Meditation-Based Lifestyle Modification in Mild-to-Moderate Depression: Outcomes and Moderation Effects of Spirituality

Author: Holger C Bringmann1,2, Anne Berghöfer1, Michael Jeitler1,3, Andreas Michalsen1,3, Stefan Brunnhuber2, Heidemarie Haller4
1 Institute of Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany).
2 Department of Psychiatry, Psychosomatics, and Psychotherapy, Diakoniekliniken, Zschadrass, Germany.
3 Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany.
4 Center for Integrative Medicine and Planetary Health, University Hospital Essen, University of Duisburg-Essen, Germany.
Conference/Journal: J Integr Complement Med
Date published: 2023 Nov 27
Other: Special Notes: doi: 10.1089/jicm.2023.0179. , Word Count: 305

Objective: Understanding the relevance of religion or spirituality (R/S) in the treatment of mental disorders is central to clinical and academic psychiatry. In this secondary analysis, associations of R/S with depression were investigated with respect to a new second-generation mindfulness-based intervention, the Meditation-Based Lifestyle Modification (MBLM) program. Methods: Different aspects of spirituality, spiritual coping, and spiritual engagement were assessed in 81 patients with a diagnosis of mild-to-moderate depression. Treatment effects on R/S postscores and predictor and moderation effects of depression severity and stress change-scores were evaluated at 8 weeks (MBLM vs. CONTROL [drug continuation therapy] vs. TAU [inpatient treatment as usual]) and 6 months (TAU+MBLM vs. TAU). Results: At both time points, significant differences between MBLM versus TAU and CONTROL were found in a range of spiritual outcomes, most of them with a medium-to-large effect size and in favor of MBLM. Baseline interest in spirituality (p = 0.001) and baseline spiritual mind-body practice (p = 0.017) were identified as independent predictors of change in depression severity at 6 months. Moreover, moderation analyses found that patients reporting often/regular spiritual mind-body practice at 6 months did not benefit differently from TAU+MBLM versus TAU (p = 0.437) regarding their change in depression severity and stress, while those reporting no/seldom spiritual mind-body practice at 6 months benefited significantly worse from TAU than from TAU+MBLM (p = 0.002). Conclusions: Participation in the MBLM program resulted in significantly greater increases in spirituality in depressed patients than standard therapy. Interest in spirituality and engagement in spiritual mind-body practices at baseline were positive predictors of clinical outcome in both groups. Patients of any group who regularly performed spiritual mind-body practices benefited equally in terms of antidepressant outcomes, underlining the benefit of these practices within a general therapeutic framework. Identifier: NCT03652220.

Keywords: complementary medicine; depression; ethical living; mantra; meditation; mind–body medicine; psychiatry; spirituality; yoga.

PMID: 38011739 DOI: 10.1089/jicm.2023.0179