The impact of mindfulness intervention on emotion regulation in athletes: a meta-analysis.

Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition frequently associated with substantial functional impairment (). It is characterized by intrusive thoughts or images known as obsessions, and ritualistic mental or physical behaviors performed to alleviate associated anxiety or distress, termed compulsions (). An epidemiological study has found that the global lifetime prevalence among adults is approximately 1.3%, with males consistently exhibiting a lower risk than females (). Left untreated, obsessive-compulsive disorder can impair social functioning and significantly diminish quality of life (). Prior studies have classified OCD symptoms into four distinct, yet overlapping, dimensions, including: (a) contamination and cleaning; (b) symmetry and ordering; (c) forbidden thoughts; and (d) harm (). However, this broad dimensional summary limits its direct applicability in clinical practice. The Y-BOCS is widely regarded as the gold standard for assessing OCD severity in clinical populations. It differentiates symptom types across specific domains, including aggressive, contamination, sexual, religious, symmetry/exactness, and somatic obsessions, as well as hoarding-related symptoms (). Despite being ranked among the 10 most debilitating disorders, OCD is characterized by suboptimal treatment-seeking rates. Studies report a mean duration of untreated illness estimated at 17 years following symptom emergence. Consequently, the timely identification of early OCD symptoms and the prompt implementation of effective intervention are of substantial clinical importance (, ). Studies indicate that exposure and response prevention (ERP) demonstrates significant efficacy in treating OCD among children, adolescents, and adults, with a treatment response rate of 65 to 70% and a remission rate of 57% (). Evidence indicates that cognitive-behavioral therapy (CBT), incorporating ERP, is effective in approximately 50% of clinical cases (, ). A substantial proportion of patients discontinue treatment prematurely, often due to perceiving exposure exercises as excessively challenging or the induced anxiety as overly intense (, ). Furthermore, an estimated 20% of individuals with OCD do not respond to all available treatment modalities (). Therefore, it is imperative to refine existing treatment approaches and advance alternative therapies to enhance the quality of life for individuals with OCD. The AS is a prevalent therapeutic approach within Traditional Chinese Medicine. It encompasses various techniques, including acupressure, acupuncture, acupoint injection, finger pressure, transcutaneous electrical acupoint stimulation (TEAS), and moxibustion. AS has been explored in preliminary clinical research and TCM-based literature for OCD, but the evidence remains limited and has not been systematically evaluated (). Crucially, the specific impact of AS as an adjunctive therapy on the mental state and anxiety symptoms of OCD patients remains underexplored in systematic reviews. Conducting a rigorous and up-to-date systematic review addressing this gap is essential. Therefore, the systematic review and meta-analysis focus on evaluating the effects of AS on obsessive-compulsive symptoms, illness severity, and anxiety in OCD. This meta-analysis was conducted in adherence to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The study protocol was prospectively registered on PROSPERO under registration number CRD420251070503.