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BACKGROUND Sleep problems are particularly prevalent in people with depression or anxiety disorder. Although mindfulness has been suggested as an important component in alleviating insomnia, no comprehensive review and meta-analysis has been conducted to evaluate the effects of different mindfulness-based intervention (MBI) programs on sleep among people with depression or anxiety disorder. AIM To compare the effects of different MBI programs on sleep among people with depression or anxiety disorder. METHODS Related publications in Embase, Medline, PubMed and PsycINFO databases were systematically searched from January 2010 to June 2020 for randomised controlled trials. Data were synthesized using a random-effects or a fixed-effects model to analyse the effects of various MBI programs on sleep problems among people with depression or anxiety disorder. The fixed-effects model was used when heterogeneity was negligible, and the random-effects model was used when heterogeneity was significant to calculate the standardised mean differences (SMDs) and 95% confidence intervals (CIs). RESULTS We identified 397 articles, of which 10 randomised controlled trials, involving a total of 541 participants, were included in the meta-analysis. Studies of internet mindfulness meditation intervention (IMMI), mindfulness meditation (MM), mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and mindfulness-based touch therapy (MBTT) met the inclusion criteria. The greatest effect sizes are reported in favour of MBTT, with SMDs of -1.138 (95%CI: -1.937 to -0.340; P = 0.005), followed by -1.003 (95%CI: -1.645 to -0.360; P = 0.002) for MBCT. SMDs of -0.618 (95%CI: -0.980 to -0.257; P = 0.001) and -0.551 (95%CI: -0.842 to -0.260; P < 0.0001) were reported for IMMI and MBSR in the pooling trials, respectively. Significant effects on sleep problem improvement are shown in all reviewed MBI programs, except MM, for which the effect size was shown to be non-significant. CONCLUSION All MBI programs (MBTT, MBCT, IMMI and MBSR), except MM, are effective options to improve sleep problems among people with depression or anxiety disorder.

Objectives This review investigates the efficacy and safety of non-invasive brain stimulation (NIBS) combined with psychosocial intervention on depressive symptoms. Materials and methods We systematically searched five electronic databases from their inception to June 2021: PubMed, Embase, PsycINFO, Web of Science, and Medline. Randomized or non-randomized clinical trials in which NIBS plus psychosocial intervention was compared to control conditions in people with depressive symptoms were included. Results A total of 17 eligible studies with 660 participants were included. The meta-analysis results showed that NIBS combined with psychosocial therapy had a positive effect on moderate to severe depression ([SMD = − 0.46, 95%CI (− 0.90, − 0.02), I2 = 73%, p < .01]), but did not significantly improve minimal to mild depression ([SMD = − 0.12, 95%CI (− 0.42, 0.18), I2 = 0%, p = .63]). Compared with NIBS alone, the combination treatment had a significantly greater effect in alleviating depressive symptoms ([SMD = − 0.84, 95%CI (− 1.25, − 0.42), I2 = 0%, p = .93]). However, our results suggested that the pooled effect size of ameliorating depression of NIBS plus psychosocial intervention had no significant difference compared with the combination of sham NIBS [SMD = − 0.12, 95%CI (− 0.31, 0.07), I2 = 0%, p = .60] and psychosocial intervention alone [SMD = − 0.97, 95%CI (− 2.32, 0.38), I2 = 72%, p = .01]. Conclusion NIBS when combined with psychosocial intervention has a significant positive effect in alleviating moderately to severely depressive symptoms. Further well-designed studies of NIBS combined with psychosocial intervention on depression should be carried out to consolidate the conclusions and explore the in-depth underlying mechanism.

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Background The goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy versus health qigong-based cognitive therapy versus waitlist control among individuals with mood disorders. Methods A total of 187 individuals with mood disorders were randomized and allocated into mindfulness-based cognitive therapy, health qigong-based cognitive therapy, or waitlist control groups. All participants were assessed at three time points with regard to depressive and anxiety symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data. Results Mindfulness-based cognitive therapy and health qigong-based cognitive therapy both produced greater improvements on all outcome measures as compared with waitlist control. Relatively, more reductions of mood symptoms were observed in the health qigong-based cognitive therapy group as compared with the mindfulness-based cognitive therapy group. Health qigong-based cognitive therapy is more conducive to physical health status whereas mindfulness-based cognitive therapy has more favorable mental health outcomes. Individual growth curve models indicated that alterations in perceived stress was the common predictor of mood changes in both intervention groups. Conclusions The predominant emphasis on physical health in health qigong-based cognitive therapy makes it more acceptable and effective than mindfulness-based cognitive therapy as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed. Trial registration HKU Clinical Trials Registry. Identifier: HKUCTR-2558. Registered 21st Nov 2018.