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Mindfulness meditation

Deliberately attending to present-moment experience, such as the breath or bodily sensations, with an open and non-judgemental attitude.

At a glance

  • Evidence: Mindfulness meditation produces small to moderate reductions in anxiety symptoms compared with no intervention, but the advantage is not statistically significant against active controls.Anxiety symptoms in adults · Moderate certainty · Randomized intervention
  • What’s uncertain: Trials have substantial bias concerns, and anxiety benefits are not clearly better than active comparison treatments.
  • First step: Choose a structured mindfulness programme; the main trials used eight-week courses rather than isolated clips.
  • Before you try it: Meditation can trigger anxiety, traumatic memories or emotional sensitivity; adverse experiences and functional impairment have been reported. All precautions
Read the full takeaway

Program findings

Mindfulness has a real but modest evidence base, and it is narrower than the marketing suggests. Eight-week, teacher-led programmes show small to moderate reductions in anxiety and depressive symptoms, and mindfulness-based cognitive therapy reduces depressive relapse in people with recurrent depression compared with usual care, where it performs about as well as maintenance antidepressants.

Comparisons and app practice

Against no treatment the effects are consistent, but where trials use an active comparison the advantage mostly disappears, and no synthesis has shown meditation to be superior to an established treatment. For brief self-guided app practice the pooled effects are small (roughly g 0.24 to 0.28 for depression and anxiety) and not significant against active therapeutic comparisons, so the MBCT relapse prevention result is not evidence that a phone app prevents relapse.

Study limitations

Most trials are at high risk of bias, prediction intervals cross zero in the largest non-clinical review, and reported adverse experiences are common in survey data. The honest summary is a low-cost, low-risk practice with dependable small benefits for distress and a specific clinical indication for recurrent depression, not a general treatment for mental illness.

A monk meditating beneath a treeDiscussed by2 peopleView statements ↓
FocusEnergyStress & wellbeing10–20 min · Moderate · Free
Reviewed Sep 23, 2026
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Scientific evidence

What the research shows

Outcome assessments based on research, including its uncertainties and limitations.

Anxiety symptoms in adults

Finding: Benefit supportedCertainty: Moderatestudies found a benefit from doing this

Evidence basis: randomised trials

Mindfulness meditation produces small to moderate reductions in anxiety symptoms compared with no intervention, but the advantage is not statistically significant against active controls.

Population: Adults across mixed clinical and non-clinical settings: 47 randomised trials with 3,515 participants in the meditation-programmes meta-analysis; 142 non-overlapping samples with 12,005 participants with psychiatric disorders in the clinical meta-analysis; 136 randomised trials with 11,605 participants in non-clinical settings, 77% women, aged 18 to 73 years, in 29 countries.

Research details

Summary

Mindfulness meditation produces small to moderate reductions in anxiety symptoms compared with no intervention. In a meta-analysis of 47 randomised trials with 3,515 participants restricted to trials with active controls, mindfulness meditation programmes had moderate-strength evidence of improved anxiety (effect size 0.38, 95% CI 0.12 to 0.64 at 8 weeks and 0.22, 95% CI 0.02 to 0.43 at 3 to 6 months), and the authors found no evidence that meditation programmes were better than any active treatment such as drugs, exercise or other behavioural therapies. A meta-analysis of 136 randomised trials in non-clinical settings (11,605 participants) found a larger average improvement in anxiety than no intervention (SMD -0.56, 95% CI -0.80 to -0.33, 95% PI -1.19 to 0.06) but no statistically significant evidence of improvement over non-specific active controls and none over specific active controls. A meta-analysis of 142 samples of clinical populations found mindfulness-based interventions superior to no treatment (d 0.55), minimal treatment (d 0.37), non-specific active controls (d 0.35) and specific active controls (d 0.23), but not different from evidence-based treatments (d -0.004).

Why this certainty

Rated Moderate: three independent syntheses agree on direction and on statistical significance against no-intervention comparators; the advantage is not statistically significant against active controls, and the clinical-population meta-analysis found a graded pattern of effect sizes across comparator strength that is difficult to explain by bias alone. It is not rated Strong because the effect against active controls is not demonstrated, the meta-analysis with the strictest inclusion criteria graded its anxiety evidence as moderate, all trials in the non-clinical review were at high risk of bias, prediction intervals cross zero, and no review isolates self-guided app practice for anxiety against an active comparator.

Limitations

The largest non-clinical review judged all included trials to be at high risk of bias, and effects on anxiety did not survive restriction to trial quality or comparison with active controls; its GRADE confidence was moderate to very low and prediction intervals for anxiety crossed zero. The meditation-programmes meta-analysis is limited by clinical heterogeneity, variable control types and heterogeneous interventions, and its 8-week anxiety estimate rests on data with a lower confidence bound of 0.12. Efficacy against no treatment is also the comparison most vulnerable to expectancy, attention and regression to the mean.

Effect estimate

Mindfulness meditation versus active control: effect size 0.38 (95% CI 0.12 to 0.64) at 8 weeks and 0.22 (95% CI 0.02 to 0.43) at 3 to 6 months (Goyal 2014). Mindfulness-based programmes versus no intervention in non-clinical settings: SMD -0.56 (95% CI -0.80 to -0.33; p < 0.001; 95% prediction interval -1.19 to 0.06; 8 trials) (Galante 2021). Mindfulness-based interventions versus comparators in clinical populations: d 0.55 versus no treatment, 0.35 versus non-specific active controls, 0.23 versus specific active controls, -0.004 versus evidence-based treatments (Goldberg 2018). Mindfulness apps versus control: g 0.28 (95% CI 0.21 to 0.35; 48 comparisons, 6,082 participants) (Linardon 2024).

Sources for this outcome:

Depressive symptoms and relapse prevention in recurrent depression

Finding: Benefit supportedCertainty: Moderatestudies found a benefit from doing this

Evidence basis: randomised trials

This is the strongest part of the mindfulness evidence base, and it is specific to eight-week mindfulness-based cognitive therapy (MBCT) for people with recurrent depression.

Population: Adults with recurrent major depression in full or partial remission: 1,258 patients (mean age 47.1 years, 75.0% female) in 9 trials with individual patient data; 2,077 participants in 14 randomised trials in the network meta-analysis; 424 primary-care patients with three or more previous episodes taking maintenance antidepressants in the PREVENT trial. The broader symptom estimates come from mixed adult populations, including 47 trials with 3,515 participants and 45 randomised trials of mindfulness apps with 5,852 participants for depression.

Research details

Summary

This is the strongest part of the mindfulness evidence base, and it is specific to eight-week mindfulness-based cognitive therapy (MBCT) for people with recurrent depression. An individual patient data meta-analysis of nine randomised trials (1,258 patients) found that MBCT reduced the risk of depressive relapse over 60 weeks compared with not receiving MBCT (hazard ratio 0.69, 95% CI 0.58 to 0.82), and also compared with active treatments including antidepressants (hazard ratio 0.79, 95% CI 0.64 to 0.97), with some evidence that greater residual symptom severity before treatment was associated with a larger effect. A network meta-analysis of 14 randomised trials (2,077 participants) found MBCT superior to treatment as usual for relapse (RR 0.73, 95% CI 0.54 to 0.98) and for time to relapse (hazard ratio 0.57, 95% CI 0.37 to 0.88), and superior to placebo for time to relapse (hazard ratio 0.23, 95% CI 0.08 to 0.67), with no statistically significant difference from active treatment strategies. The largest single trial found no superiority over maintenance antidepressants (hazard ratio 0.89, 95% CI 0.67 to 1.18; p=0.43 over 24 months), which is a comparison against an effective treatment rather than against nothing. Broader symptom evidence is smaller: in the meta-analysis with active controls, mindfulness meditation had moderate-strength evidence of improved depression (effect size 0.30, 95% CI 0.00 to 0.59 at 8 weeks and 0.23, 95% CI 0.05 to 0.42 at 3 to 6 months), and mindfulness apps produced only a small pooled effect (g 0.24, 95% CI 0.17 to 0.31) that was not significant against active therapeutic comparisons (g -0.15).

Why this certainty

Rated Moderate: an individual patient data meta-analysis and an independent network meta-analysis agree on a clinically meaningful reduction in relapse risk against usual care, the effect is consistent with the wider finding that mindfulness-based interventions perform best in higher-risk clinical populations, and the comparison against maintenance antidepressants shows equivalence rather than inferiority in the largest trial. It is not rated Strong because relapse prevention rests on a limited number of trials in one clinical population, the headline comparison against usual care conflates MBCT with whatever care those patients otherwise received, residual heterogeneity and small trial sizes persist, and no evidence supports the same claim for the brief app-based practice that most readers will actually use.

Limitations

The MBCT relapse-prevention evidence applies to a defined clinical population, namely adults with multiple previous depressive episodes who are in remission, usually while taking maintenance antidepressants and often with clinician support to taper them; it does not extend to brief self-guided app practice or to prevention of a first episode. The individual patient data meta-analysis combined only nine trials and explicitly says remaining uncertainties need addressing, the network meta-analysis pooled 14 trials mostly of small size, and the largest trial found no advantage over maintenance medication. Trial populations were predominantly female and, in the largest trial, predominantly White British. Not every trial is positive: a 101-patient randomised trial in Nigeria found no significant difference in relapse between MBCT and control over a two-month follow-up while finding significantly reduced depressive symptom scores.

Effect estimate

MBCT versus no MBCT (individual patient data, 9 trials, 1,258 patients): hazard ratio 0.69 (95% CI 0.58 to 0.82) for depressive relapse within 60 weeks; versus active treatments: hazard ratio 0.79 (95% CI 0.64 to 0.97). MBCT versus treatment as usual (network meta-analysis): RR 0.73 (95% CI 0.54 to 0.98) for relapse and hazard ratio 0.57 (95% CI 0.37 to 0.88) for time to relapse; MBCT versus placebo: hazard ratio 0.23 (95% CI 0.08 to 0.67). MBCT with tapering support versus maintenance antidepressants (PREVENT, 424 patients): hazard ratio 0.89 (95% CI 0.67 to 1.18; p=0.43).

Sources for this outcome:

Perceived stress, psychological distress and general mental health

Finding: Benefit supportedCertainty: Limitedstudies found a benefit from doing this

Evidence basis: randomised trials

Mindfulness practice is consistently associated with lower self-reported stress and distress, but this is where the evidence is thinnest and most vulnerable to bias.

Population: Non-clinical and mixed adult populations: 1,641 participants in 17 randomised trials of non-clinical adults; 11,605 participants in 136 randomised trials in non-clinical settings; 3,515 participants in 47 trials with active controls; 27 comparisons for stress and 43 for quality of life in a meta-analysis of 66 randomised trials of app-supported smartphone interventions; 574 participants in 8 studies of app-guided mindfulness.

Research details

Summary

Mindfulness practice is consistently associated with lower self-reported stress and distress, but this is where the evidence is thinnest and most vulnerable to bias. In a meta-analysis of 17 randomised trials in non-clinical adults (1,641 participants), baseline stress did not differ between groups (SMD 0.15, 95% CI -0.07 to 0.36; p=0.18) while post-intervention perceived stress was significantly lower with mindfulness-based interventions (SMD -0.53, 95% CI -0.72 to -0.33; p<0.00001), with larger effects for indirect delivery formats and minimal evidence of publication bias. In the largest non-clinical review, mindfulness-based programmes improved psychological distress relative to no intervention (27 trials; SMD -0.45, 95% CI -0.58 to -0.31; 95% prediction interval -1.04 to 0.14) and well-being (9 trials; SMD 0.33, 95% CI 0.11 to 0.54), but showed no statistically significant benefit on distress against non-specific active controls. The meta-analysis restricted to trials with active controls graded the evidence for improved stress and distress, and for mental-health-related quality of life, as low, and found low-strength evidence of no effect or insufficient evidence of any effect on positive mood, attention, sleep and weight. Mindfulness apps show a small pooled effect on stress (g 0.35) and on general psychiatric distress (g 0.40) in one meta-analysis of app-supported psychological interventions, but a meta-analysis restricted to eight app-delivered mindfulness studies in non-clinical populations was small, methodologically weak and lacked randomised trials.

Why this certainty

Rated Limited: the direction is consistent across independent syntheses and a dedicated perceived-stress meta-analysis reports a moderate pooled effect with no baseline imbalance and minimal publication bias, but the underlying trials are at high risk of bias, the effect does not survive comparison with active controls in the largest review, prediction intervals include no effect, and the app-based evidence is small, heterogeneous and in one case not randomised. Confidence in the size of the benefit is therefore low even though the direction is consistent.

Limitations

All trials in the largest non-clinical review were rated at high risk of bias and its GRADE confidence was moderate to very low, with wide prediction intervals that cross zero for depression and anxiety; only the effect on distress survived exclusion of the highest-risk trials, and effects were smaller in USA-based trials. The trials with active controls graded stress and distress evidence as low. Study populations and instruments differ (Perceived Stress Scale, distress and quality-of-life questionnaires), so these estimates are not interchangeable, and the app-based estimates come from a literature that includes non-randomised and methodologically weak studies. Positive dimensions of mental health such as mood, attention and sleep have not been shown to improve.

Effect estimate

Perceived stress in non-clinical adults: SMD -0.53 (95% CI -0.72 to -0.33; p<0.00001; 17 randomised trials, 1,641 participants) with no baseline difference between groups (SMD 0.15, 95% CI -0.07 to 0.36) (Rajan 2026). Psychological distress versus no intervention: SMD -0.45 (95% CI -0.58 to -0.31; p<0.001; 95% prediction interval -1.04 to 0.14; 27 trials) and well-being SMD 0.33 (95% CI 0.11 to 0.54; 9 trials) (Galante 2021). App-supported smartphone interventions: stress g 0.35 (n=27) and general psychiatric distress g 0.40 (n=12) (Linardon 2019). App-guided mindfulness in non-clinical populations: negative emotions SMD -0.232 (95% CI -0.398 to -0.066; p=0.006) (Wu 2021).

Sources for this outcome:

Adverse effects of meditation practice (safety signal)

Finding: Potential harmCertainty: Limitedstudies found a signal of harm

Evidence basis: observational studies (association, not proof of cause)

Meditation is not a risk-free practice.

Population: 470 adults in the United States with lifetime exposure to meditation practice identified from a population-based screening survey of 953 participants, of whom 434 completed the follow-up adverse-effects survey (92.3% response rate); plus 424 primary-care patients with recurrent depression in the PREVENT randomised trial.

Research details

Summary

Meditation is not a risk-free practice. In a two-stage population-based survey in the United States, 434 of 470 respondents with lifetime meditation exposure completed a follow-up survey, and a higher proportion than hypothesised reported meditation-related adverse effects: 32.3% endorsed a general adverse-effect item, 50.0% endorsed at least one specific item, and 10.4% reported effects lasting a month or longer, with anxiety, traumatic re-experiencing and emotional sensitivity the most common. Some degree of functional impairment was reported by 10.6% and impairment lasting a month or more by 1.2%, and childhood adversity was associated with elevated risk. Notably, participants reporting adverse effects were equally glad to have practised meditation as those who did not, and the survey cannot establish how much of this reflects meditation rather than the conditions that led people to meditate. In the largest relapse-prevention trial, serious adverse events were balanced between arms (five adverse events including two deaths in each of the MBCT and maintenance antidepressant groups, none attributed to the interventions or the trial). Most randomised trials of mindfulness do not report adverse events systematically, so absence of reported harm in trial publications is not evidence of absence.

Why this certainty

Rated Limited: this is a single population-based survey plus one large trial's serious adverse event reporting, with no controlled comparison and no pooled estimate across studies, so the magnitude of risk cannot be quantified with confidence. It is reported separately because it is a safety signal rather than an efficacy outcome, and because the evidence base for a health habit should not present benefits without the documented potential for harm. It is not rated higher because the design cannot separate meditation effects from selection and recall.

Limitations

The prevalence estimates come from a self-report survey with no control group, no randomisation and retrospective recall, so they cannot be attributed to meditation causally or compared against a matched non-meditating group; the survey item set was designed to be broad and the authors note the rates were higher than they had hypothesised, which raises the possibility of over-inclusive items. Duration and functional-impairment estimates rely on small numbers of respondents. The trial safety data cover serious adverse events only, in a specific clinical population and over 24 months.

Effect estimate

In 434 respondents with lifetime meditation exposure: general adverse-effect item endorsed by 32.3%, at least one specific item by 50.0%, adverse effects lasting one month or more by 10.4%; any functional impairment 10.6% and impairment lasting one month or more 1.2%.

Sources for this outcome:

What people say

Who discusses this?

Public statements, with positions specific to each source and topic. These views do not determine the scientific evidence assessment.

What the research shows ↑

Practical steps and precautions

How to try it

  1. Pick a structured programme rather than random clips: the trials behind the relapse-prevention and symptom evidence used manualised eight-week group courses (MBSR or MBCT) with weekly sessions and home practice, and an editorial starting point of 10 to 20 minutes of guided practice a day sits well below those protocols and is not itself a tested dose.
  2. Anchor the practice to a fixed time of day and use audio guidance at first; the programme trials delivered mindfulness as a structured course with recorded or teacher-led guidance rather than as self-invented practice, and the app trials that were pooled all used guided exercises.
  3. Continue for at least eight weeks before judging it; the meta-analytic benefit on anxiety and depression was measured at 8 weeks and had attenuated by 3 to 6 months, and relapse-prevention trials followed people for 60 weeks or longer.
  4. Treat an app as a convenient entry point rather than an equivalent substitute: pooled effects for mindfulness apps are small and were not significant against active therapeutic comparisons, and no app trial has tested relapse prevention in recurrent depression as MBCT trials have.

Precautions

  • Meditation is not always pleasant: in a population-based US survey, 32.3% of 434 respondents with lifetime meditation exposure endorsed a general adverse-effect item and 50.0% endorsed at least one specific item, most commonly anxiety, traumatic re-experiencing and emotional sensitivity, with functional impairment in 10.6% and impairment lasting a month or more in 1.2%; childhood adversity was associated with higher risk.
  • Mindfulness is not a replacement for treatment of a diagnosed mental health condition; meditation programmes have not outperformed drugs, exercise or other behavioural therapies in head-to-head synthesis, and in the PREVENT trial five adverse events including two deaths occurred in each arm with none attributed to the interventions, so serious risk was not elevated but benefit over medication was also not demonstrated.
  • MBCT for recurrent depression was delivered by trained teachers to patients in remission and sometimes involved tapering prescribed antidepressants; do not stop or reduce psychiatric medication to take up meditation without medical supervision.
  • Be cautious with intensive or long retreat practice and with trauma-related material; the adverse-effect literature is drawn mainly from regular meditators and program participants rather than from brief app use, so the risk profile of an app is less well characterised than that of taught programmes.

References

Meditation programs for psychological stress and well-being: a systematic review and meta-analysis

Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA · JAMA Internal Medicine · 2014

Systematic review and meta-analysis of randomized clinical trials with active controls, with strength of evidence graded across four domains (risk of bias, precision, directness, consistency)Verified from abstract
Open original source

Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials

Galante J, Friedrich C, Dawson AF, Modrego-Alarcón M, Gebbing P, Delgado-Suárez I, Gupta R, Dean L, Dalgleish T, White IR, Jones PB · PLOS Medicine · 2021

Systematic review and meta-analysis of randomised controlled trials with prespecified protocol (PROSPERO CRD42018105213), Cochrane Risk-of-Bias Tool 2.0 appraisal, multivariate random-effects meta-analysis and prediction intervalsVerified from full text
Open original source

Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis

Goldberg SB, Tucker RP, Greene PA, Davidson RJ, Wampold BE, Kearney DJ, Simpson TL · Clinical Psychology Review · 2018

Systematic review and meta-analysis of randomized trials in clinical populations, coding comparison groups into five strength categories from no treatment to evidence-based treatmentVerified from abstract
Open original source

The efficacy of mindfulness apps on symptoms of depression and anxiety: An updated meta-analysis of randomized controlled trials

Linardon J, Messer M, Goldberg SB, Fuller-Tyszkiewicz M · Clinical Psychology Review · 2024

Updated systematic review and random-effects meta-analysis of randomized controlled trials of mindfulness apps, with moderator and risk-of-bias sensitivity analysesVerified from abstract
Open original source

Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials

Kuyken W, Warren FC, Taylor RS, Whalley B, Crane C, Bondolfi G, Hayes R, Huijbers M, Ma H, Schweizer S, Segal Z, Speckens A, Teasdale JD, Van Heeringen K, Williams M, Byford S, Byng R, Dalgleish T · JAMA Psychiatry · 2016

Individual patient data meta-analysis of randomized trials of manualized mindfulness-based cognitive therapy for relapse prevention in recurrent depression in full or partial remissionVerified from abstract
Open original source

Mindfulness-based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta-analysis

McCartney M, Nevitt S, Lloyd A, Hill R, White R, Duarte R · Acta Psychiatrica Scandinavica · 2021

Systematic review and network meta-analysis of randomised controlled trials with follow-up of 12 months or longerVerified from abstract
Open original source

Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial

Kuyken W, Hayes R, Barrett B, Byng R, Dalgleish T, Kessler D, Lewis G, Watkins E, Brejcha C, Cardy J, Causley S, Cowderoy S, Evans A, Gradinger F, Kaur S, Lanham P, Morant N, Richards J, Shah P, Sutton H, Vicary R, Weaver A, Wilks J, Williams M, Taylor RS, Byford S · The Lancet · 2015

Single-blind, parallel, group randomised controlled trial (PREVENT) with 24-month follow-up and intention-to-treat primary analysis, registered ISRCTN26666654Verified from abstract
Open original source

Evaluating the Efficacy of Mindfulness-Based Cognitive Therapy in Alleviating Depressive Symptoms, Reducing Rumination, and Preventing Relapse Among the Institutionalized Patients in Nigeria: A Randomized Controlled Trial

Argungu ZM, Alhaiti A, Jibreel EA · International Journal of Social Psychiatry · 2026

Randomised controlled trial with 101 adult patients with three or more previous depressive episodes, eight-week group mindfulness-based cognitive therapy versus control, assessments at baseline, post-treatment and two-month follow-upVerified from abstract
Open original source

Effects of mindfulness-based interventions on perceived stress among non-clinical adults: a systematic review and meta-analysis

Rajan A, Kumar M, Raj P P · npj Mental Health Research · 2026

Systematic review and meta-analysis of randomized controlled trials in non-clinical adults, with subgroup analyses, meta-regression and publication bias assessment (PRISMA)Verified from abstract
Open original source

The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials

Linardon J, Cuijpers P, Carlbring P, Messer M, Fuller-Tyszkiewicz M · World Psychiatry · 2019

Meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems, with moderator analyses including control type and risk of biasVerified from abstract
Open original source

Effects of Mindfulness Exercise Guided by a Smartphone App on Negative Emotions and Stress in Non-Clinical Populations: A Systematic Review and Meta-Analysis

Wu J, Ma Y, Zuo Y, Zheng K, Zhou Z, Qin Y, Ren Z · Frontiers in Public Health · 2021

Systematic review and random-effects meta-analysis of studies of app-guided mindfulness exercise in non-clinical populations, with Cochrane risk-of-bias assessmentVerified from abstract
Open original source

Prevalence of meditation-related adverse effects in a population-based sample in the United States

Goldberg SB, Lam SU, Britton WB, Davidson RJ · Psychotherapy Research · 2022

Two-stage population-based survey (screening survey plus follow-up survey assessing meditation-related adverse effects) with no control groupVerified from abstract
Open original source

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Editorial history and review method

Revision 4 · Approved for publication · Codex (publication approval explicitly authorized by site owner; category migration)

Prepared and checked with AI. Publication approval does not imply independent expert review. Request a correction.

Applied the audit corrections for mindfulness-meditation. The anxiety-symptoms comparator was misdescribed in three places and is now fixed: the headline, the first sentence of the summary and the certainty rationale all claimed benefit against 'no treatment or non-specific control conditions', which directly contradicted both the entry's own effectEstimate field ('versus active control') and its cited sources, since Galante 2021 found no statistically significant improvement in anxiety or distress against non-specific active controls and Goyal 2014 reported no evidence that meditation programmes beat any active treatment. The card summary was replaced because it repeated the entry's overall verdict rather than describing the card outcome. Second reviewer must re-check: (a) that no other field still implies a benefit over non-specific or active controls; (b) whether Moderate certainty for anxiety remains defensible now that the comparator wording is correct - the audit judged it defensible because three independent syntheses agree on direction against no intervention and the entry records the null against active controls in its limitations. The depressive-symptoms-relapse-prevention, perceived-stress and adverse-effects outcomes were verified sound and were left untouched. Publication release 2026-10-04: site owner authorized a bounded AI audit and release of this exact revision. See docs/release-audit-2026-10-04.md for source-check findings and limits. No independent health-professional or peer review is claimed. Category migration 2026-10-04: removed the separate goals field; categories: Focus, Energy → Focus, Energy, Stress & wellbeing. Research assessments, sources, guidance, precautions, and evidence review dates are unchanged. This revision awaits publication approval; no new evidence review is claimed. Publication approval 2026-10-04: site owner explicitly accepted all current category-migration revisions for deployment and requested that remaining limitations be retained in docs/content-review-backlog.md. Approval applies to this exact content revision. No new evidence review, independent expert review, or clinical validation is claimed; existing precautions and disclosures remain in effect.