Depress Anxiety. 2025 Sep 11;2025:7499120. doi: 10.1155/da/7499120. eCollection 2025.
ABSTRACT
Background: This study aimed to: (1) compare the rates of change in the severity of depression and anxiety symptoms (primary outcomes) as well as internalized stigma and its components (shame with appearance [SWA], speech and social concerns [SSCs], sense of stigma [SS], and regret [R]; secondary outcomes) between the mindfulness-based stress reduction (MBSR) group and the treatment-as-usual (TAU) control group across three timepoints (T 0 = baseline assessment, prior to intervention; T 1 = postintervention, immediately after completion of intervention or at 8 weeks after commence of intervention; T 2 = follow-up assessment, 12 weeks after completion of intervention), and (2) evaluate the mediating effects of reductions in internalized stigma and its components on the relationship between MBSR and the severity of depression and anxiety symptoms among head and neck cancer (HNC) patients. Methods: This multicenter, two-armed, parallel, and double-blind randomized controlled trial (RCT) recruited 110 HNC patients. All participants were assessed for the severity of depression and anxiety symptoms, and the degrees of internalized stigma and its components, at each timepoint. Results: MBSR significantly reduced the severity of depression and anxiety symptoms and degrees of internalized stigma and its components across timepoints (T 0, T 1, and T 2). In contrast, no reduction in scores was observed in the TAU group. Furthermore, internalized stigma, SWA, and SSC partially mediated the relationship between MBSR and the severity of depression and anxiety symptoms. Sensitivity analyses confirmed that the changes in the severity of depression and anxiety symptoms and degrees of internalized stigma and its components according to intention-to-treat (ITT) analysis were similar to that of per-protocol (PP) and last observation carry forward (LOCF) analyses. Conclusion: MBSR could be recommended as part of the treatment regimen for HNC patients. Trial Registration: ClinicalTrials.gov identifier: NCT06991309.
PMID:40979247 | PMC:PMC12446601 | DOI:10.1155/da/7499120
