IMPORTANCEMany people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation.OBJECTIVE To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations.EVIDENCE REVIEW We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals.FINDINGS After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03-0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies). CONCLUSIONS AND RELEVANCEClinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.

Longitudinal Data in Two Groups Longitudinal Data in Two Groups with interaction of covariate by group 42 Adapting the CAT12 workflow for unusual populations Customized Tissue Probability Maps 46 Customized DARTEL-template Other variants of computational morphometry Deformation-based morphometry (DBM) Surface-based morphometry (SBM) Region of interest (ROI) analysis Additional information on native, normalized and modulated volumes Naming convention of output files Calling CAT from the UNIX command line Technical information CAT12 Citation References 1 Note to filter sizes for Gaussian smoothing Due to the high accuracy of the spatial registration approaches used in CAT12, you can also try to use smaller filter sizes. However, for very small filter sizes or even no filtering, you have to apply a non-parametric permutation test such as the TFCE-statistics. Please also note that for the analysis of cortical folding measures such as gyrification or cortical complexity the filter sizes have to be larger (i.e. in the range of 15-25mm). This is due to the underlying nature of this measure that reflects contributions from both sulci as well as gyri. Therefore, the filter size should exceed the distance between a gyral crown and a sulcal fundus.

Depressed patients performed worse than healthy subjects on a novel spatial memory task. Virtual reality navigation may provide a consistent, sensitive measure of cognitive deficits in patients with affective disorders, representing a mechanism to study a putative endophenotype for hippocampal function.

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