Economic evaluation of mindfulness group therapy for patients with depression, anxiety, stress and adjustment disorders compared with treatment as usual
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Background: A randomised controlled trial found that a structured mindfulness group therapy (MGT) programme was as effective as treatment as usual (mostly cognitive–behavioural therapy) for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden (ClinicalTrials.gov: NCT01476371). Aims: To perform a cost-effectiveness analysis of MGT compared with treatment as usual from both a healthcare and a societal perspective for the trial duration (8 weeks). Method: The costs from a healthcare perspective included treatment as usual, medication and costs for providing MGT. The societal perspective included costs from the healthcare perspective plus savings from productivity gains for the trial duration. The effectiveness was measured as quality-adjusted life-years (QALY) using the EQ-5D-5L questionnaire and the UK value set. Uncertainty surrounding the incremental costs and effects were estimated using non-parametric bootstrapping with 5000 replications and presented with 95% confidence intervals and cost-effectiveness acceptability curves. Results: The MGT group had significantly lower healthcare and societal costs (mean differences –€115 (95% CI −193 to −36) and –€112 (95% CI −207 to −17), respectively) compared with the control group. In terms of effectiveness, there was no significant difference in QALY gain (mean difference −0.003, 95% CI −0.0076 to 0.0012) between the two groups. Conclusions: MGT is a cost-saving alternative to treatment as usual over the trial duration from both a healthcare and a societal perspective for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden.
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Sundquist's study in Sweden showed that mindfulness is a cost-effective alternative to standard treatment for patients with depression, anxiety, or stress and adjustment disorders in general practice.
“This aligns with Sundquist’s study in Sweden, which showed that mindfulness is a cost-effective alternative to standard treatment for patients with depression, anxiety, or stress and adjustment disorders in general practice [56].”
From Exploring patient experiences with a mindfulness course in a general practice setting: a qualitative study. (2025) · cites this paper as [56]
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Cites
An Introduction to the Bootstrap
Efron, B., & Tibshirani, R. J. (1994) · doi:10.1201/9780429246593 · Cited by 40,500 · see citing works
Multiple Imputation for Nonresponse in Surveys
Rubin, D. B. (1987) · Wiley Series in Probability and Statistics · doi:10.1002/9780470316696 · Cited by 20,701 · see citing works
Methods for the Economic Evaluation of Health Care Programmes
Drummond, M. E., Sculpher, M. J., Torrance, G. W., O’Brien, B. J., & Stoddart, G. L. (2005) · doi:10.1093/oso/9780198529446.001.0001 · Cited by 13,648 · see citing works
Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., Bonsel, G., & Badia, X. (2011) · Quality of Life Research · doi:10.1007/s11136-011-9903-x · Cited by 9,795 · see citing works
An Introduction to the Bootstrap.
Buckland, S. T., Efron, B., & Tibshirani, R. J. (1994) · Biometrics · doi:10.2307/2532810 · Cited by 3,236 · see citing works
Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders
(1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.7.936 · Cited by 1,941 · see citing works
Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement
Husereau, D., Drummond, M., Petrou, S., Carswell, C., Moher, D., Greenberg, D., Augustovski, F., Briggs, A. H., Mauskopf, J., Loder, E., et al. (2013) · BMJ · doi:10.1136/bmj.f1049 · Cited by 1,776 · see citing works
Valuing health-related quality of life: an EQ-5D-5L value set for England
Devlin, N. J., Shah, K. K., Feng, Y., Mulhern, B., & van Hout, B. (2018) · Health Economics · doi:10.1002/hec.3564 · Cited by 1,356 · see citing works
Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse
Morgan, D. (2003) · Psychotherapy Research · doi:10.1080/713869628 · Cited by 1,203 · see citing works
Manca, A., Hawkins, N., & Sculpher, M. J. (2005) · Health Economics · doi:10.1002/hec.944 · Cited by 1,024 · see citing works
Cost‐effectiveness acceptability curves – facts, fallacies and frequently asked questions
Fenwick, E. A. L., OʼBrien, B. J., & Briggs, A. H. (2004) · Health Economics · doi:10.1002/hec.903 · Cited by 946 · see citing works
Piet, J., & Hougaard, E. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.05.002 · Cited by 807 · see citing works
Kabat-Zinn, J., Lipworth, L., Burncy, R., & Sellers, W. (1986) · The Clinical Journal of Pain · doi:10.1097/00002508-198602030-00004 · Cited by 483 · see citing works
A multiple imputation strategy for clinical trials with truncation of patient data
Lavori, P. W., Dawson, R., & Shera, D. M. (1995) · Statistics in Medicine · doi:10.1002/sim.4780141707 · Cited by 291 · see citing works
The Valuation of Human Capital
Weisbrod, B. A. (1961) · Journal of Political Economy · doi:10.1086/258535 · Cited by 236 · see citing works
Economic evaluation and clinical trials: size matters
Briggs, A. H. (2000) · BMJ · doi:10.1136/bmj.321.7273.1362 · Cited by 224 · see citing works
Down and out: estimating the relationship between mental health and unemployment
Hamilton, V. H., Merrigan, P., & Dufresne, É. (1997) · Health Economics · doi:10.1002/(sici)1099-1050(199707)6:4 · Cited by 147 · see citing works
Applied Methods of Cost-benefit Analysis in Health Care
McIntosh, E., Clarke, P., Frew, E. J., & Louviere, J. J. (2010) · ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) · Cited by 130 · see citing works
Sundquist, J., Lilja, Å., Palmér, K., Memon, A. A., Wang, X., Johansson, L. M., & Sundquist, K. (2015) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.150243 · Cited by 123 · see citing works
Self-citationKuyken, W., Hayes, R. A., Barrett, B. M., Byng, R., Dalgleish, T., Kessler, D. S., Lewis, G., Watkins, E. R., Morant, N. J., Taylor, R. S., et al. (2015) · Health Technology Assessment · doi:10.3310/hta19730 · Cited by 81 · see citing works
Depression and anxiety in Swedish primary health care: prevalence, incidence, and risk factors
Lejtzén, N., Sundquist, J., Sundquist, K., & Li, X. (2013) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-013-0422-3 · Cited by 48 · see citing works
Self-citationSundquist, J., Palmér, K., Johansson, L. M., & Sundquist, K. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2017.01.328 · Cited by 40 · see citing works
Self-citationMorriss, R. K., Garland, A., Nixon, N. L., Guo, B., James, M., Kaylor‐Hughes, C., Moore, R. G., Ramana, R., Sampson, C., Sweeney, T., et al. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30143-2 · Cited by 38 · see citing works
Edwards, R. T., Bryning, L., & Crane, R. S. (2014) · Mindfulness · doi:10.1007/s12671-014-0282-6 · Cited by 22 · see citing works
Mindfulness-based cognitive therapy for recurrent major depression: A ‘ best buy ’ for health care?
Shawyer, F., Enticott, J., Özmen, M., Inder, B., & Meadows, G. N. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867416642847 · Cited by 22 · see citing works
Briggs (1998) · doi:10.1002/(sici)1099-1050(199812)7:8
Flagged first, then by citations
Research works printed but not linked: 1
- Briggs AH, Wonderling DE, Mooney CZ. Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation. Health Econ 1997; 6: 327-40.
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Zhang, L., Lopes, S. S., Lavelle, T. A., Jones, K. O., Chen, L., Jindal, M., Zinzow, H. M., & Shi, L. (2022) · Mindfulness · doi:10.1007/s12671-022-01960-1 · Cited by 45 · see citing works
Phillips, S. T., & Mychailyszyn, M. P. (2022) · School Mental Health · doi:10.1007/s12310-021-09492-0 · Cited by 38 · see citing works
Zhou, Y., Huang, J., Baker, P. N., Liao, B., & Yu, X. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-05203-y · Cited by 25 · see citing works
Elices, M., Pérez, V., Pérez‐Aranda, A., Colom, F., Polo, M., Martín‐Lopez, L. M., & Gárriz, M. (2021) · Mindfulness · doi:10.1007/s12671-021-01794-3 · Cited by 24 · see citing works
Ginsberg, K. H., Alsweiler, J., Alyami, M., & Serlachius, A. (2023) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-022-09902-8 · Cited by 22 · see citing works
Wijnen, B. F. M., Jansen, M., van Velthoven, A. S. M., Hanssen, I., Huijbers, M. J., Evers, S., & Speckens, A. E. M. (2023) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1981 · Cited by 3 · see citing works
Zhou, Y., Tang, Z.-M., Mei, L., Yang, X., Zheng, H.-L., Liao, B., & Yu, X. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1572633 · Cited by 4 · see citing works
Waiting list intervention for adolescents with anorexia nervosa
Lavan, O., Goldstein, A., Bar-Eyal, A., Shir, A., Hammer, T., Label, A., Valik, N., Ratzon, R., Tahar, T., & Fennig, S. (2025) · Eating Disorders · doi:10.1080/10640266.2025.2519900 · Cited by 3 · see citing works
Fort-Rocamora, C., Casañas, R., Torres-Torres, A., Mas-Expósito, L., González, M., & Carbonero-Judez, M. T. (2024) · Enfermería Clínica (English Edition) · doi:10.1016/j.enfcle.2023.11.004 · Cited by 2 · see citing works
Ding, R., Liu, X.-Y., Ding, Y., Leng, M., Yang, L., & Zhang, A. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i12.112672 · Cited by 2 · see citing works
Fort-Rocamora, C., Casañas, R., Torres-Torres, A., Mas-Expósito, L., González, M., & Carbonero-Judez, M. T. (2023) · Enfermería clínica · doi:10.1016/j.enfcli.2023.11.004 · Cited by 3 · see citing works
Dupont, J. K., Waldorff, F. B., & Graungaard, A. H. (2025) · BMC Primary Care · doi:10.1186/s12875-025-02970-3 · Cited by 1 · see citing works
Sado, M., Koreki, A., Ninomiya, A., Kurata, C., Park, S., Fujisawa, D., Kosugi, T., Nagaoka, M., Nakagawa, A., & Mimura, M. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1391786 · Cited by 1 · see citing works
Being mindful of reducing cost in depression and anxiety
(2018) · PharmacoEconomics & Outcomes News · doi:10.1007/s40274-018-5508-8
Paredes-Gonzales, Y., Centeno-Terrazas, G., la Cruz-Torralva, K. D., Romani-Huacani, E., Lozada, Y. P. A.-M., & Villarreal‐Zegarra, D. (2025) · medRxiv · doi:10.1101/2025.05.05.25327011
Ruíz-Íñiguez, R., Sacristán-Martín, O., Burgos-Julián, F. A., Casillas-Barragán, B., Resurrección, D., & Duncan, L. G. (2025) · Mindfulness · doi:10.1007/s12671-025-02694-6
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Weideman, Z., Kolbe-Alexander, T. L., & Trimmer, K. (2024) · Research Square · doi:10.21203/rs.3.rs-4798178/v1
Poerbodipoero, S., Demmers, A., van Os, J., & van Hartingsveldt, M. J. (2026) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2026.102702
Joss, D. (2026) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-026-00395-y
- Authors
- Saha, S., Jarl, J., Gerdtham, U.-G., Sundquist, K., & Sundquist, J.
- Affiliations
- Lund University (SE)
- Shimane University (JP)
- Corresponding author
- Saha, Sanjib
- Venue
- The British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2018-11-23
- Volume
- 216
- Issue
- 4
- Pages
- 197-203
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2900786286
- Cited by
- 20
- References
- 26
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 1 · 2018: 1
- FWCI
- 0.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Vetenskapsrådet (2014-10134, 2018-02400)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- cost-effectiveness, depression, anxiety, stress, adjustment disorder, quality-adjusted life years, social costs, productivity improvement, usual care, cognitive behavioral therapy, EQ-5D-5L
- MeSH terms
- Adjustment Disorders, Adult, Anxiety Disorders, Cost-Benefit Analysis, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychotherapy, Group, Stress, Psychological, Program Evaluation, Health Care Costs, Cost of Illness, Mindfulness
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