorder (GAD) is common and disabling, and pharmacotherapy is frequently discontinued because of adverse effects C_LIO_LIPrevious reviews of mindfulness-based interventions for anxiety pooled different programs and diagnoses, with inconsistent findings C_LIO_LIRecent noninferiority trials comparing Mindfulness-Based Stress Reduction (MBSR) with escitalopram had not been synthesized C_LI What this study addsO_LIMBSR reduced anxiety symptoms compared with waitlist and general active comparators, although certainty of evidence for the waitlist comparison was very low C_LIO_LIIn two linked trials, anxiety reductions with MBSR were similar to those with escitalopram (high certainty evidence; g=0.09, 95% CI -0.11 to 0.29), with fewer adverse events in the in-person trial (15% v 79%; number needed to treat to avoid harm 2) C_LIO_LIIndependent replication and head-to-head trials against cognitive behavioral therapy are needed C_LI
ER -