Single-session meditation in oncology outpatient clinic

Chaoul, A., et al. (2014). An Analysis of Meditation Consultations in an Integrative Oncology Outpatient Clinic. The Journal of Alternative and Complementary Medicine, 20(5), A86-A86.

From the Abstract. The majority of cancer patients use some complementary medicine modality. Mind-body practices, and especially meditation, are amongst the most utilized. Research shows that they help cancer patients manage psychological distress and control symptoms such as pain, nausea, and sleep disturbances. However, the effects of a single meditation session on self-reported symptoms, including physical, psychological and symptom distress in an outpatient setting, are largely unknown.

All patients [received] an individual meditation consultation (60 minute initial visits, and 30 minute follow-up visits). Our analysis included 81 meditation visits for 121 participants over 32 months. The [results] revealed a significant reduction from pre- to post-meditation session in physical, psychological, and symptom distress component scores. The greatest mean reductions for individual symptoms were for: Anxiety, Fatigue, Distress, Well Being, Sleep, and Pain; all changes reaching statistically and clinically significant thresholds.

Further research with a larger sample size is needed to better understand the symptoms that meditation can help control and the frequency of self-practice outside of the clinic to help maintain the long-term benefits.

Recommended intervention for anxiety and depressive disorder

Strauss, C., Cavanagh, K., Oliver, A., & Pettman, D. (2014). Mindfulness-Based Interventions for People Diagnosed with a Current Episode of an Anxiety or Depressive Disorder: A Meta-Analysis of Randomised Controlled Trials. PLOS ONE, 9(4), e96110. Full text.

Mindfulness-based interventions (MBIs) can reduce risk of depressive relapse for people with a history of recurrent depression who are currently well. However, the cognitive, affective and motivational features of depression and anxiety might render MBIs ineffective for people experiencing current symptoms. This paper presents a meta-analysis of randomised controlled trials (RCTs) of MBIs where participants met diagnostic criteria for a current episode of an anxiety or depressive disorder.

This is the first meta-analysis of RCTs of MBIs where all studies included only participants who were diagnosed with a current episode of a depressive or anxiety disorder. Effects of MBIs on primary symptom severity were found for people with a current depressive disorder and it is recommended that MBIs might be considered as an intervention for this population.

MBI and somatization disorders

Lakhan, S. E., & Schofield, K. L. (2013). Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis. PloS one, 8(8), e71834. Full Text.

Mindfulness-based therapy (MBT) has been used effectively to treat a variety of physical and psychological disorders, including depression, anxiety, and chronic pain. Recently, several lines of research have explored the potential for mindfulness-therapy in treating somatization disorders, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.

Thirteen studies were identified as fulfilling the present criteria of employing randomized controlled trials to determine the efficacy of any form of MBT in treating somatization disorders. A meta-analysis of the effects of mindfulness-based therapy on pain, symptom severity, quality of life, depression, and anxiety was performed to determine the potential of this form of treatment.

Preliminary evidence suggests that MBT may be effective in treating at least some aspects of somatization disorders. Further research is warranted.

Worry symptoms and cognitive dysfunction with older adults

Lenze, E. J., et al. (February, 2014). Mindfulness‐based stress reduction [MBSR] for older adults with worry symptoms and co‐occurring cognitive dysfunction. International Journal of Geriatric Psychiatry. Published online before inclusion in an issue. From the Abstract.

In this treatment development project, we examined MBSR in older adults with worry symptoms and co-occurring cognitive dysfunction. We examined (i) acceptability of MBSR, (ii) whether MBSR needs to be lengthened providing more repetition, (iii) MBSR’s benefits for worry reduction and cognitive improvements, and (iv) continued use of MBSR techniques during follow-up.

Methods. Two sites enrolled individuals aged 65 years or older with significant anxiety-related distress plus subjective cognitive dysfunction, into traditional 8-session MBSR groups and 12-session groups that had the same content but more repetition of topics and techniques. We examined measures of mindfulness, worry, and a neuropsychological battery focused on memory and executive function before and after the MBSR program, and we followed up participants for 6 months after the completion of MBSR regarding their continued use of its techniques.

Results. Participants (N = 34) showed improvements in worry severity, increases in mindfulness, and improvements in memory as measured by paragraph learning and recall after a delay, all with a large effect size. Most participants continued to use MBSR techniques for 6 months post-instruction and found them helpful in stressful situations. There was no evidence that the extended 12-week MBSR produced superior cognitive or clinical outcomes, greater satisfaction, or greater continuation of MBSR techniques than 8-week MBSR.

Conclusions. These preliminary findings are promising for the further testing and use of MBSR in older adults suffering from clinical worry symptoms and co-occurring cognitive dysfunction. These are common problems in a broad range of older adults, many of whom have anxiety and mood disorders; therefore, stress reduction intervention for them may have great public health value.

Nurses’ coping with stress, burnout, and anxiety

Smith, S. A. (2014). Mindfulness‐Based Stress Reduction: An Intervention to Enhance the Effectiveness of Nurses’ Coping With Work‐Related Stress. International Journal of Nursing Knowledge. Published online before inclusion in an issue.

Abstract: This critical literature review explored the current state of the science regarding mindfulness-based stress reduction (MBSR) as a potential intervention to improve the ability of nurses to effectively cope with stress.

Empirical evidence regarding utilizing MBSR with nurses and other healthcare professionals suggests several positive benefits including decreased stress, burnout, and anxiety; and increased empathy, focus, and mood.

Web-based mindfulness course for stress, anxiety and depression

Krusche, A., Cyhlarova, E., & Williams, J. M. G. (2013). Mindfulness online: an evaluation of the feasibility of a web-based mindfulness course for stress, anxiety and depression. BMJ Open, 3(11), e003498. Full text.

From the Abstract: Face-to-face mindfulness interventions have been shown to significantly decrease perceived stress, anxiety and depression and research is beginning to show similar benefits for such courses delivered via the internet. We investigated the feasibility and effectiveness of an online mindfulness course for perceived stress, anxiety and depression.

Perceived stress, anxiety and depression significantly decreased at course completion and further decreased at 1 month follow-up, with effect sizes comparable to those found with face-to-face and other online mindfulness courses and to other types of intervention, such as cognitive behavioural therapy for stress. The amount of meditation practice reported did affect outcome when controlling for baseline severity.

The online mindfulness course appears to be an acceptable, accessible intervention which reduces stress, anxiety and depression. However, there is no control comparison and future research is required to assess the effects of the course for different samples.

Mindfulness training improves psychological functioning in Grade 7-8 boys

Sibinga, E., Perry-Parrish, C., Chung, S. E., Johnson, S. B., Smith, M., & Ellen, J. M. (2013). School-based mindfulness instruction for urban male youth: A small randomized controlled trial. Preventive Medicine. In press – available online Sept. 8. Abstract.

Excerpt: 7th and 8th graders at a small school for low-income urban boys were randomly assigned to 12-session programs of MBSR or health education (HT). Data were collected at baseline, post-program, and three-month follow-up on psychological functioning; sleep; and salivary cortisol, a physiologic measure of stress.

Forty-one of the 42 eligible boys participated, of whom 95% were African American, with a mean age of 12.5 years. Following the programs, MBSR boys had less anxiety, less rumination, and showed a trend for less negative coping than HT boys. Comparing baseline with post-program, cortisol levels increased during the academic terms for HT participants at a trend level but remained constant for MBSR participants.

In this study, MBSR participants showed less anxiety, improved coping, and a possible attenuation of cortisol response to academic stress, when compared with HT participants. These results suggest that MBSR improves psychological functioning among urban male youth.

Highlights:

  • We conducted a trial of school-based mindfulness meditation vs. an active control.
  • Mindfulness meditation reduced anxiety for middle-school urban boys.
  • Mindfulness meditation improved coping for middle-school urban boys.
  • Compared with a control, mindfulness meditation improved psychological functioning.