Effects of Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy on Symptomatic Generalized Anxiety Disorder: A Randomized Controlled Trial
Abstract Background: Mindfulness-based cognitive therapy (MBCT) is a promising treatment for generalized anxiety disorder (GAD). Cognitive behavioral therapy (CBT) is currently considered a first-line treatment for GAD. The objective of this study was to examine the efficacy of MBCT in symptomatic GAD patients compared with CBT for a variety of outcomes of anxiety symptoms, as well as depressive symptoms, overall illness severity, quality of life and mindfulness. Methods: Adult patients with GAD (n = 138) were randomized to a MBCT or CBT group. Both groups received either MBCT or CBT in addition to treatment-as-usual (TAU). The primary outcomes were the anxiety response and remission rates, as measured using the Hamilton Anxiety Scale (HAMA). Secondary outcomes included scores on the HAMA, the state-trait anxiety inventory (STAI), the Hamilton Depression Scale (HAMD), the Severity Subscale of the Clinical Global Impression Scale (CGI-S), and the 12-item Short-Form Health Survey (SF-12) , as well as mindfulness measured by the Five Facet Mindfulness Questionnaire (FFMQ). Assessments were performed at baseline, 8 weeks after treatment, and at a 3-month follow-up. For primary analyses, response and remission rates were analyzed by the χ2 test in the two groups at each assessment time. For the secondary analyses, separate two-way mixed ANOVAs were performed to compare the mean differences in all secondary outcomes. Results: The anxiety remission rate of the two groups significantly differed (63.8% in the MBCT group vs. 44.6% in the CBT group, p = 0.040, Cohen’s d = 0.39) but not in anxiety response rate (86.2% vs. 80.4%, p = 0.402; Cohen’s d = 0.16) at 8 weeks. Overall illness severity and mindfulness were significantly different between the groups at 8 weeks. There were no significant differences between the two groups at the 3-month follow-up. Conclusions: Our data indicate that MBCT was effective in reducing anxiety symptoms in GAD patients. While MBCT appeared to have better short-term benefits, the long-term benefits of CBT may be superior.Trial registration: registered at chic.org.cn (registration number: ChiCTR1800019150, registration date: 27/10/2018).
