Mindfulness-Based Interventions for Chronic Pulmonary Diseases: A Systematic Review of Effects on Anxiety, Depression, Stress, Dyspnea, and Quality of Life.

(1) Background: Chronic pulmonary diseases (CPDs), such as COPD, asthma, and interstitial lung disease, are often accompanied by psychological distress and reduced quality of life. Mindfulness-Based Interventions (MBIs), including digital and virtual reality (VR) formats, have emerged as promising non-pharmacological approaches to improve symptom management and well-being. This systematic review aimed to evaluate the effectiveness of MBIs-delivered in-person or digitally-on anxiety, depression, disease-related stress, dyspnea, and health-related quality of life in individuals with CPDs. (2) Methods: A systematic review was conducted following PRISMA guidelines across PubMed, Scopus, and Web of Science (2005-2025). Thirteen studies (8 randomized controlled trials, 5 non-randomized) met inclusion criteria. Outcomes assessed included psychological distress, physical symptoms, and health-related quality of life (HRQoL). Risk of bias was evaluated using RoB 2 and ROBINS-I tools. (3) Results: MBIs were associated with improvements in anxiety, depression, stress, and HRQoL in several studies. Interventions were generally well-tolerated and effective across various delivery methods, including digital and VR-based formats. Improvements were especially notable when interventions were tailored and sustained. (4) Conclusions: MBIs, including digital and VR-delivered formats, show promise in supporting psychological and physical outcomes in CPD populations. They represent a feasible and complementary tool in modern respiratory care.