The Effects of a Mindfulness-Based Intervention on Depression and Anxiety in the Long-COVID Population, 2025 , Welbel et al.

[SNT Gatchaman]

The Effects of a Mindfulness-Based Intervention on Depression and Anxiety in the Long-COVID Population

Spoiler: Authors

Rachel Welbel; Elizabeth Rutha; Jeffrey Ording; Douglas Wang; Jana Hirschtick

Long-COVID is a complicated, post-viral syndrome involving multiple body systems and can present with neuropsychiatric symptoms. Little has been reported about the neuropsychiatric symptoms of long-COVID, and validated treatments do not yet exist. There is prior evidence that mindfulness based strategies have been helpful for those with chronic illnesses; shown significant decreases in anxiety, stress, and depression; and enhanced quality of life. In this study, we report on the utility of a mindfulness-based intervention on levels of anxiety and depression in a long-COVID population.

Our hospital system founded both a “Covid Recovery Clinic” (CRC) and a “Post-COVID Resilience Program” (PCRP). The PCRP consisted of a six-week virtual group therapy protocol that focused on mindfulness-based practices. Before and after the therapy intervention, participants answered questionnaires to capture depressive and anxiety symptoms.

Pre-and post-questionnaire scores do not show a significant improvement in depressive or anxiety symptoms, although the study was limited by a small sample size.

Further research is needed to investigate whether similar programs with a larger sample size can improve the mental health status of patients suffering from long-COVID.

Web | PDF | Journal of Patient-Centered Reviews and Research | Open Access

 

[SNT Gatchaman]

Little has been reported about the neuropsychiatric symptoms of long-COVID

Imma stop you there.

 

[Hutan]

Pre-and post-questionnaire scores do not show a significant improvement in depressive or anxiety symptoms, although the study was limited by a small sample size.

Further research is needed to investigate whether similar programs with a larger sample size can improve the mental health status of patients suffering from long-COVID.

So, 'It didn't work, but give us more money, lots more money, so we can do it again, just, next time, bigger.'

 

[Hutan]

I wonder what is going on. We seem to be seeing more of this type of study reporting a null result. Is it that requirements for trial registration and protocol publishing are reducing the number of trials that get quietly filed in the bin?

Is the gloss of mindfulness wearing off? Are people with Long Covid wising up a bit, perhaps some people have been sick for many years now, perhaps word is getting around that the whole journalling, gratitude, and sitting listening to the wind or whatever is not really getting to the nub of the problem?

 

[hotblack]

I think I mentioned this in the thread on the paper on awe. I believe there to be positive aspects or experiencing awe and wonder. I meditate and practice mindfulness. I enjoy all these things.

But neither are cures or treatments for illness. They will not cure depression or ME/CFS. When I was very depressed I could not experience awe or be mindful. Now I have ME/CFS I can but it doesn’t stop me having ME/CFS or enable me to do things I cannot. They are not fixes.

At absolute best they may have some positive impact on my life at the periphery. They may sometimes even help me be less of a **** to others. Generally speaking I think most of these things may help (well) people feel a bit better about things, if they are things they enjoy.

Nice things are nice. We should encourage and enable people to do nice things for themselves and others. Build a society that removes barriers to this, rather than creates them. It doesn’t need to be made more complicated than that.

I wonder what is going on. We seem to be seeing more of this type of study reporting a null result. Is it that requirements for trial registration and protocol publishing are reducing the number of trials that get quietly filed in the bin?

That would be good. Or maybe it’s that getting something published is more important than the results? That’s not necessarily a bad thing.

 

[EndME]

I wonder what is going on. We seem to be seeing more of this type of study reporting a null result.

A growing number of undercover anti-recovery activists!

 

[EndME]

The amusing part is that this actually suggests that the authors aren't particularly "mindful" as they can't even get improvements consistent with bias, whilst others that are more "mindful" are able to do that.

 

[hotblack]

As well as here being no statistically significant change from the intervention it’s unclear exactly what they were trying to measure in the first place…

A total of eight patients participated in the study and were not all in the same PCRP group. Five patients attended all six sessions, two patients attended five sessions, and one patient attended four sessions.

So no control group and no varied involvement in the intervention.

Prior to their COVID-19 diagnosis, five out of eight (62.5%) participants had a diagnosis of depressive or anxiety disorder. After their COVID-19 diagnosis, all participants had a diagnosis of depressive, anxiety, and/or stress disorders. Additionally, six out of eight (75%) participants were taking psychotropic medications prior to study initiation.

The relationship between symptoms and covid-19 let alone long covid seems questionable and people were also on medication which doesn’t seem to have been accounted for.

Edit: it would be interesting to know how the 3 who didn’t attend all sessions were grouped in relation to the groups with prior diagnoses of depressive/anxiety disorders and prescribed medications. And indeed if any participants had prior experience of these sort of interventions.

For example, mindfulness meditation techniques are an empirically-supported treatment for anxiety and depression and have shown promising results in the treatment of cancer, hypertension, diabetes, HIV/AIDS, chronic pain, skin disorders and immune disorders.

The reference for this is coming up with a cloudflare dns error, but I found another version here. It seems to be an old literature review on Mindfulness Based Stress Reduction, and even that has the following to say (note the final sentence).

Although the number of researches conducted on Mindfulness based stress reduction therapy, to measure its effects on patients with chronic pain, is insufficient to establish MBSR as a proven intervention to help people suffering from chronic illnesses, the results suggest that MBSR may help a broad range of individuals to cope with their clinical and non-clinical problems. It is important to note that the interpretation of results of many researches was limited due to faulty study design, method or analysis

 

[Peter T]

Within traditional Buddhist meditation practice, the source of modern mindfulness techniques, using mindfulness practices to achieve personal growth might be seen as requiring years or even decades, not just a handful of sessions.

Now funding for a ten year study would keep the researchers going for much longer before concluding they needed more money for a bigger better study.

 

[Sean]

I wonder what is going on. We seem to be seeing more of this type of study reporting a null result. Is it that requirements for trial registration and protocol publishing are reducing the number of trials that get quietly filed in the bin?

Is the gloss of mindfulness wearing off? Are people with Long Covid wising up a bit, perhaps some people have been sick for many years now, perhaps word is getting around that the whole journalling, gratitude, and sitting listening to the wind or whatever is not really getting to the nub of the problem?

I hope so.

I have no doubt that all this drivel will eventually collapse under the weight of it's own inconsistency, vacuity, cruelty, and sheer lack of practical meaningful results.

Problem is how long it will take and the human cost.

I think I mentioned this in the thread on the paper on awe. I believe there to be positive aspects or experiencing awe and wonder. I meditate and practice mindfulness. I enjoy all these things.

But neither are cures or treatments for illness. They will not cure depression or ME/CFS. When I was very depressed I could not experience awe or be mindful. Now I have ME/CFS I can but it doesn’t stop me having ME/CFS or enable me to do things I cannot. They are not fixes.

At absolute best they may have some positive impact on my life at the periphery. They may sometimes even help me be less of a **** to others. Generally speaking I think most of these things may help (well) people feel a bit better about things, if they are things they enjoy.

Try to make the most of your circumstances? No argument. Perfectly good parental advice to give to a 10 yo.

Beyond that it is not particularly novel, insightful, or helpful advice for most people, who learned it fairly early on in life. It all too often just rapidly sinks into patient blaming woo.

 

[Mij]

They've done studies that measure brain waves of Tibetan Buddhist monks, one monk in particular (meditating for 40 years) while he was in a state of meditation via fMRI, and the findings suggest that meditative states can result in permanent transformation in the brain by elevating gamma brain waves that improve memory, increased brain processing speed, and a better mood.

 

[rvallee]

I wonder what is going on. We seem to be seeing more of this type of study reporting a null result. Is it that requirements for trial registration and protocol publishing are reducing the number of trials that get quietly filed in the bin?

Is the gloss of mindfulness wearing off? Are people with Long Covid wising up a bit, perhaps some people have been sick for many years now, perhaps word is getting around that the whole journalling, gratitude, and sitting listening to the wind or whatever is not really getting to the nub of the problem?

Are we? I'm not getting that impression. There is still an unhealthy balance of null results and fake positive results, all supported by the exact same conclusion to keep this mess going: give us more money to do it again. Plenty of trials are still pretending that they have something, it probably just depends on how excessive the biases are in the researchers.

Maybe there's a slight difference, but it's really small, and probably mostly caused by the introduction of more researchers who are only interested in cashing in on the easy gravy train, but don't feel particularly strongly about the sham interventions they're pushing. They know the formula by now, it's probably the easiest way for any academic to push a few papers out.

Because ultimately it doesn't matter, most "systematic" reviews will still ignore most of the null results anyway. It's only the real systematic reviews, where they actually review the whole literature, that the scam is exposed but those are also ignored so they don't matter. We're still seeing tiny "systematic" reviews where they cherry-pick a handful of recent studies to, as is tradition, claim that more of the same copy-paste research is needed.

 

[Hutan]

I was amazed by the revelation that the study only had 8 participants, so went to check it myself. Along the way, I saw the first sentences of the paper:

In December 2019, multiple cases of pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported in
Wuhan, Hubei Province, China.1 The subsequent disease, COVID-19, quickly spread across the world.

Really? In a study of mindfulness, the authors thought the location of the Covid-19 outbreak was so important it warranted being the first sentence?


On the positives, the investigators deserve a lot of credit for recognising that the treatment is not currently supported by evidence and deciding to do a study at a time when I expect things were very difficult in the hospital. They also deserve credit for publishing the null results, and for not allowing bias to preclude finding a null result. Those are significant things.


262 patients were seen by the Covid Recovery Clinic. If, on an initial screening, a patient reported anxiety or depression, they were offered the Post-Covid Resilience Program, a six-week virtual group therapy.

The program’s goal was to educate patients on mindfulness, mindful breathing, cognitive behavioral techniques, acceptance and commitment therapy, and meditation.

So, the offering was actually quite a mixture of all the usual stuff, it wasn't just mindfulness. It also included chat among the members of the group. Each group included 2 to 8 participants. 88 people participated in the program.

All the 88 participants were asked if they wanted to also participate in a study of the program, involving completing surveys before and 3 weeks after the program. The surveys were a measure of depression (PHQ-9) and anxiety (GAD-7). Demographic and illness history information was also obtained.

They found nothing to suggest the therapy reduced anxiety or depression.

I'm surprised, they don't seem to have any measure of 'would you recommend this therapy to others?'. I would have thought that was something they could have asked all 88 participants, it's the obvious thing to do with a new therapy. Perhaps they did, but the results were not published.

Yes, they only had 8 participants in the study.

A total of eight patients participated in the study and were not all in the same PCRP group. Five patients attended all six sessions, two patients attended five sessions, and one patient attended four sessions.

And they found nothing to suggest the therapy was helpful. Depression scores were essentially unchanged, the mean was the same before and after. The authors clutch at a trend to reduced anxiety scores, but it really is minimal and easily explained by the passing of time and politeness on the part of the participants. It sounds as if some of the participants were also getting individual psychotherapy at the time of their course participation too, and there may well be some value in the group aspect of the therapy, quite apart from the content of the course. With only 8 participants, the authors could have given us a chart with individual trajectories.

This study introduces a mindfulness and CBT-based intervention for long-COVID patients in a virtual group format, demonstrating that long-COVID behavioral health treatment is feasible, with the potential to improve symptoms.

It really doesn't. There is no evidence here that the mindfulness and CBT content of the course did anything useful at all.