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Meditation Is Associated with Improved PTSD and Depression Symptoms, but the Evidence Is Limited

• Ten randomized controlled trials (RCTs) on meditation interventions for PTSD met inclusion criteria. Intervention approach, intensity, and study quality varied considerably. Six RCTs focused exclusively on patients exposed to combat-associated trauma.
• Meditation interventions — including mindfulness-based stress therapy, yoga, and mantram repetition program offered as adjunctive therapy — reduced PTSD symptoms statistically significantly compared with all comparators across all sources of trauma; the quality of evidence was rated as low.
• Adjunctive meditation interventions were also efficacious in reducing depression symptoms; the quality of evidence was rated as moderate.
• Effects were positive but not statistically significantly different for quality of life or anxiety symptoms, and no study addressed functional status. Only five RCTs assessed safety. None of these five studies identified any adverse events as a result of meditation interventions.
• No head-to-head trials compared different meditation approaches, and indirect comparisons did not systematically favor one type of meditation over another. Treatment effect estimates did not vary systematically by comparator. It was not possible to determine the differential effect of offering meditation as adjunctive or monotherapy, and meta-regressions did not identify a systematic effect of the intervention intensity or trauma type.

RAND researchers conducted a systematic review and meta-analysis that synthesized evidence from randomized controlled trials of meditation interventions to provide estimates of their efficacy and safety in treating adults diagnosed with posttraumatic stress disorder (PTSD).

Outcomes of interest included PSTD symptoms, depression symptoms, anxiety, health-related quality of life, functional status, and adverse events. Meta-analyses were conducted using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (or GRADE) approach.

In total, ten trials on meditation interventions for PTSD with 643 participants met inclusion criteria. Across interventions, adjunctive meditation interventions of mindfulness-based stress reduction, yoga, and the mantram repetition program improve PTSD symptoms and depression compared with control groups based on low to moderate quality of evidence. Effects were positive but not statistically significant for quality of life and anxiety, and no studies addressed functional status. The variety of meditation intervention types, the short follow-up times, and the quality of studies limited analyses. There were no adverse events in the included studies, but only half of the studies reported on safety. In order to increase confidence in these findings, researchers should conduct more high-quality studies on meditation as adjunctive treatment with PTSD-diagnosed participant samples large enough to detect statistical differences in outcomes.

• Chapter One

  Introduction

• Chapter Two

  Methods

• Chapter Three

  Results

• Chapter Four

  Discussion

• Appendix A

  Search Strategies

• Appendix B

  Excluded Full-Text Articles

• Appendix C

  Evidence Table