Researchers find no symptom worsening following mindfulness-based cognitive therapy

by University of Wisconsin-Madison

edited by Swati Mestri, reviewed by Andrew Zinin

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Madison's Center for Healthy Minds (CHM), along with the UW–Madison Department of Educational Psychology and a multi-university team, has found no evidence that mindfulness-based cognitive therapy (MBCT) increases the risk of symptom worsening in a meta-analysis published in JAMA Network Open.

MBCT is a widely adopted, evidence-based intervention used to help people with recurrent depression prevent relapse. The program combines cognitive behavioral therapy with mindfulness practices like meditation. A 2016 meta-analysis combining results from nine studies of MBCT supported it as a leading treatment for depression, which affects nearly 332 million people worldwide.

That meta-analysis also played an important role in MBCT's adoption as a recommended treatment for preventing depression relapse. However, since then, the safety of MBCT has been questioned following limited studies that revealed patient-reported harm.

Importantly, these studies did not include a control (a group that receives no treatment to provide a basis for comparison). The lack of a control makes it difficult to account for symptom worsening directly related to MBCT.

"Due to the pervasiveness of global depression, as well as the wide dissemination of MBCT across health care systems, it is crucial to investigate any possible risk factors. The original meta-analysis has been very influential, so we hoped we might be able to collaborate with the original authors to investigate this follow-up question about symptom worsening that was not asked in the original study," says Simon Goldberg, core faculty at the Center for Healthy Minds and associate professor at UW–Madison's Department of Counseling Psychology.

The team reevaluated individual participant data (IPD) from the 2016 meta-analysis for symptom worsening following treatment relative to control conditions. De-identified IPD were gathered from nine randomized controlled trials evaluating MBCT for the prevention of depression relapse in 1,258 adult patients.

The data were analyzed to compare the odds of increased depressive symptoms after treatment with those of controls. Some studies in the meta-analysis included patients taking antidepressants in the control group.

Results showed no evidence that MBCT increased the odds of depressive symptom worsening relative to control conditions. In some secondary analyses, there was evidence that MBCT decreased the risk of symptom worsening relative to other treatments, including antidepressants. Taken together, the results support the continued dissemination of MBCT as an evidence-based treatment for recurrent depression.

It is important to note that the included trials focused on individuals in partial or full remission from recurrent depression, so the results may not fully apply to those with acute depression or other clinical populations. "We hope that future randomized controlled trials will include a broader assessment of patient experiences; however, we are optimistic following these important findings that MBCT is both helpful and not harmful to the average patient," Goldberg says.

Publication details

Simon B. Goldberg et al, Symptom Worsening in Mindfulness-Based Cognitive Therapy, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.29946

Journal information: JAMA Network Open

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PsychiatryPsychology & Mental health Provided by University of Wisconsin-Madison Who's behind this story?

Swati Mestri

Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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