Effect of mindfulness-based stress reduction (MBSR) program on depression, emotion regulation, and sleep problems: A randomized controlled trial study on depressed elderly.

The short version

This randomized controlled trial with 60 depressed older adults living in nursing homes in Isfahan, Iran, explored whether an 8-week Mindfulness-Based Stress Reduction (MBSR) program could ease depression, improve emotion regulation, and reduce sleep problems. MBSR is a structured group program, originally developed for stress and chronic illness, that trains people to notice thoughts, emotions, and body sensations without judgment through practices like body scanning and gentle movement. Emotion regulation here covers two distinct skills the study measured separately: cognitive reappraisal (reinterpreting a situation to change its emotional impact) and expressive suppression (holding back outward emotional expression), the latter generally considered a less adaptive coping strategy. Participants, referred by geriatricians and screened with the Geriatric Depression Scale, were randomly split into an MBSR group (30 people, average age 66) and a no-treatment control group (30 people, average age 67); 60% of each group were women. The MBSR group attended eight weekly 90-minute sessions with a certified instructor, practicing body scans, mindful movement, loving-kindness meditation, walking meditation, and mindful eating, plus home practice between sessions. Before the program and one week after it ended, both groups completed the Geriatric Depression Scale, the Emotion Regulation Questionnaire, and the Pittsburgh Sleep Quality Index. After 8 weeks, the MBSR group showed significantly lower depression scores than the control group (adjusted averages 6.28 vs. 8.82, p<0.001), with a large effect size (partial eta squared=0.57, meaning the intervention accounted for over half the variance in the outcome). Emotion regulation shifted favorably on both subscales: cognitive reappraisal rose (22.67 vs. 20.36, p<0.001) while expressive suppression fell (12.32 vs. 15.65, p<0.001, partial eta squared=0.56) — a pattern consistent with Gross's emotion regulation model, in which stronger reappraisal skills reshape an emotional response early, reducing reliance on effortful suppression later. Sleep quality also improved, with lower Pittsburgh Sleep Quality Index scores in the MBSR group (11.58 vs. 13.35, p<0.001), which the authors link to MBSR increasing attentional control over the automatic arousal and rumination that disrupt sleep. All four outcomes reached statistical significance with observed power near 1.00 (a near-certain ability to detect a true effect). For nursing-home psychologists and caregivers, MBSR appears to be a practical, side-effect-free complement to standard depression care for older residents, requiring only a certified instructor and a weekly 90-minute time commitment. Limitations are real: outcomes relied entirely on self-report in a population prone to inaccurate self-assessment, the control group received no intervention at all rather than an active comparison, there was no follow-up beyond one week, and the sample was limited to depressed nursing-home residents in Iran. Future research should add objective measures and longer follow-up before these findings are treated as conclusive.

Key findings

• An 8-week Mindfulness-Based Stress Reduction (MBSR) program — a structured group course that trains non-judgmental awareness of thoughts, emotions, and body sensations through practices like body scanning and gentle movement — significantly reduced depression symptoms in depressed elderly nursing home residents compared to a no-treatment control group (p<0.001).
• Emotion regulation improved on two fronts: participants increased their use of cognitive reappraisal (reframing a situation to change how it feels emotionally) and decreased their reliance on expressive suppression (holding back outward displays of emotion, generally considered a less adaptive coping style).
• Sleep quality also improved, as measured by the Pittsburgh Sleep Quality Index (PSQI), a standard questionnaire covering sleep duration, disturbances, and daytime functioning.
• All four outcomes showed large effect sizes (partial eta-squared values above 0.22, meaning the program explained a substantial share of the difference between groups) with statistical power near 100%, indicating the results are unlikely to be due to chance.
• The evidence comes from a single moderate-quality randomized controlled trial with self-reported outcomes only and no long-term follow-up, so the findings should be confirmed by future research with objective measures and extended monitoring before being considered definitive.

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