Mindfulness in treatment-seeking adults with comorbid obsessive-compulsive and major depressive disorders: Mediating effects of obsessive beliefs and mental well-being

Background: Mindfulness-based interventions have shown promise in alleviating symptoms associated with obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). However, the specific mechanisms that drive these effects, mainly through obsessive beliefs and mental well-being, are seldom examined. Aim: To explore the mechanisms by which mindfulness influences symptom severity in adults with comorbid OCD and MDD, focusing on the mediating roles of obsessive beliefs and mental well-being. Methods: Primary data from 60 treatment-seeking adults with comorbid OCD and MDD were analyzed. Ordinary least-squares path analysis was employed to examine the mediating roles of obsessive beliefs and mental well-being in the relationship between mindfulness and the severity of OCD and MDD symptoms. Results: Mindfulness was significantly associated with reduced symptom severity for both OCD (β = − 0.40, P < 0.001) and MDD (β = − 0.49, P < 0.001). For MDD, obsessive beliefs (β = − 0.20, P < 0.001) and mental well-being (β = − 0.33, P < 0.001) significantly mediated the relationship. In contrast, no significant indirect effects were observed for OCD symptoms through obsessive beliefs (β = − 0.10, P = 0.16) or mental well-being (β = − 0.08, P = 0.20). Conclusion: These findings highlight the distinct mechanisms of mindfulness in comorbid OCD and MDD, underscoring the importance of customized interventions based on specific pathways.