BackgroundInterest in mindfulness has increased exponentially, particularly in the fields of psychology and medicine. The trait or state of mindfulness is significantly related to several indicators of psychological health, and mindfulness-based therapies are effective at preventing and treating many chronic diseases. Interest in mobile applications for health promotion and disease self-management is also growing. Despite the explosion of interest, research on both the design and potential uses of mindfulness-based mobile applications (MBMAs) is scarce.ObjectiveOur main objective was to study the features and functionalities of current MBMAs and compare them to current evidence-based literature in the health and clinical setting.MethodsWe searched online vendor markets, scientific journal databases, and grey literature related to MBMAs. We included mobile applications that featured a mindfulness-based component related to training or daily practice of mindfulness techniques. We excluded opinion-based articles from the literature.ResultsThe literature search resulted in 11 eligible matches, two of which completely met our selection criteria–a pilot study designed to evaluate the feasibility of a MBMA to train the practice of “walking meditation,” and an exploratory study of an application consisting of mood reporting scales and mindfulness-based mobile therapies. The online market search eventually analyzed 50 available MBMAs. Of these, 8% (4/50) did not work, thus we only gathered information about language, downloads, or prices. The most common operating system was Android. Of the analyzed apps, 30% (15/50) have both a free and paid version. MBMAs were devoted to daily meditation practice (27/46, 59%), mindfulness training (6/46, 13%), assessments or tests (5/46, 11%), attention focus (4/46, 9%), and mixed objectives (4/46, 9%). We found 108 different resources, of which the most used were reminders, alarms, or bells (21/108, 19.4%), statistics tools (17/108, 15.7%), audio tracks (15/108, 13.9%), and educational texts (11/108, 10.2%). Daily, weekly, monthly statistics, or reports were provided by 37% (17/46) of the apps. 28% (13/46) of them permitted access to a social network. No information about sensors was available. The analyzed applications seemed not to use any external sensor. English was the only language of 78% (39/50) of the apps, and only 8% (4/50) provided information in Spanish. 20% (9/46) of the apps have interfaces that are difficult to use. No specific apps exist for professionals or, at least, for both profiles (users and professionals). We did not find any evaluations of health outcomes resulting from the use of MBMAs.ConclusionsWhile a wide selection of MBMAs seem to be available to interested people, this study still shows an almost complete lack of evidence supporting the usefulness of those applications. We found no randomized clinical trials evaluating the impact of these applications on mindfulness training or health indicators, and the potential for mobile mindfulness applications remai...

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population.Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed.Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience.Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted.Clinical Trials.gov Registration ID: NCT02643927

BackgroundOne-quarter of the world’s population will suffer from depression symptoms at some point in their lives. Mental health services in developed countries are overburdened. Therefore, cost-effective interventions that provide mental health care solutions such as Web-based psychotherapy programs have been proposed.ObjectiveThe intent of the study was to identify expectations regarding Web-based psychotherapy for the treatment of depression in primary care among patients and health professionals that might facilitate or hinder its effects.MethodsThe expectations of untreated patients and health professionals were examined by means of interviews and focus groups. There were 43 participants (20 patients with mild and moderate levels of depression, 11 primary care physicians, and 12 managers; 22 of them for interviews and 21 for groups). A thematic content analysis from the grounded theory for interviews, and an analysis of the discursive positions of participants based on the sociological model for groups were performed. Interpretations were achieved by agreement between three independent analysts.ResultsAll participants showed a good general acceptance of Web-based psychotherapy, appreciating possible advantages and improvements. Patients, physicians, and managers shared the same conceptualization of their expectations, although highlighting different aspects. Patients focused on the need for individualized and personalized interaction, while professionals highlighted the need for the standardization of the program. Physicians were concerned with extra workload, while managers were worried about optimizing cost-effectiveness.ConclusionsExpectations of the different participants can conflict with each other. Finding a balanced position among them is needed if we are to harmoniously implement effective Web-based interventions for depression in routine clinical practice.

Fibromyalgia (FM) is a prevalent and disabling chronic disease. Recent studies have found elevated levels of glutamate in several brain regions, leading to hypotheses about the usefulness of glutamate-blocking drugs such as memantine in the treatment of FM. The aim of this study was to evaluate the efficacy of memantine in the treatment of pain and other clinical variables (global function, clinical impression, depression, anxiety, quality of life) in FM patients. A double-blind, parallel randomised controlled trial was developed. A total of 63 patients diagnosed with FM were recruited from primary health care centres in Zaragoza, Spain. Memantine was administered at doses of 20mg/d after 1 month of titration. Assessments were carried out at baseline, posttreatment, and 3- and 6-month follow-up. Compared with a placebo group, memantine significantly decreased ratings on a pain visual analogue scale (Cohen's d=1.43 at 6 months) and pain measured with a sphygmomanometer (d=1.05). All other secondary outcomes except anxiety also improved, with moderate-to-large effect sizes at 6 months. Compared with placebo, the absolute risk reduction obtained with memantine was 16.13% (95% confidence interval=2.0% to 32.6%), and the number needed to treat was 6.2 (95% confidence interval=3 to 47). Tolerance was good, with dizziness (8 patients) and headache (4 patients) being the most frequent side effects of memantine. Although additional studies with larger sample sizes and longer follow-up times are needed, this study provides preliminary evidence of the utility of memantine for the treatment of FM.