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PreprintCited by 0Mindfulness and Compassion InterventionsReligion, Spirituality, and PsychologyIndian and Buddhist Studies

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Traditional Buddhist Mindfulness versus Secular Mindfulness-based Cognitive Therapy for Residual Depressive Symptoms in Patients Treated for Depressive Disorder: A Pilot Randomized Controlled Trial

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Baminiwatta, Anuradha, Hamamura, Takeshi, Madhubhashini, Anjalika, Dasanayaka, Sidath, Dhananjaya, Samitha, Chandradasa, Miyuru, Dam, Nicholas T Van·2026·Mindfulness
DOI 10.21203/rs.3.rs-8648236/v1

Preprint — published as 10.1007/s12671-026-02913-8 · Paper page

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Abstract

Objectives To compare the efficacy, acceptability, and feasibility of traditional Buddhist mindfulness (TBM) versus secular mindfulness-based cognitive therapy (MBCT) for residual depressive symptoms, and to examine whether TBM is non-inferior to MBCT in improving depressive symptoms and psychological wellbeing. Methods In this pilot randomized controlled trial, Buddhist adults with residual depressive symptoms (Beck Depression Inventory–II [BDI-II] score > 13) receiving outpatient antidepressant treatment were randomized to an 8-week group-based TBM or MBCT intervention. Primary outcomes were depressive symptoms (BDI-II) and psychological wellbeing (WHO-5 Well-Being Index). Secondary outcomes included mindfulness, self-compassion, and perceived benefits from religiosity/spirituality. Primary analyses followed the intention-to-treat principle. Non-inferiority margins were prespecified at 2.5 BDI-II points and 1.25 WHO-5 points. Results Sixty-six participants were randomized (TBM = 34; MBCT = 32). Both interventions produced significant within-group improvements. Mean BDI-II scores decreased by 13.1 points in TBM ( p < .001; Cohen’s d = 0.93) and 12.9 points in MBCT ( p < .001; d = 1.15). WHO-5 scores increased by 6.8 points in TBM ( p < .001; d = 0.93) and 6.9 points in MBCT ( p < .001; d = 0.95). Between-group differences were not statistically significant, and non-inferiority of TBM was not demonstrated (BDI-II: Mdiff = − 0.16, 95% CI − 5.4 to 5.1; WHO-5: Mdiff = − 0.2, 95% CI − 3.2 to 2.8). Mindfulness and self-compassion increased in both groups, while religiosity/spirituality increased only in TBM. Conclusions Both TBM and MBCT were associated with large, clinically meaningful improvements and comparable acceptability. TBM’s selective effect on religiosity/spirituality highlights its cultural relevance and supports further evaluation in larger trials. Pre-registration: This study was registered in the Clinical Trial Registry ([Blinded for Review]) on 13/06/2024.

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Metadata

Authors
Baminiwatta, A., Hamamura, T., Madhubhashini, A., Dasanayaka, S., Dhananjaya, S., Chandradasa, M., & Dam, N. T. V.
Affiliations
  • Barwon Health (AU)
  • Curtin University (AU)
  • University of Kelaniya (LK)
  • The University of Melbourne (AU)
Corresponding author
Baminiwatta, Anuradha
ORCID
Venue
Mindfulness
Publisher
Springer Science and Business Media LLC
Published
2026-02-26
Volume
17
Issue
8
Pages
2344-2358
ISSN
1868-8527 (ISSN-L)
DOI
10.21203/rs.3.rs-8648236/v1
OpenAlex
W7166293353
Cited by
0
References
1
FWCI
0.00
Type
journal article
Language
en
Open access
Licence
Locations
  • Mindfulness (publishedVersion)
  • Research Square (acceptedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Social Sciences › Arts and Humanities › Religious studies › Indian and Buddhist Studies
Keywords
mindfulness-based cognitive therapy, residual depressive symptoms, depressive disorders, non-inferiority, religiosity and spirituality, psychological well-being, self-compassion, group intervention, WHO-5 well-being

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