Positive effects in the management of MS (review)

Levin, A. B., Hadgkiss, E. J., Weiland, T. J., & Jelinek, G. A. (2014). Meditation as an Adjunct to the Management of Multiple Sclerosis. Neurology Research International. http://dx.doi.org/10.1155/2014/704691. Full text.

From the Abstract. Multiple sclerosis (MS) disease course is known to be adversely affected by several factors including stress. A proposed mechanism for decreasing stress and therefore decreasing MS morbidity and improving quality of life is meditation. This review aims to critically analyse the current literature regarding meditation and MS.

Four major databases were used to search for English language papers published before March 2014 with the terms MS, multiple sclerosis, meditation, and mindfulness. 12 pieces of primary literature fitting the selection criteria were selected: two were randomised controlled studies, four were cohort studies, and six were surveys. The current literature varies in quality; however common positive effects of meditation include improved quality of life (QOL) and improved coping skills.

All studies suggest possible benefit to the use of meditation as an adjunct to the management of multiple sclerosis. Additional rigorous clinical trials are required to validate the existing findings and determine if meditation has an impact on disease course over time.

MBCR vs. group therapy with survivors of breast cancer

Carlson, L. E., et al. (2013). Randomized controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). Journal of Clinical Oncology, 31(25), 3119-3126. From the Abstract:

Purpose. To compare the efficacy of the following two empirically supported group interventions to help distressed survivors of breast cancer cope: mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET).

Patients and Methods. This multisite, randomized controlled trial assigned 271 distressed survivors of stage I to III breast cancer to MBCR, SET, or a 1-day stress management control condition. MBCR focused on training in mindfulness meditation and gentle yoga, whereas SET focused on emotional expression and group support. Both intervention groups included 18 hours of professional contact. Measures were collected at baseline and after intervention by assessors blind to study condition. Primary outcome measures were mood and diurnal salivary cortisol slopes. Secondary outcomes were stress symptoms, quality of life, and social support.

Results. Women in MBCR improved more over time on stress symptoms compared with women in both the SET and control groups. Per-protocol analyses showed greater improvements in the MBCR group in quality of life compared with control group and in social support compared with the SET group.

Conclusion. In the largest trial to date, MBCR was superior for improving a range of psychological outcomes for distressed survivors of breast cancer. Both SET and MBCR also resulted in more normative diurnal cortisol profiles than the control condition. The clinical implications of this finding require further investigation.

Multiple sclerosis: systematic review

Simpson, R., et al. (2014). Mindfulness based interventions in multiple sclerosis — a systematic review. BMC neurology, 14(1), 15. Full text.

Conclusions: Although the evidence is limited, this review indicates that MBIs can hold benefit for people with MS, specifically in terms of quality of life, mental health, and some physical aspects of the condition. It is unclear at this time whether these result are generalisable to different ethnic groups; both genders; all age groups; different disease phenotypes; and diverse socio-economic groups. There is no evidence regarding health service utilisation costs. It also remains unclear what benefit MBIs may hold for people with more advanced MS. Further high quality studies are needed to clarify the feasibility, practicality, acceptability, health and psychosocial benefits of MBIs for people with MS.

Important component in treating ulcerative colitis

Jedel, S., et al. (2009). Relationship of Mindfulness, Quality of Life, and Psychiatric Symptoms Among Patients with Ulcerative Colitis. Mindfulness, 1-5.

From the Abstract: Inflammatory bowel disease (IBD) is a significant health problem. IBD patients have an exaggerated response to stress, which is also implicated as a flare-up trigger. Stress management techniques can potentially prevent flare-ups and improve quality of life. This study examines the relationship between dispositional mindfulness and perceived stress, quality of life, and psychiatric distress. Participants with ulcerative colitis (UC) completed questionnaires and were classified into two groups: asymptomatic and symptomatic.

In the asymptomatic group, mindfulness scores were significantly and inversely correlated with anxiety, depression, and perceived stress scores, and significantly but positively correlated with quality of life. In the symptomatic group, mindfulness was significantly and inversely correlated with perceived stress scores and was not significantly correlated with other psychosocial variables.

Our data suggest that mindfulness training, which can be incorporated into a stress management program, may be an important component in treating UC, by improving physical and psychiatric functioning. Randomized, placebo-controlled trials are necessary to determine whether MBSR is useful in managing UC.

Effective in reducing psychological distress and improving quality of life in cancer patients

Fish, J. A., Ettridge, K., Sharplin, G. R., Hancock, B., & Knott, V. E. (2013). Mindfulness‐based Cancer Stress Management: impact of a mindfulness‐based programme on psychological distress and quality of life. European journal of cancer care. Epub ahead of print.

From the Abstract: Within the area of cancer care, mindfulness-based therapeutic interventions have been found to be efficacious in reducing psychological distress related to a cancer diagnosis; however, the impact of mindfulness-based interventions on quality of life is unclear. This study explores the impact of a Mindfulness-Based Cancer Stress Management programme on psychological distress and quality of life.

Significant improvements were observed on all measures following the intervention, which were maintained at 3-month follow-up. Mindfulness was significantly correlated with all main outcome measures at post-intervention and 3-month follow-up, providing evidence for the internal validity of the study. Our findings indicate that the MBCSM programme is effective in reducing psychological distress and improving quality of life, including spiritual well-being.

Mind, body, and spirit self-empowerment for women with breast cancer

Kinney, C. K., Rodgers, D. M., Nash, K. A., & Bray, C. O. (2003). Holistic healing for women with breast cancer through a mind, body, and spirit self-empowerment program. Journal of Holistic Nursing, 21(3), 260-279. Full text.

This article reports results of an integrated mind-body-spirit self-empowerment program for breast cancer survivors. Fifty-women at various stages of breast cancer completed a series of eclectic lessons offered in a support group format. The followed an integrated and cumulative lesson plan that progressively and systematically introduced multiple strategies creating a balance among mental, emotional, spiritual, and physical health.

The program’s goals were to enable to experience a reduction in distress, improve perceived quality of life, reach a deeper sense of meaning and purpose in life and experience a greater sense of perceived wellness. Self-assessments were obtained on four well-documented measures to both pre- and postprogram participation. Differences in pre- and postscores showed statistically significant and large estimated effect sizes on all four measures. Participants’ written comments provide examples of the scope and of the program.

Helps to support well-being in primary care physicians

Fortney, L., et al. (2013). Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study. The Annals of Family Medicine, 11(5), 412-420. Full text.

Excerpts from Abstract:  Burnout, attrition, and low work satisfaction of primary care physicians are growing concerns and can have a negative influence on health care. Interventions for clinicians that improve work-life balance are few and poorly understood. We undertook this study as a first step in investigating whether an abbreviated mindfulness intervention could increase job satisfaction, quality of life, and compassion among primary care clinicians.

A total of 30 primary care clinicians participated in an abbreviated mindfulness course. We used a single-sample, pre-post design. At 4 points in time (baseline, and 1 day, 8 weeks, and 9 months post-intervention), participants completed a set of online measures assessing burnout, anxiety, stress, resilience, and compassion. Participants had improvements compared with baseline at all 3 follow-up time points.

In this uncontrolled pilot study, participating in an abbreviated mindfulness training course adapted for primary care clinicians was associated with reductions in indicators of job burnout, depression, anxiety, and stress. Modified mindfulness training may be a time-efficient tool to help support clinician health and well-being, which may have implications for patient care.