Self-Administered Mindfulness Interventions Reduce Stress in a Large, Randomized Controlled Multi-Site Study

Mindfulness witnessed a substantial popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a preregistered (OSF https://doi.org/10.17605/OSF.IO/UF4JZ; retrospective registration at ClinicalTrials.gov NCT06308744) multi-site study (nsites = 37, nparticipants = 2,239, 70.4% women, Mage = 22.4, s.d.age = 10.1, all fluent English speakers), we experimentally tested whether four single, standalone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of 0.27 (d = −0.56; 95% confidence interval, −0.43 to −0.69) between the control condition (M = 1.95, s.d. = 0.50) and the condition with the largest stress reduction (body scan: M = 1.68, s.d. = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries

Correction: Antidepressant and Neurocognitive Effects of Isoflurane Anesthesia versus Electroconvulsive Therapy in Refractory Depression.

[This corrects the article DOI: 10.1371/journal.pone.0069809.]

Antidepressant and neurocognitive effects of isoflurane anesthesia versus electroconvulsive therapy in refractory depression.

BACKGROUND:Many patients have serious depression that is nonresponsive to medications, but refuse electroconvulsive therapy (ECT). Early research suggested that isoflurane anesthesia may be an effective alternative to ECT. Subsequent studies altered drug, dose or number of treatments, and failed to replicate this success, halting research on isoflurane's antidepressant effects for a decade. Our aim was to re-examine whether isoflurane has antidepressant effects comparable to ECT, with less adverse effects on cognition. METHOD:Patients with medication-refractory depression received an average of 10 treatments of bifrontal ECT (n = 20) or isoflurane (n = 8) over 3 weeks. Depression severity (Hamilton Rating Scale for Depression-24) and neurocognitive responses (anterograde and retrograde memory, processing speed and verbal fluency) were assessed at Pretreatment, Post all treatments and 4-week Follow-up. RESULTS:Both treatments produced significant reductions in depression scores at Post-treatment and 4-week Follow-up; however, ECT had modestly better antidepressant effect at follow-up in severity-matched patients. Immediately Post-treatment, ECT (but not isoflurane) patients showed declines in memory, fluency, and processing speed. At Follow-up, only autobiographical memory remained below Pretreatment level for ECT patients, but isoflurane patients had greater test-retest neurocognitive score improvement. CONCLUSIONS:Our data reconfirm that isoflurane has an antidepressant effect approaching ECT with less adverse neurocognitive effects, and reinforce the need for a larger clinical trial

Scores on Hamilton Rating Scale for Depression (HRSD-24) at Pretreatment), 24–48 hours after the last treatment (Post-treatment) and at 4-week Follow-up.

<p>Treatment with ECT and ISO result in significant decreases in HRSD-24 depressive symptoms at both Post-treatment and Follow-up compared to Pretreatment. No significant group differences were seen at Post-treatment, but ECT-Matched maintained these low scores better than ISO at Follow-up. <b>+</b> ECT-All vs. ISO p<0.05, <b>&</b> ECT-Matched vs. ISO p<0.05, <b>*</b>Within-group ECT-All Change from Pretreatment p<0.001, <b>#</b> Within-group ECT-Matched Change from Pretreatment p<0.01, <b>@</b> Within-group ISO Change from Pretreatment p<0.005 at Post-treatment and p<0.05 at Follow-up.</p

Neurocognitive Means (SEM) at Pretreatment, Post-Treatment and Follow-up, Adjusted for Intellectual Level and Age.

<p><i>All p-values are for mean comparisons versus ISO after adjustment for group differences in age and WTAR score. Post-treatment and Follow-up p-values are also adjusted for group differences in Pretreatment and thus test group differences in performance decline or improvement from Pretreatment levels.</i></p><p><i>Cohen's d effect sizes for significant comparisons were consistently large and ranged from 1.1 to 1.7.</i></p

Group Demographics, Intellectual Level, Depression Severity, and Pretreatment Medications.

*<p><i>ECT-All vs. ISO, p<0.05; ECT-Matched vs. ISO nonsignificant.</i></p>**<p><i>ECT-Matched vs. ISO, p<0.05; ECT-All vs. ISO non-significant.</i></p>a<p><i>Group differences non-significant.</i></p>b<p><i>Responders are defined as at least 50% reduction in HRSD score.</i></p>c<p><i>Anticonvulsant medications were stopped during treatment sessions in all groups.</i></p

Scores on the Quick Inventory of Depression Scale (QIDS-SR16) self report form over 21 days of treatment (treatment sessions 1–10).

<p>For brevity, results are depicted showing change over each week, from Day 1 (prior to 1st treatment), Day 7 (prior to 4^th treatment), Day 14 (prior to 7^th treatment), and Day 21 (prior to 10th treatment). <b>*</b>Within-group ECT-All Change from Day 1 p<0.05, <b>#</b> Within-group ECT-Matched Change from Day 1 p<0.05, <b>@</b> Within-group ISO Change from Day 1 p<0.05.</p

Self-administered mindfulness interventions reduce stress in a large, randomized controlled multi-site study

Mindfulness witnessed a substantial popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a preregistered (OSF https://doi.org/10.17605/OSF.IO/UF4JZ; retrospective registration at ClinicalTrials.gov NCT06308744) multi-site study (nsites = 37, nparticipants = 2,239, 70.4% women, Mage = 22.4, s.d.age = 10.1, all fluent English speakers), we experimentally tested whether four single, standalone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of 0.27 (d = −0.56; 95% confidence interval, −0.43 to −0.69) between the control condition (M = 1.95, s.d. = 0.50) and the condition with the largest stress reduction (body scan: M = 1.68, s.d. = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries

Self-administered mindfulness interventions reduce stress in a large, randomized controlled multi-site study

Mindfulness witnessed a significant popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a pre-registered (OSF: https://doi.org/10.17605/OSF.IO/UF4JZ; retrospective registration at ClinicalTrials.gov: NCT06308744) multi-site study (Nsites = 37, Nparticipants = 2,239, 70.4% women, Mage = 22.4, SDage = 10.1, all fluent English speakers) we experimentally tested whether four single, stand-alone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of .27 (d = -.56; 95% CI, -.43 to -.69) between the control condition (M = 1.95, SD = 0.50) and the condition with the largest stress reduction (i.e., Body Scan: M = 1.68, SD = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries