Introduction

Mental health is conceived as a state of balance between an individual's emotional, psychological, and social well-being, transcending the absence of mental disorders. Its presence is an essential component in ensuring an adequate quality of life. 1 More broadly, it constitutes an indispensable foundation for individual and collective development, directly influencing the ability to make decisions, establish functional interpersonal relationships, and effectively meet everyday demands. Likewise, mental health must be understood as a fundamental human right and essential for personal, community, and socioeconomic development. 2 It should be noted that each individual experiences their mental health in a unique way, facing different levels of psychological distress and contextual challenges, which leads to considerable variability in observable clinical and social outcomes among individuals. 1 , 2

Mental health problems include not only mental disorders and psychosocial disabilities but also other mental states associated with a high degree of anxiety, functional disability or risk of self-harm. 1 , 2

According to the World Health Organization (WHO), after the impact of COVID-19 that began in 2020, depression and anxiety became the mental health disorders that most affect millions of people worldwide. 3 , 4 These conditions significantly impact the life quality of those who suffer from them and represent a significant challenge for public health. 3 , 4

In recent years, there has been an increase in the prevalence of depression and anxiety, especially among young adults, prompting the search for complementary interventions to optimize the treatment of these diagnoses. 4 , 5 Among them, mindfulness has shown consistent evidence of reducing emotional symptoms by promoting affective regulation and full awareness, constituting a relevant and innovative strategy for addressing these disorders.

Epidemiology of anxiety and depression

The epidemiology of anxiety and depression examines the prevalence, incidence, risk factors, and distribution of these mental health disorders in different populations and contexts. In the health field, the most common mental disorders include anxiety, mood disorders such as depression, and, in some cases, somatic manifestations. 6 A significant correlation has been shown between symptoms of stress, anxiety, and depression and quality of life in adults. 7

These emotional disorders are widely treated at the primary care level, with an estimated prevalence of 49.2% of potential cases, and are often linked to other chronic diseases. 8 , 9 Among psychiatric disorders, anxiety disorders are the most common, according to epidemiological studies that indicate that around one-third of the population experiences them at some point in their lives. 6 , 10

Below are some relevant data:

Global Prevalence

Distribution by Gender and Age:

Anxiety disorders can manifest from childhood, with specific phobias and separation anxiety disorder being the most common at this stage, with an average age of onset around 7 years. 6 , 8 , 11 In adolescence, anxiety disorders continue to be the most common, with the addition of agoraphobia, which usually appears between the ages of 13 and 17. Prevalence peaks in middle age, with generalized anxiety disorder, panic disorder, and social anxiety being the most common, and then decreases in old age. 13

These disorders affect women more frequently than men, with a prevalence almost double in women; specifically, 17.5% of women compared to 9.5% of men have experienced anxiety at some point in their lives. 6 , 8 , 11

Risk Factors

Genetic factors influence the predisposition to anxiety disorders, especially panic disorder, obsessive-compulsive disorder, and social phobia. 9 Extreme traumatic experiences (accidents, disasters, assaults, etc.) can cause brain damage and severe anxiety symptoms. 6 , 9 Anxiety disorders and depression are common in people with cardiovascular and respiratory diseases, with a prevalence of 12.2% and 11.5%, respectively, in young adults and 8.0% and 7.4% in those over 45 years of age. 6 , 8 , 10

Impact on Public Health

According to the WHO, depression is the leading cause of disability worldwide and a key risk factor for suicide, generating a high economic burden on health systems due to lost productivity and the use of medical resources. 11 , 14 , 15

The COVID-19 pandemic significantly increased the prevalence of anxiety and depression, with increases of up to 25% in some studies globally. 16 , 17 , 18

Epidemiology of Anxiety and Depression in Mexico

The epidemiology of anxiety and depression in Mexico reveals significant data on the prevalence and impact of these mental health disorders in the Mexican population:

Anxiety in Mexico

In 2021, the National Institute of Statistics and Geography (INEGI) conducted the first National Self-Reported Well-being Survey (ENBIARE) to produce statistical information on various dimensions of measuring the well-being of the adult population in Mexico. 19 The ENBIARE survey found that 19.3% of the Mexican adult population has symptoms of severe anxiety, while another 31.3% shows symptoms of minimal or some degree of anxiety. The prevalence of anxiety among Mexican females is higher: 23.2% have minimal anxiety, 32.8% have severe anxiety, and 44.0% do not suffer from it. 19

The highest average adult population percentages of anxiety symptoms, whether mild or severe, are in Puebla, Chiapas, and Michoacán, while the lowest percentages are in Nuevo León, Baja California, and Quintana Roo. 19

In 2024, 303,356 cases of mental health care were reported in the Mexican health system. Of these, 52.8% were for anxiety disorders, making them the most frequently treated condition in this area. 20

Depression in Mexico

Regarding depression in Mexico, a 2021 study conducted by the Psychiatric Care Services (SAP) of the Ministry of Health estimated that 3.6 million adults suffer from depression in Mexico; of these, 1% are severe cases. 21 In this regard, the 2018-19 National Health and Nutrition Survey (Encuestas Nacionales de Salud y Nutrición, ENSANUT) reported a prevalence of depressive symptoms in adults aged 20 years or older. 22

16.7 % of Mexican adults presented depressive symptoms, with a higher prevalence in older adults (38.3%) than in younger adults (11.3%). Women (15.0%) and those with lower well-being (14.2%) showed higher rates compared to men (7.3%) and those with higher well-being (8.4%). This trend, where depression is almost double in Mexican women, had already been documented in previous global studies such as that of the WHO 11 and the National Health and Nutrition Surveys (ENSANUT)from 2018, 2019, and 2021 in México. 22

It is relevant to mention that the treatment of anxiety and depression represents a major challenge in mental health, considering their high incidence and significant impact on individuals' quality of life. Therefore, interventions based on Cognitive-Behavioral Therapy (CBT) to reduce the symptoms of stress, anxiety, and depression have been widely demonstrated. 23 , 24

Traditional CBT techniques, such as relaxation, cognitive restructuring, and social skills training, seek to alter the relationship between thoughts, emotions, and behaviors. 23 , 24 , 25 However, in recent decades, an alternative approach has been developed within CBT, which has shown positive results. 25 According to Kahl et al., this approach, known as third wave-cognitive-behavioral psychotherapy or Third Generation Contextual Therapies, focuses on promoting mindfulness, acceptance, compassion, and spirituality. 25

Several systematic reviews Click or tap here to enter text.have highlighted the effectiveness of third-wave psychotherapies, such as mindfulness-based interventions, compassion-focused programs, and acceptance and commitment therapy, in reducing work-related stress, anxiety, and depression, as well as increasing resilience, including in healthcare professionals. 26 , 27 , 28

Based on this prevalence, it has been relevant to research new treatment techniques that positively address these Mental Health disorders, for which the effectiveness of the mindfulness technique has been demonstrated, which has shown considerable scientific evidence in diagnoses of anxiety and depression. 26 , 27 , 28

WHAT is MINDFULNESS?

Mindfulness is a psychological and spiritual technique that originated in meditation traditions, especially Buddhism. 29 However, it has recently been adapted and used in clinical psychology. 30 , 31 This approach is based on paying full attention to the here and now, without judging or automatically reacting emotionally. Mindfulness has been shown to positively impact various psychological disorders, such as anxiety and depression, in recent decades. 30 -32 These mental conditions are some of the most common public health problems today and are characterized by a cycle of repetitive thoughts and negative emotions that exacerbate suffering. In this sense, mindfulness offers a unique therapeutic approach to help patients break these cycles and improve their emotional well-being. 30 , 31 , 32 According Kabat-Zinn, mindfulness is a full-attention practice defined by four fundamental elements 33 :

This clinical approach defined by Kabat-Zinn as “intentionally paying attention to the present moment, non-judgmentally,” was introduced into interventions with his Mindfulness-Based Stress Reduction (MBSR) program in the 1980s, and later, Marsha Linehan developed Mindfulness-Based Cognitive Therapy (MBCT), which focused on preventing relapse in depression. 33 It is important to mention that MBCT is an adaptation of MBSR. 28

Historical implications of mindfulness

As previously indicated, mindfulness is a discipline originating in the ancient traditions of Buddhism. It has gained relevance in the Western world in recent decades due to its mental and physical health benefits. 30

Over the years, this practice has evolved, integrating into fields as diverse as psychology, education, and business. Table 1 below describes the key moments that have defined the development and expansion of mindfulness, from its origins to the present day.

MINDFULNESS in the treatment of anxiety

Anxiety is a mental disorder characterized by excessive fear and worry and associated behavioral disturbances. The symptoms are severe enough to cause significant distress or functional impairment in the person's life. 4

Most patients with anxiety disorders suffer from one or more associated psychiatric disorders, such as major depression, specific phobia, social anxiety, or panic disorder. 36

Mindfulness-based interventions have shown significant potential for reducing anxiety symptoms. 36 , 37 Mindfulness practice allows people to observe their thoughts and emotions from a distance, which helps decrease emotional reactivity. This can lead to less anticipatory worry, reduced cognitive overload, and greater acceptance of uncertainty. 37

Numerous studies support the effectiveness of mindfulness in reducing anxiety. 23 , 24 , 26 , 27 , 28 , 30 Research has shown that MBSR and MBCT are effective in decreasing Generalized Anxiety Disorder (GAD), panic disorder, Obsessive-Compulsive Disorder (OCD), burnout syndrome, and phobias. Proposed mechanisms include improved emotional regulation, a shift in perceived stress, and increased tolerance for uncertainty. 26 , 27 , 33

MINDFULNESS in the treatment of depression

On the other hand, depression involves a sad mood and a loss of pleasure or interest in activities over long periods. It affects all areas of life, including family, friendship, and community relationships. 38 , 39

Table 1Evolution of the use and development of mindfulness as a technique in clinical practice. Prepared by the author. 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35

DecadeKey MomentDevelopment
Approximately 2500 years agoBuddhism as the “spiritual” basis of mindfulnessThe Buddhist tradition encompasses aspects such as body scanning meditation, sitting, eating, and walking meditation, as well as mindful communication.30
1970sOrigins of mindfulness as a therapeutic basisAlthough the concept of mindfulness has its roots in Buddhist teachings, in this decade, Dr. Jon Kabat-Zinn introduced the concept of mindfulness into a Western clinical context through his Mindfulness-Based Stress Reduction (MBSR) program at the University of Massachusetts.33
1980sThe first application in the clinical fieldKabat-Zinn and his team began using MBSR to treat patients with a variety of conditions, including anxiety and depression, as a way to improve stress management.33
1990sResearch and expansionIn this decade, the practice of mindfulness in the treatment of anxiety and depression began to be investigated more rigorously. Several controlled studies demonstrated that MBSR had positive effects on reducing stress and anxiety.32,33
2000sMindfulness and Mindfulness-Based Cognitive Therapy (MBCT)Mindfulness-Based Cognitive Therapy (MBCT), an adaptation of MBSR, is developed. Dr. Zindel Segal, Dr. Mark Williams, and Dr. John Teasdale pioneered this approach, which focuses on preventing relapse into depression by combining cognitive therapy and mindfulness.32
2010sPopularization and expansion in clinical treatmentsMindfulness is becoming increasingly widespread in the treatment of anxiety and depression. A growing body of research demonstrates the practice's effectiveness in reducing anxiety and depression symptoms, both in individual and group therapies..In addition, online programs and mindfulness apps are being developed to make these practices accessible to more people.29-34.
2020sMindfulness as a standard part of treatmentPracticing mindfulness is being established as a regular tool to treat anxiety and depression, both in clinical programs and complementary approaches. Multiple studies have demonstrated the benefits of mindfulness-based interventions for these disorders.26-28 Furthermore, there is a growing focus on the use of mindfulness in digital mental health (apps, online therapy, etc.) and its integration into different types of therapy.35
Tabla 1 Tabla extraída del documento.

Mindfulness has been particularly useful in treating recurrent depression. 28 , 29 , 30 ,40,41 MBCT is effective in preventing relapse in people with a history of major depression. This approach promotes awareness of negative thinking patterns and their interruption before they develop into ruminative cycles. 28

Research also suggests that regular mindfulness practice can improve emotional well-being and reduce symptoms of depression by increasing emotional regulation, self-compassion, and self-awareness. 28 , 29 , 30 ,40,41 Neuroimaging studies have shown changes in brain areas related to emotional regulation, such as the prefrontal cortex, in patients who regularly practice mindfulness. 30

Recent studies related to the impact of mindfulness on disorders such as anxiety and depression

To select the articles for this review, a systematic search was conducted in the PubMed database using keywords such as "mindfulness," "anxiety," "depression," and "mental disorders". Furthermore, only studies with experimental or quasi-experimental designs, systematic reviews, and meta-analyses were included. Initially, a total of 150 relevant studies were identified. After reviewing the titles and abstracts, 90 articles were excluded for not meeting the inclusion criteria or for dealing with different topics, such as interventions unrelated to mental health or mindfulness applied to other contexts (e.g., schools). Subsequently, we conducted a complete reading of the remaining 60 articles and excluded 30 more due to weak methodologies, unrepresentative samples, or a lack of specific data on anxiety and depression. Finally, we included 30 articles meeting the established methodological criteria. In addition, government reports, publications or statistics not referred to in the articles are mentioned in academics. For the studies listed below, we established inclusion criteria based on studies published within the last year in English or Spanish, which evaluated the effectiveness of mindfulness-based interventions in anxiety or depression treatment:

In this research line, based on mindfulness, a study carried out in China by Dai et al. 42 aimed to evaluate the long-term impact of a six-week online mindfulness intervention course “Mindfulness Living With Challenge (MLWC)” on the mental health of undergraduate nursing students in Beijing, China, over a three-month follow-up. The MLWC program significantly reduced stress and anxiety levels and improved mindfulness and social support among 108 participants (52 intervention, 56 control), undergraduate nursing students, confirming that mindfulness interventions, such as this online one, can address mental health challenges in nursing students. 42

Continuing to evaluate the effects of mindfulness in different contexts, another study 43 aimed to identify motivators and barriers to participation in mindfulness interventions and applied a cross-sectional survey to adults (n=94) with spinal cord injury (SCI) at an acute rehabilitation center in the United States, showing a strong interest in mindfulness among people with SCI and almost half began practicing mindfulness at least once a week. The primary objective of this study was to understand the motivators for practicing mindfulness, which included relaxation, curiosity, improved mental well-being, and reduction of stress, anxiety, and depression. 43

Mindfulness has also been shown to impact pregnancy and prenatal attachment positively. 44 A research conducted by Findik et al. 44 aimed to determine the effect of the Mindfulness-Based Childbirth and Parenting Program (MBCP) on Childbirth and Parenting Program on the prenatal attachment of pregnant women and their stress, anxiety and depression levels. . The randomized controlled trial included 36 participants, randomly assigned to two groups: the MBCP group (n=18) and the control group (n=18). The Depression, Anxiety and Stress Scales-21 (DASS-21), together with the Prenatal Attachment Inventory (PAI), were administered at baseline and again eight weeks later, to evaluate changes in the psychological variables analyzed, demonstrating significantly higher scores on the Prenatal Attachment Inventory in the MBCP group compared to the control group. Regarding stress levels, the MBCP group showed significantly lower stress scores than the control group. 44

On the other hand, when exploring the impact of mindfulness on young populations, a study 45 conducted on 155 adolescents aged 16–25 who had sought psychological help aimed to determine how an early-stage mindfulness-based intervention impacts the development of internalizing symptoms, cognitive and brain processes associated with the progression of mental illness (stress, anxiety, depression) in young people seeking help. The training combined mindfulness exercises with mindful physical activity and yoga in eight weekly two-hour sessions. We conducted assessments at the beginning and end of treatment and 2 and 6 months after its completion. As this is a study protocol for a randomized controlled trial, this mindfulness intervention is expected to be appropriate for young people with mental health problems. 45

In addition to conventional interventions, an interesting alternative is Mindfulness-Based Boxing Therapy (MBBT) 46 a structured, instructor-led, non-contact group boxing exercise program that offers 90-minute sessions twice a week for ten weeks. It integrates mindfulness exercises with group therapy. This study 44 aimed to evaluate the acceptability and feasibility of MBBT in adults with Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD). Nine patients diagnosed with MDD and/or GAD were recruited from an outpatient clinic in Toronto, Canada, for a ten-week feasibility trial of MBBT using a pre-post design. Psychometric assessments were conducted for eight of the participants, which included five females and three males. Results showed a significant percentage reduction in depression (54%), anxiety (51%), and distress (36%), along with a 79% increase in mindfulness. A qualitative post-intervention study revealed themes of inclusion and accessibility, emotional release and control, improved self-esteem, confidence, self-management, community, and trust in leadership. 46

Mindfulness has been studied in relation to physical health situations, such as myocardial infarction (MI). 47 Research indicates that elevated perceived stress is linked to negative outcomes following an MI. This stress may contribute to poorer recovery in both women and men, as well as higher likelihood of developing mental health issues such as anxiety and depression. 47 A randomized controlled trial evaluated the effects of a mindfulness-based intervention on stress levels among women with MI. 45 Women with elevated stress were recruited at least two months after MI from twelve hospitals in the United States and Canada. Participants were randomly assigned to an eight-week remote mindfulness intervention (MBCT-Brief) supplemented with heart disease education. The sample included 130 women with a history of MI and a mean age of 59.8 years. Within the MBCT-Brief group, mindfulness practice was associated with higher reductions in stress, depressive symptoms, and anxiety. 47

Finally, within the field of occupational health, a study carried out with health professionals evaluated a digital mindfulness program. A study 48 aimed to design a digital mindfulness-based program to address exhaustion and burnout syndrome in physicians. Two separate, non-randomized pilot studies were conducted. In the first study, physicians and professional nurses received the program in podcast format. In the second study, 29 physicians and professional nurses received the same training through a free platform based on the program. 48 The primary outcome measure was cynicism, a burnout dimension. Secondary outcomes were emotional exhaustion, anxiety, depression, uncertainty intolerance, empathy, self-compassion, and mindfulness. Both studies showed that the program decreased cynicism. They found significant reductions in anxiety and uncertainty intolerance. There were increases in self-compassion and mindfulness. Both studies revealed positive correlations between burnout syndrome and anxiety. 48

The aforementioned research conducted in China 42 , the United States 46 , 47 , 48 , Canada 43 , Turkey 44 , and the Netherlands 45 reaffirms the promising results of using mindfulness-based interventions. However, it is relevant to note that these studies have several methodological and contextual limitations that should be considered when interpreting their findings:

Mindfulness has been integrated into various therapeutic programs for treating anxiety and depression. However, its implementation is not without challenges. 37 , 38

Despite these challenges, evidence suggests that mindfulness can be a valuable complement to traditional treatments, such as cognitive-behavioral therapy (CBT) or antidepressants. Integrating mindfulness into therapeutic programs could provide a more holistic approach to treating anxiety and depression, addressing both emotional and cognitive symptoms. 30 , 32 , 47 , 48

Conclusions

Mindfulness has proven to be a promising intervention in treating anxiety disorders and depression. Thanks to its ability to increase awareness and acceptance of internal experiences, mindfulness can help interrupt negative thought cycles and improve emotional regulation. Although mindfulness research continues to evolve, current studies suggest that mindfulness-based interventions, such as MBSR and MBCT, offer significant benefits as stand-alone and complementary treatments. However, further research is needed to overcome current limitations and better understand the underlying mechanisms that make mindfulness effective in this context. This review addresses the impact of mindfulness-based interventions on the psychological treatment of anxiety and depression disorders, providing relevant and recent evidence on their effectiveness and clinical utility. The results analyzed in this review show the historical transformation of the mindfulness concept and how it has been particularly involved in clinical applications such as MBSR (Mindfulness-Based Stress Reduction) and MBCT (Mindfulness-Based Cognitive Therapy), programs that have been scientifically proven to contribute significantly to reducing anxiety and depression symptoms in various populations, which leads to the opening of several investigations addressing this third-generation approach to mental health diseases of the 21st century.

References

  1. Arrogante O Aparicio-Zaldivar EG Burnout syndrome in intensive care professionals: relationships with health status and wellbeing Enferm Intensiva (Engl Ed) 2020 31 2 60 70
  2. Manwell LA Barbic SP Roberts K Durisko Z Lee C Ware E What is mental health? Evidence towards a new definition from a mixed methods multidisciplinary international survey BMJ Open 2015 5 6 e007079
  3. Nicolini H Depression and anxiety during COVID-19 pandemic Cir Cir 2020 88 5 542 547
  4. World Health Organization Disorders mental 2018 https://www.who.int/es/news-room/fact-sheets/detail/mental-disorders
  5. Ochoa-Fuentes DA Gutiérrez-Chablé LE Méndez-Martínez S García-Flores MA Ayón-Aguilar J Confinamiento y distanciamiento social: estrés, ansiedad, depresión en niños y adolescentes Rev Med Inst Mex Seguro Soc 2022 60 3 338 344
  6. Domínguez Domínguez JA Expósito Duque V Torres Tejera E Epidemiología de la ansiedad y su contexto en atención primaria Atn Prim Prác 2024 6 2 100194
  7. Bautista de Freitas PH Meireles AL da Silva Ribeiro IK Silva Abreu MN de Paula W Silva Cardoso C Symptoms of depression, anxiety and stress in health students and impact on quality of life Rev Lat Am Enfermagem 2023 31 e3884
  8. Macías-Carballo M Pérez-Estudillo C López-Meraz L Beltrán-Parrazal L Morgado-Valle C Trastornos de ansiedad: revisión bibliográfica de la perspectiva actual Rev eNeurobiologia 2019 10 24 090519
  9. Navas OW Vargas BMJ Trastornos de ansiedad: Revisión dirigida para atención primaria Rev Med Cos Cen 2012 69 604 497 507
  10. Bandelow B Michaelis S Epidemiology of anxiety disorders in the 21st century Dialogues Clin Neurosci 2015 17 3 327 335
  11. World Health Organization Depression and other common mental disorders: global health estimates 2017 https://iris.who.int/handle/10665/254610
  12. World Health Organization Comprehensive mental health action plan 2013–2030 2021 https://iris.who.int/bitstream/handle/10665/345301/9789240031029-eng.pdf
  13. Cisneros GE Ausín B Prevalencia de los trastornos de ansiedad en las personas mayores de 65 años: una revisión sistemática Rev Esp Geriatr Gerontol 2019 54 1 34 48
  14. Muntean RI Stefanica V Rosu D Boncu A Stoian I Oravitan M Examining the interplay between mental health indicators and quality of life measures among first-year law students: a cross-sectional study PeerJ 2024 12 e18245
  15. Thönes S Oberfeld D Time perception in depression: a meta-analysis J Affect Disord 2015 175 359 372
  16. Zapatero Gaviria A Barba Martin R What do we know about the origin of COVID-19 three years later? Rev Clin Esp (Barc) 2023 223 4 240 243
  17. Anzaldo-Rodríguez JA Palacios-Hernández A Cruz-Cid MA Síntomas de ansiedad por covid-19 en adultos mayores en el primer nivel de atención Aten Fam 2024 31 5 45
  18. Garg N Verma S Palframan JT Positive reframing as a mediator between gratitude and technostress among Indian students during the COVID-19 pandemic Kybernetes 2023 52 8 2810 2825
  19. Instituto Nacional de Estadística y Geografía (INEGI) Encuesta Nacional de Bienestar Autorreportado (ENBIARE ) 2021 2021 https://www.inegi.org.mx/contenidos/productos/prod_serv/contenidos/espanol/bvinegi/productos/nueva_estruc/889463903628.pdf
  20. CONASAMA Una mirada a la atención en salud mental en México: principales condiciones atendidas en el Sistema de Salud 2024 2024 https://www.gob.mx/cms/uploads/attachment/file/949747/04_DATOS_SM_2024.pdf?utm_source=chatgpt.com
  21. Secretaría de Salud 008. En México, 3.6 millones de personas adultas padecen depresión 2023 2023 https://www.gob.mx/salud/prensa/008-en-mexico-3-6-millones-de-personas-adultas-padecen-depresion?idiom=es
  22. Vázquez-Salas A Hubert C Portillo-Romero A Valdez-Santiago R Barrientos-Gutiérrez T Villalobos A Sintomatología depresiva en adolescentes y adultos mexicanos: Ensanut 2022 Salud Publica Mex 2023 65 s117 s125
  23. Otto AK Gutsch C Bischoff LL Wollesen B Interventions to promote physical and mental health of nurses in elderly care: A systematic review Prev Med 2021 148 106591
  24. Alkhawaldeh JMA Soh KL Mukhtar FBM Peng OC Anshasi HA Stress management interventions for intensive and critical care nurses: A systematic review Nurs Crit Care 2020 25 2 84 92
  25. Kahl KG Winter L Schweiger U The third wave of cognitive behavioral therapies: what is new and what is effective? Curr Opin Psychiatry 2012 25 6 522 528
  26. Karo M Simorangkir L Daryanti Saragih I Suarilah I Tzeng HM Effects of mindfulness-based interventions on reducing psychological distress among nurses: A systematic review and meta-analysis of randomized controlled trials J Nurs Scholarsh 2024 56 2 319 330
  27. Rudaz M Twohig MP Ong CW Levin ME Mindfulness and acceptance-based trainings for fostering self-care and reducing stress in mental health professionals: A systematic review J Contextual Behav Sci 2017 6 4 380 390
  28. Kriakous SA Elliott KA Lamers C Owen R The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review Mindfulness (NY) 2021 12 1 1 28
  29. Asensio-Martínez A Magallón-Botaya R García-Campayo J Historical review of the concepts used to define mindfulness and compassion Mindfulness & Compassion 2017 2 86 91
  30. Hervás Torres G Cebolla I Martí A Soler J Mindfulness-based psychological interventions and their benefits: current state of the art J Empir Res Psychol 2016 27 3 115 124
  31. Ong JC Smith CE Using mindfulness for the Treatment of Insomnia Curr Sleep Med Rep 2017 3 2 57 65
  32. Segal ZV Williams JMG Teasdale JD Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse N.Y Guilford Press 2002
  33. Kabat-Zinn J An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results Gen Hosp Psychiatry 1982 4 1 33 47
  34. Miró E Lupiáñez J Martínez MP Sánchez AI Díaz-Piedra C Guzmán MA Cognitive-behavioral therapy for insomnia improves attentional function in fibromyalgia syndrome: a pilot, randomized controlled trial J Health Psychol 2011 16 5 770 782
  35. Sharpe L Bisby MA Menzies RE Boyse JB Richmond B Todd J A Tale of Two Treatments: A Randomized Controlled Trial of mindfulness or Cognitive Behavior Therapy Delivered Online for People with Rheumatoid Arthritis Psychother Psychosom 2025 94 2 89 100
  36. Langarita-Llorente R Gracia-Garcia P Neuropsicologia del trastorno de ansiedad generalizada: revision sistematica Rev Neurol 2019 69 2 59 67
  37. Miró MT Perestelo -Pérez L Pérez J Rivero A González M de la Fuente J Effectiveness of mindfulness-based treatments for anxiety disorders and depression: a systematic review Rev Psicopatol Psicol Clín 2011 16 1 1 14
  38. Caldiroli CL Procaccia R Negri A Mangiatordi A Sarandacchi S Antonietti A Mindfulness and mental health: the importance of a clinical intervention to prevent the effects of a traumatic event. A pilot study Front Psychol 2024 15 1449629
  39. Monroe SM Harkness KL Major Depression and Its Recurrences: Life Course Matters Annu Rev Clin Psychol 2022 18 329 357
  40. Goldberg SB Tucker RP Greene PA Davidson RJ Wampold BE Kearney DJ Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis Clin Psychol Rev 2018 59 52 60
  41. Hofmann SG Sawyer AT Witt AA Oh D The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review J Consult Clin Psychol 2010 78 2 169 183
  42. Dai Z Jing S Wu Y Chen X Fu J Pan C Long-term effects of an online mindfulness intervention on mental health in Chinese nursing students: a randomized controlled trial follow-up BMC Public Health 2025 25 1 682
  43. Korupolu R Ratcliff CG Andampour A Robinson-Whelen S Lohiya S Cohen AS Examining motivators and barriers to meditation practice among individuals with spinal cord injury: Insights from a survey study J Spinal Cord Med 2025 1 9
  44. Fındık E Yılmaz Sezer N Aker MN Badur D The effects of the mindfulness-Based Childbirth and Parenting Program (MBCP) on prenatal attachment, depression, stress, and anxiety in pregnant women: A randomized controlled trial J Affect Disord 2025 376 341 346
  45. Schepers M Lagerweij P Geurts D Krause F Ouden HD Cools R Promoting Resilience in Youth through mindfulness meditation (PRYME): Study protocol for a randomized controlled trial investigating the effects of mindfulness training as add-on to care-as-usual on internalizing problems, mental illness development, and associated brain and cognitive processes in help-seeking youth BMC Psychiatry 2025 25 1 126
  46. Bozdarov J Jones BDM Umer M Blumberger DM Husain IM Mindfulness-based (non-contact) boxing therapy (MBBT) for depression and anxiety: A feasibility study PLoS One 2025 20 2 e0318364
  47. Spruill TM Park C Kalinowski J Arabadjian ME Xia Y Shallcross AJ Brief mindfulness-Based Cognitive Therapy in Women With Myocardial Infarction: Results of a Multicenter Randomized Controlled Trial JACC Adv 2025 4 2 101530
  48. Antico L Brewer J Digital mindfulness Training for Burnout Reduction in Physicians: Clinician-Driven Approach JMIR Form Res 2025 9 e63197