{"doi":"10.1016/j.jad.2025.04.145","title":"A randomized controlled trial comparing mindfulness to escitalopram for anxiety: In-person and remote, synchronous delivery pre and post COVID-19 pandemic","abstract":"BACKGROUND: During the pandemic, a randomized controlled trial (RCT) of Mindfulness-Based Stress Reduction (MBSR) versus the antidepressant, escitalopram (ESC) added a second phase using a synchronous, videoconference (VC) format for both interventions, enabling randomized and naturalistic comparisons. The original in-person RCT demonstrated non-inferiority of MBSR to ESC. In the second phase, we hypothesized that MBSR-VC would be non-inferior to ESC-VC, and that MBSR-VC would be non-inferior to in-person MBSR (MBSR-IN). METHODS: Adults with anxiety disorders were recruited for a 3-center RCT. Primary (Clinical Global Impression of Severity: CGIS) and secondary outcomes (satisfaction, other measures for anxiety subtypes) were compared between MBSR-IN vs MBSR-VC, ESC-IN vs ESC-VC and MBSR-VC vs ESC-VC. RESULTS: MBSR-VC (n = 100) and ESC-VC (n = 102) did not significantly differ in mean CGI-S change at endpoint (1.39 vs 1.51, p = 0.17) but non-inferiority of MBSR-VC was not supported. MBSR did not vary by delivery format (VC: 1.3 vs. IN: 1.3, p = 0.77) and MBSR-VC's non-inferiority to MBSR-IN was demonstrated within the pre-specified margin of -0.40 (95 % CI: -0.34 to 0.25). ESC-IN and ESC-VC were not significantly different in CGI-S change in unadjusted comparisons (1.4 vs 1.5, p = 0.53), but the average CGI-S at endpoint was significantly lower in the ESC-VC group in a multivariable longitudinal model. Other findings included in-person treatments having a greater impact on social anxiety compared to their VC version, ESC-VC having higher satisfaction ratings and a greater impact on panic symptoms than MBSR-VC. CONCLUSIONS: Remotely delivered MBSR demonstrated comparable effectiveness to in-person MBSR for anxiety disorders, providing support for this delivery approach. Social anxiety symptoms improved more with in-person care. TRIAL REGISTRATION: Clinicaltrials.gov: NCT03522844.","journal":"Journal of Affective Disorders","year":2025,"id":525661,"datarank":0.23895337014040222,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.031009215972418604,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.031009215972418604,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":2,"citers_with_citation_signal":1,"citers_with_endowment":1,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9493,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03522844"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":594667,"name":"Mihriye Mete","orcid":"0000-0002-0347-1604","position":1,"is_corresponding":false},{"id":463530,"name":"Amanda W. Baker","orcid":"0000-0002-0103-5411","position":2,"is_corresponding":false},{"id":691021,"name":"Kristin L. Szuhany","orcid":"0000-0003-2063-6180","position":3,"is_corresponding":false},{"id":1093189,"name":"Caroline H. Armstrong","orcid":"0000-0002-1320-1923","position":4,"is_corresponding":false},{"id":1400370,"name":"Margot H. Steinberg","orcid":"0000-0002-3601-8267","position":5,"is_corresponding":false},{"id":404923,"name":"Mary Ann Dutton","orcid":"0000-0002-0195-0791","position":6,"is_corresponding":false},{"id":404922,"name":"Éric Bui","orcid":"0000-0002-1413-6473","position":7,"is_corresponding":false},{"id":366662,"name":"Naomi M. Simon","orcid":"0000-0002-8867-889X","position":8,"is_corresponding":false},{"id":404919,"name":"Elizabeth A. Hoge","orcid":"0000-0002-5513-2292","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-19T02:50:21.274116Z","pmid":"40324655","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}