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Objectives <p>The study aimed&#xa0;to compare the efficacy, acceptability, and feasibility of traditional Buddhist mindfulness (TBM) versus secular mindfulness-based cognitive therapy (MBCT) for residual depressive symptoms, and to examine whether TBM is non-inferior to MBCT in improving depressive symptoms and psychological wellbeing.</p> Method <p>In this pilot randomized controlled trial, Buddhist adults with residual depressive symptoms (Beck Depression Inventory-II [BDI-II] score &gt; 13) receiving outpatient antidepressant treatment were randomized to an 8-week group-based TBM or MBCT intervention. Primary outcomes were depressive symptoms (BDI-II) and psychological wellbeing (WHO-5 Well-Being Index). Secondary outcomes included mindfulness, self-compassion, and perceived benefits from religiosity/spirituality (R/S). Primary analyses followed the intention-to-treat principle. Non-inferiority margins were prespecified at 2.5 BDI-II points and 1.25 WHO-5 points.</p> Results <p>Sixty-six participants were randomized (TBM = 34; MBCT = 32). Both interventions produced significant within-group improvements. Mean BDI-II scores decreased by 13.1 points in TBM (<i>p</i> &lt; 0.001; Hedges’ <i>g</i> = 0.91) and 12.9 points in MBCT (<i>p</i> &lt; 0.001; <i>g</i> = 1.12). WHO-5 scores increased by 6.8 points in TBM (<i>p</i> &lt; 0.001; <i>g</i> = 0.91) and 6.9 points in MBCT (<i>p</i> &lt; 0.001; <i>g</i> = 0.93). Between-group differences were not statistically significant, and non-inferiority of TBM was not statistically demonstrated (BDI-II: <i>Mdiff</i> = − 0.16, 95% CI − 5.4 to 5.1; WHO-5: <i>Mdiff</i> = − 0.2, 95% CI − 3.2 to 2.8). Mindfulness and self-compassion increased in both groups, while perceived R/S benefits increased only in TBM.</p> Conclusions <p>Both TBM and MBCT were associated with large, clinically meaningful improvements and comparable acceptability. TBM’s selective effect on R/S highlights its cultural relevance and supports further evaluation in larger trials.</p> Pre-registration <p>This study was registered in the Clinical Trial Registry (NCT06456931) on 13/06/2024.</p>

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Traditional Buddhist Mindfulness Versus Secular Mindfulness-Based Cognitive Therapy for Residual Depressive Symptoms in Patients Treated for Depressive Disorder: A Pilot Randomized Controlled Trial

  • 期刊论文

  • 发表日期：

    2026年6月27日

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  • Anuradha Baminiwatta,
  • Takeshi Hamamura,
  • Anjalika Madhubhashini,
  • Sidath Dasanayaka,
  • Samitha Dhananjaya,
  • Miyuru Chandradasa,
  • Nicholas T. Van Dam

摘要

Objectives

The study aimed to compare the efficacy, acceptability, and feasibility of traditional Buddhist mindfulness (TBM) versus secular mindfulness-based cognitive therapy (MBCT) for residual depressive symptoms, and to examine whether TBM is non-inferior to MBCT in improving depressive symptoms and psychological wellbeing.

Method

In this pilot randomized controlled trial, Buddhist adults with residual depressive symptoms (Beck Depression Inventory-II [BDI-II] score > 13) receiving outpatient antidepressant treatment were randomized to an 8-week group-based TBM or MBCT intervention. Primary outcomes were depressive symptoms (BDI-II) and psychological wellbeing (WHO-5 Well-Being Index). Secondary outcomes included mindfulness, self-compassion, and perceived benefits from religiosity/spirituality (R/S). Primary analyses followed the intention-to-treat principle. Non-inferiority margins were prespecified at 2.5 BDI-II points and 1.25 WHO-5 points.

Results

Sixty-six participants were randomized (TBM = 34; MBCT = 32). Both interventions produced significant within-group improvements. Mean BDI-II scores decreased by 13.1 points in TBM (p < 0.001; Hedges’ g = 0.91) and 12.9 points in MBCT (p < 0.001; g = 1.12). WHO-5 scores increased by 6.8 points in TBM (p < 0.001; g = 0.91) and 6.9 points in MBCT (p < 0.001; g = 0.93). Between-group differences were not statistically significant, and non-inferiority of TBM was not statistically demonstrated (BDI-II: Mdiff = − 0.16, 95% CI − 5.4 to 5.1; WHO-5: Mdiff = − 0.2, 95% CI − 3.2 to 2.8). Mindfulness and self-compassion increased in both groups, while perceived R/S benefits increased only in TBM.

Conclusions

Both TBM and MBCT were associated with large, clinically meaningful improvements and comparable acceptability. TBM’s selective effect on R/S highlights its cultural relevance and supports further evaluation in larger trials.

Pre-registration

This study was registered in the Clinical Trial Registry (NCT06456931) on 13/06/2024.