In response to questions regarding the scientific basis for mindfulness-based interventions (MBIs), we evaluated their empirical status by systematically reviewing meta-analyses of randomized controlled trials (RCTs). We searched six databases for effect sizes based on four or more trials that did not combine passive and active controls. Heterogeneity, moderators, tests of publication bias, risk of bias, and adverse effects were also extracted. Representative effect sizes based on the largest number of studies were identified across a wide range of populations, problems, interventions, comparisons, and outcomes (PICOS). A total of 160 effect sizes were reported in 44 meta-analyses (k = 336 RCTs, N = 30,483 participants). MBIs showed superiority to passive controls across most PICOS (ds = 0.10–0.89). Effects were typically smaller and less often statistically significant compared with active controls. MBIs were similar or superior to specific active controls and evidence-based treatments. Heterogeneity was typically moderate. Few consistent moderators were found. Results were generally robust to publication bias, although other important sources of bias were identified. Reporting of adverse effects was inconsistent. Statistical power may be lacking in meta-analyses, particularly for comparisons with active controls. Because MBIs show promise across some PICOS, future RCTs and meta-analyses should build on identified strengths and limitations of this literature.

为了回答有关基于正念的干预 (MBI) 的科学基础的问题，我们通过系统回顾随机对照试验 (RCT) 的荟萃分析来评估它们的经验状态。我们根据四个或更多未结合被动和主动控制的试验搜索了六个数据库的效果大小。还提取了异质性、调节因素、发表偏倚检验、偏倚风险和不利影响。在广泛的人群、问题、干预、比较和结果 (PICOS) 中确定了基于最大数量研究的代表性效应量。44 项荟萃分析报告了总共 160 种效应量（k = 336 项 RCT，N = 30,483 名参与者）。MBI 在大多数 PICOS 中显示出优于被动控制的优势（d s = 0.10–0.89)。与主动控制相比，效果通常更小，并且通常在统计学上不太显着。MBI 类似于或优于特定的主动控制和循证治疗。异质性通常是适度的。很少有一致的主持人被发现。尽管发现了其他重要的偏倚来源，但结果通常不受发表偏倚的影响。不良反应的报告不一致。荟萃分析可能缺乏统计能力，特别是与主动对照的比较。由于 MBI 在某些 PICO 中显示出前景，因此未来的 RCT 和荟萃分析应建立在已确定的该文献的优势和局限性之上。