Effects of online mindfulness-based stress reduction training on depression and anxiety symptoms among psychiatric healthcare workers in a randomized controlled trial: the mediating role of emotional suppression.

Abstract

Background: Psychiatric healthcare workers experience prolonged exposure to psychological trauma and negative emotions, which ultimately predisposes them to mental health issues. The effectiveness of online mindfulness-based stress reduction training on depression and anxiety symptoms among psychiatric healthcare workers (HCWs) and the possible mechanisms that benefit these outcomes remain unclear.

Methods: This randomized controlled trial evaluated the effect of an 8-week online MBSR among psychiatric HCWs (165 participants) at the mental health center in Shenyang, China from August to November 2022, compared with the waitlist control group. The effective sample size that actually completed the intervention was 135 (74 participants in the intervention group and 61 in the control group), and the loss-to-follow-up rate was approximately 18%. Participants completed assessments of depression and anxiety symptoms (Hospital Anxiety and Depression Scale, HADS), and emotional suppression (Courtauld Emotional Control Scale, CECS) at baseline and week 8 online via the "Wenjuanxing" Platform. Intervention outcomes were estimated via analysis of covariance (ANCOVA). Multiple linear regression and mediation models with bias-corrected bootstrapping were performed to explore the mediating role of emotional suppression.

Results: Compared with those in the control group, the participants in the online MBSR group presented lower emotional suppression (P < 0.001), symptoms of depression (P < 0.001) and anxiety (P = 0.002). The decrease in emotional suppression mediated the effects of online MBSR on 8-week symptoms of depression (indirect effect = - 1.106, 95% CI [- 1.683, - 0.600]) and anxiety (indirect effect = - 1.182, 95% CI [- 1.731, - 0.706]).

Conclusions: Online MBSR training could be utilized to alleviate depression and anxiety symptoms in psychiatric HCWs. It might weaken depression and anxiety symptoms by reducing emotional suppression. Emotional suppression might be the key change process of the effects of online MBSR on depression and anxiety symptoms in psychiatric HCWs.

Trial registration: The clinical trial registration code was obtained from the Chinese Clinical Trial Registry (date of registration: 02/08/2022, registration number: ChiCTR2200062347).