Month: May 2020

Reduce Burnout in Medical Residents with Mindfulness

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Reduce Burnout in Medical Residents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“while they appreciate the great meaning in their work, clinicians’ ability to disconnect and recharge may be even more critical than it is for others when it comes to how they view work environments and feel as employees.” – David Gregg

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. Hence, mindfulness may be a means to reduce burnout and improve well-being in hospital residents.

 

In today’s Research News article “Evidence-Based Interventions that Promote Resident Wellness from the Council of Emergency Residency Directors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081870/), Parsons and colleagues review and summarize the published research regarding methods to reduce burnout in medical residents. From this research they formed conclusions  and recommendations.

 

They report that the published studies demonstrate that medical resident burnout is mitigated by interventions that emphasize mindfulness, stress management, and resilience training. The evidence is fairly strong from well conducted controlled trials. It should be noted that mindfulness training improves both stress management and resilience. So, mindfulness training may be the key to all of the effective training strategies. They also report that working conditions tend to produce fatigue and stress that contribute to burnout. Reduction in burnout can be accomplished by adjustments to the work environment including shift scheduling.

 

So, reduce burnout in medical residents with mindfulness.

 

“Research exploring the effects of mindfulness training suggests it produces broad and significant improvements in attributes applicable to patient care and physician well-being.” – American Medical Association

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Parsons, M., Bailitz, J., Chung, A. S., Mannix, A., Battaglioli, N., Clinton, M., & Gottlieb, M. (2020). Evidence-Based Interventions that Promote Resident Wellness from the Council of Emergency Residency Directors. The western journal of emergency medicine, 21(2), 412–422. https://doi.org/10.5811/westjem.2019.11.42961

 

Abstract

Initiatives for addressing resident wellness are a recent requirement of the Accreditation Council for Graduate Medical Education in response to high rates of resident burnout nationally. We review the literature on wellness and burnout in residency education with a focus on assessment, individual-level interventions, and systemic or organizational interventions.

Best Practice Recommendations for Individual Interventions

  • Mindfulness training should be incorporated into residency training to improve wellness and reduce burnout (Level 1b, Grade B).
  • Consider incorporating behavioral interventions, such as reframing, self-compassion, and empathy into residency training (Level 4, Grade C)
  • Encourage self-care with respect to physical, psychological, and emotional health. This should include an emphasis on sleep, healthy eating, regular exercise, development of social and professional support networks, PCP visits, resources for substance abuse, and counseling or mentoring programs (Level 4, Grade C)
  • Program faculty should meet privately with residents potentially suffering from burnout to identify the unique causes and appropriate interventions. Close follow-up meetings should assess improvement (Level 4, Grade C)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081870/

 

Lower Depression is Associated with Buddhism in Thailand

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Lower Depression is Associated with Buddhism in Thailand

 

By John M. de Castro, Ph.D.

 

“The lay life of Thai Buddhism focuses on living ethically in the worldly life. While it is okay to enjoy the conveniences and joys of the material world, one should live ethically and not cause suffering to others. Lay people should also still be mindful of the law of impermanence and that all things must come to an end. The key to true happiness comes from within, through personal practice, not through material enjoyment.” – Nicholas Liusuwan

 

Religion and spirituality have been promulgated as solutions to the challenges of life both in a transcendent sense and in a practical sense. What evidence is there that these claims are in fact true? The transcendent claims are untestable with the scientific method. But the practical claims are amenable to scientific analysis. There have been a number of studies of the influence of religiosity and spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. A growing body of studies, however, have suggested that Western religious practices may be contributing to depression. But there is very little research on Eastern religious practices, such as Buddhism and its effects on depression.

 

In today’s Research News article “Buddhism and Depressive Symptoms among Married Women in Urban Thailand.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037506/), Xu and colleagues recruited a multistage cross sectional sample of urban Thai adults and had them complete a questionnaire measuring sociodemographic characteristics, depression, religious preference, and frequency of participation in religious practices.

 

They found that 91% of the respondents were identified as Buddhist. They also found that Buddhist participants reported significantly lower levels of depression than the non-Buddhist participants. In addition, they found that the greater the frequency of participation in Buddhist practices the lower the levels of depression.

 

It should be kept in mind that the present study was correlational and causation cannot be determined. Nevertheless, the results suggest that in and Eastern society, Thailand, the practice of Buddhism is associated with better mental health. Studies in Western cultures have generally found that being spiritual has greater positive benefits for mental health than being religious. The fact that the frequency of Buddhist practice was associated with lower depression suggests that spirituality might also here be the most impactful factor on mental health. Additionally, Buddhist practice frequently employs meditation, chanting, and other techniques that promote mindfulness. Since, mindfulness is associated with lower levels of depression, it is possible that the present findings of lower depression in Buddhist practitioners was due to these practices promoting mindfulness.

 

So, lower depression is associated with Buddhism in Thailand.

 

“In their long history of existence the Thais seem to have been predominantly Buddhists, at least ever since they came into contact with the tenets of Buddhism. All the Thai kings in the recorded history of present-day Thailand have been adherents of Buddhism. The country’s constitution specifies that the King of Thailand must be a Buddhist and the Upholder of Buddhism.” – Karuna Kusalasaya

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Xu, T., Xu, X., Sunil, T., & Sirisunyaluck, B. (2020). Buddhism and Depressive Symptoms among Married Women in Urban Thailand. International journal of environmental research and public health, 17(3), 761. https://doi.org/10.3390/ijerph17030761

 

Abstract

A growing body of research has documented salutary associations between religious involvement and poor mental health outcomes, such as depressive symptoms and psychological distress. However, little scholarly attention has been given to the association between Buddhism, a non-Western religious faith, and depressive symptomatology in Thailand. Using random survey data collected from urban Thailand, this study examines the association between religious involvement and depressive symptoms among married women in Bangkok. Findings from multiple linear regression models reveal that (1) Buddhist respondents report significantly lower levels of depressive symptoms than their non-Buddhist counterparts, (2) the frequency of participation in religious activities is significantly and inversely associated with the level of depressive symptoms, and (3) the inverse association between religious participation and depressive symptoms is more salient for Buddhists who frequently practice their faith (i.e., significant interaction effect). Research limitations and directions for future research are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037506/

 

Improve Emotion Regulation and Reduce Pain with Mindful Acceptance

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Improve Emotion Regulation and Reduce Pain with Mindful Acceptance

 

By John M. de Castro, Ph.D.

 

“Individuals with minimal mindfulness meditation experience can quickly learn how to moderate their brains’ responses to painful experiences and negative images using a technique called mindful acceptance’” – Christopher Berglund

 

There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. In other words, mindful people are better able to experience yet control their responses to emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health

Indeed, mindfulness practices are effective in treating pain in adults.

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Emotional and pain experiences are processed in the nervous system. So, it’s likely that mindfulness practices somehow alters the brain’s processing of emotions and pain.

 

In today’s Research News article “Let it be: mindful acceptance down-regulates pain and negative emotion.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057281/), Kober and colleagues recruited healthy adults and instructed them to on cue to “react naturally, whatever your response might be” and on another cue to accept. They were instructed for the accept condition to be mindful in the present moment and not judge what is happening but to accept it as it is. They then underwent brain scanning with functional Magnetic Resonance Imaging (fMRI). While in the scanner they were presented with a cue to either react or accept their experience. They were then presented with either neutral or emotionally negative images or a warm or hot thermal stimulus on their forearm. Afterward they rated how negatively they felt.

 

They found that the participants rated the emotionally negative picture and the hot stimulus as more negative than the neutral pictures or warm stimulus. But after the accept cue they reported lower negative ratings to both the negative images and hot stimulus. Hence, expressing an attitude of mindful acceptance produced lesser negative reactions to negative emotional and thermal stimuli.

 

The brain activity to the stimuli revealed that during the accept condition there was less activity in the amygdala than during the react condition. The painful, hot, thermal stimulus produced increased brain activity in widespread regions but during the mindful acceptance condition, the activations were significantly lower. Hence, expressing an attitude of mindful acceptance produced less brain activation to negative stimuli.

 

It should be pointed out that the study design contains considerable demand characteristics. Instructing a participant to take on an attitude of non-judging acceptance cues the participant that less reaction is expected. This demand characteristic may account for the ratings. It is less likely, though, that it could account for differential brain activations. Of course, demand characteristics probably have their effects by altering brain processing of the conditions.

 

Regardless, these findings are interesting and demonstrate that a brief mindfulness instruction is sufficient to alter the participants’ experiences of and the responses of their brains to neutral and negative experiences. In addition, the instruction appears to be sufficient to alter the experience of and brain activity to painful stimuli. This suggest that the mindful acceptance instruction produced an improved ability to regulate emotional reactions and experiences of pain and the brains responses to these conditions.

 

It has been repeatedly demonstrated in prior research that mindfulness improves emotion regulation and reduces pain perception. So, the present findings are compatible with prior findings. The contribution of the present study is the demonstration that a brief instruction and training in taking on an attitude of mindful acceptance is sufficient to produce these effects. It remains for future research to determine if this instruction is sufficient to alter real world reactions.

 

So, improve emotion regulation and reduce pain with mindful acceptance.

 

“The ability to stay in the moment when experiencing pain or negative emotions suggests there may be clinical benefits to mindfulness practice in chronic conditions as well — even without long meditation practice.” – Hedy Kober

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Kober, H., Buhle, J., Weber, J., Ochsner, K. N., & Wager, T. D. (2019). Let it be: mindful acceptance down-regulates pain and negative emotion. Social cognitive and affective neuroscience, 14(11), 1147–1158. https://doi.org/10.1093/scan/nsz104

 

Abstract

Mindfulness training ameliorates clinical and self-report measures of depression and chronic pain, but its use as an emotion regulation strategy—in individuals who do not meditate—remains understudied. As such, whether it (i) down-regulates early affective brain processes or (ii) depends on cognitive control systems remains unclear. We exposed meditation-naïve participants to two kinds of stimuli: negative vs. neutral images and painful vs. warm temperatures. On alternating blocks, we asked participants to either react naturally or exercise mindful acceptance. Emotion regulation using mindful acceptance was associated with reductions in reported pain and negative affect, reduced amygdala responses to negative images and reduced heat-evoked responses in medial and lateral pain systems. Critically, mindful acceptance significantly reduced activity in a distributed, a priori neurologic signature that is sensitive and specific to experimentally induced pain. In addition, these changes occurred in the absence of detectable increases in prefrontal control systems. The findings support the idea that momentary mindful acceptance regulates emotional intensity by changing initial appraisals of the affective significance of stimuli, which has consequences for clinical treatment of pain and emotion.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057281/

 

Improve a Biological Marker of Aging, Telomeres, with Meditation

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Improve a Biological Marker of Aging, Telomeres, with Meditation

 

By John M. de Castro, Ph.D.

 

“While we might expect our bodies and brains to follow a shared trajectory of development and degeneration over time, by actively practicing strategies such as meditation, we might actually preserve and protect our physical body and brain structure to extend our golden years and shine even more brightly in old age.” – Sonima Wellness

 

One of the most exciting findings in molecular biology in recent years was the discovery of the telomere. This is a component of the DNA molecule that is attached to the ends of the strands. Recent genetic research has suggested that the telomere and its regulation is the biological mechanism that produces aging. As we age the tail of the DNA molecule called the telomere shortens. When it gets very short cells have a more and more difficult time reproducing and become more likely to produce defective cells. On a cellular basis, this is what produces aging. As we get older the new cells produced are more and more likely to be defective. The shortening of the telomere occurs each time the cell is replaced. So, slowly as we age it gets shorter and shorter.

 

Fortunately, there is a mechanism to protect the telomere. There is an enzyme in the body called telomerase that helps to prevent shortening of the telomere. It also promotes cell survival and enhances stress-resistance.  Research suggests that processes that increase telomerase activity tend to slow the aging process by protecting the telomere.  One activity that seems to increase telomerase activity and protect telomere length is mindfulness practice. Hence, engaging in mindfulness practices may protect the telomere and thereby slow the aging process.

 

In today’s Research News article “Telomere length correlates with subtelomeric DNA methylation in long-term mindfulness practitioners.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067861/), and Mendioroz colleagues recruited long-term meditators (greater than 10 years of experience) and non-meditators matched for gender, ethnic group, and age. They were measured for mindfulness, anxiety, depression, resilience, happiness, self-compassion, experiential avoidance, and quality of life. They also provided blood samples that were assayed for telomere length and DNA methylation.

 

They found that the long-term meditators were significantly higher in for mindfulness, resilience, happiness, self-compassion, and quality of life and significantly lower in for anxiety, depression, and experiential avoidance.

 

They also found that the meditators had significantly longer telomeres than the matched controls. Interestingly, while in the controls the greater the age of the participant the shorter the telomeres, in the long-term meditators, telomere length was the same regardless of age. In addition, they found that in the long-term meditators, telomere length was significantly associated with DNA methylation at specific regions but not for the matched controls.

 

This study found, as have others, that long-term meditation practice is associated with longer telomeres. The fact, that the telomere length was not associated with age in the meditators suggests that meditation practice may protect the individual from age-related erosion of telomeres. The results further suggest that meditation may do so through specific methylation of DNA. Stress has been shown to results in shortening the telomeres. Hence, a potential mechanism whereby meditation may protect telomeres may be by reducing the physiological and psychological responses to stress.

 

It is suspected, but not proven, that telomere length is related to health and well-being. The findings that the long-term meditators had significantly better mental health tends to support this notion. There is evidence that meditation practice increases longevity. It can be speculated that meditation practice may do so by affecting molecular genetic mechanisms that prevent the degradation of the telomeres with age.

 

So, improve a biological marker of aging, telomeres, with meditation.

 

“Meditation also helps to protect our telomeres, the protective caps at the end of our chromosomes. Telomeres are longest when we’re young and naturally shorten as we age. Shorter telomeres are associated with stress and higher risk for many diseases including cancer, and depend on the telomerase enzyme to enable them to rebuild and repair.”- Paula Watkins

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Mendioroz, M., Puebla-Guedea, M., Montero-Marín, J., Urdánoz-Casado, A., Blanco-Luquin, I., Roldán, M., Labarga, A., & García-Campayo, J. (2020). Telomere length correlates with subtelomeric DNA methylation in long-term mindfulness practitioners. Scientific reports, 10(1), 4564. https://doi.org/10.1038/s41598-020-61241-6

 

Abstract

Mindfulness and meditation techniques have proven successful for the reduction of stress and improvement in general health. In addition, meditation is linked to longevity and longer telomere length, a proposed biomarker of human aging. Interestingly, DNA methylation changes have been described at specific subtelomeric regions in long-term meditators compared to controls. However, the molecular basis underlying these beneficial effects of meditation on human health still remains unclear. Here we show that DNA methylation levels, measured by the Infinium HumanMethylation450 BeadChip (Illumina) array, at specific subtelomeric regions containing GPR31 and SERPINB9 genes were associated with telomere length in long-term meditators with a strong statistical trend when correcting for multiple testing. Notably, age showed no association with telomere length in the group of long-term meditators. These results may suggest that long-term meditation could be related to epigenetic mechanisms, in particular gene-specific DNA methylation changes at distinct subtelomeric regions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067861/

 

Improve the Symptoms of Parkinson’s Disease with Mind-Body Practices

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Improve the Symptoms of Parkinson’s Disease with Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“The mind-body connection recognizes that emotional, mental, and behavioral factors can directly affect our health, and mind-body techniques can improve quality of life and may help reduce symptoms of disease.” – Emily Downward

 

Parkinson’s Disease (PD) is an incurable progressive degenerative disease of the central nervous system. The condition is caused by the death of nerve cells in the brain that produce the neurotransmitter dopamine. There are around seven million people worldwide and one million people in the U.S. living with PD and about 60,000 people are diagnosed with PD every year. PD is associated with aging as the vast majority of patients are diagnosed after age 50. In fact, it has been speculated that everyone would eventually develop PD if they lived long enough.

 

Its physical symptoms include resting tremor, slow movements, muscle rigidity, problems with posture and balance, loss of automatic movements, and slurring of speech. PD itself is not fatal but is often associated with related complications which can reduce life expectancy, such as falls, choking, and cardiovascular problems. Parkinson’s Disease (PD) also has psychological effects, especially cognitive decline, anxiety, and depression. All of these symptoms result in a marked reduction in the quality of life.

 

There are no cures for Parkinson’s Disease or even treatments to slow its progression. There are only treatments that can produce symptomatic relief. So, there is a need to discover new and different treatments. Mindfulness training has been found to improve the psychological symptoms and the quality of life with PD patients.  In addition, Tai Chi practice has been shown to improve the symptoms of Parkinson’s Disease. Hence, mind-body practices may be excellent treatments for the symptoms of Parkinson’s Disease.

 

In today’s Research News article “The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981975/), Jin and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mind-body practices for the relief of the symptoms of Parkinson’s Disease. They selected randomized controlled trials with Tai Chi, Qigong and Yoga practices for patients with Parkinson’s Disease over 40 years of age. They identified 22 studies with a total of 1199 participants, 18 of which employed Tai Chi and Qigong practices and 4 employed Yoga practice.

 

They report that the studies found that the mind-body practices produced significant improvements in overall Parkinson’s Disease motor function, walking ability, balance, depression, and quality of life. Hence, the published research studies demonstrate that mind-body practices significantly improve the physical and psychological symptoms of Parkinson’s Disease.

 

Tai Chi and Qigong practices have been demonstrated in prior research to improve balance, walking ability, depression, and quality of life in a variety of healthy and sick people. In addition yoga practice has been demonstrated to improve balance, walking ability, depression and quality of life in various populations. The present study extends these findings to patients with Parkinson’s Disease. These practices appear to be a safe and effective treatment to relieve the symptoms and suffering of patients with Parkinson’s Disease.

 

So, improve the symptoms of Parkinson’s Disease with mind-body practices.

 

“Mindfulness-based interventions have the ability to reprogram brain conditioning and alter the ways in which we respond to the world. Parkinson’s patients can benefit immensely from this method as a means of decreasing stress and anxiety while slowly increasing quality of life.” – Alana Kessler

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Jin, X., Wang, L., Liu, S., Zhu, L., Loprinzi, P. D., & Fan, X. (2019). The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-analysis. International journal of environmental research and public health, 17(1), 31. https://doi.org/10.3390/ijerph17010031

 

Abstract

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson’s patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = −0.61, p < 0.001), TUG (SMD = −1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = −1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I2 = 81%) and depression (I2 = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG (I2 = 29%), Balance (I2 = 16%) and QoL (I2 = 35%), it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson’s disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981975/

 

Improve Mood with Tai Chi or Qigong Practice

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Improve Mood with Tai Chi or Qigong Practice

 

By John M. de Castro, Ph.D.

 

“adding a mind-body exercise like tai chi that is widely available in the community can improve the outcomes of treating depression in older adults. . . With tai chi, we may be able to treat these conditions without exposing patients to additional medications.” – Helen Lavretsky

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Indeed, Mindfulness practices have been shown to be quite effective in relieving anxiety. Clinically diagnosed depression affects over 6% of the population. Depression can be difficult to treat. Fortunately, Mindfulness training is also effective for treating depression.

 

Anxiety disorders and clinical depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders and for depression either alone or in combination with other therapies. Mindful Movement practices such as Qigong and Tai Chi have been found to be effective for depression and anxiety. Research has been accumulating. So, it is important to step back and examine what has been learned regarding the application of Qigong and Tai Chi practices for mood.

 

In today’s Research News article “Qigong and Tai-Chi for Mood Regulation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519567/), Yeung and colleagues review and summarize the published research studies of the effectiveness of Qigong and Tai Chi practices for improving mood.

 

They found that the published research reports that Qigong and Tai Chi practice produce significant decreases in anxiety and depression and increases in psychological well-being, self-esteem, and self-efficacy. In addition, Qigong and Tai Chi practice have been shown to be effective in reducing depression that accompanies diseases including fibromyalgia, arthritis, obesity, and cardiovascular disease.

 

The mechanisms by which Qigong and Tai Chi practice improves mood are unknown. But it has been speculated that it may work by increasing mindfulness, reduces perceived stress, improving interoception, producing neuroplastic changes in the brain, improving respiration control, and altering genes. It may be that these practices produce the benefits through a combination of mechanisms or that different mechanisms underlie different benefits. Regardless, the evidence is compelling that Qigong and Tai Chi practice have beneficial effects on the psychological well-being of healthy people and people with diseases.

 

Qigong and Tai Chi  practices are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. All of these characteristics make Qigong and Tai Chi  excellent practices for the improvement mood.

 

So, improve mood with Tai Chi or Qigong Practice.

 

“In 82% of studies, tai chi greatly improved mood and lowered anxiety. Plus, it was shown to be an effective treatment for depression.” – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Yeung, A., Chan, J., Cheung, J. C., & Zou, L. (2018). Qigong and Tai-Chi for Mood Regulation. Focus (American Psychiatric Publishing), 16(1), 40–47. https://doi.org/10.1176/appi.focus.20170042

 

Abstract

Qigong and Tai-Chi are traditional self-healing, self-cultivation exercises originating in ancient China. These exercises are characterized by coordinated body posture and movements, deep rhythmic breathing, meditation, and mental focus based on traditional Chinese medicine theories. Although the exact mechanisms of Qigong’s and Tai-Chi’s effects on physical and mental well-being are unknown, these practices may be viewed as meditative movements and share many of the healing elements observed in mindfulness meditation. Clinical studies including randomized controlled trials and meta-analyses have shown that both Qigong and Tai-Chi have beneficial effects on psychological well-being and reduce symptoms of anxiety and depression. Qigong and Tai-Chi frequently involve anchoring attention to interoceptive sensations related to breath or other parts of the body, which has been shown to enhance nonreactivity to aversive thoughts and impulses. Preliminary studies suggest that the slow movements in Qigong and Tai-Chi with slowing of breath frequency could alter the autonomic system and restore homeostasis, attenuating stress related to hypothalamus-pituitary-adrenal axis reactivity and modulating the balance of the autonomic nervous system toward parasympathetic dominance. Qigong’s and Tai-Chi’s effects on emotion regulation could occur through changes in multiple prefrontal regions, the limbic system, and the striatum or in the expression of genes linked to inflammatory responses and stress-related pathways.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519567/

 

Spirituality is associated with Childhood Trauma

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Spirituality is associated with Childhood Trauma

 

By John M. de Castro, Ph.D.

 

“traumatic childhood experiences must be solved by making new good experiences with relationships, with closeness.” – Gopal Klein

 

“Child maltreatment is the abuse and neglect that occurs to children under 18 years of age. It includes all types of physical and/or emotional ill-treatment, sexual abuse, neglect, negligence and commercial or other exploitation, which results in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power. Exposure to intimate partner violence is also sometimes included as a form of child maltreatment” (World Health Organization, 2016)

 

This maltreatment is traumatic and can leave in its wake symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, childhood maltreatment can continue to affect mental and physical health throughout the individual’s life. How individuals cope with childhood maltreatment helps determine the effects of the maltreatment on their mental health. It has been found that experiencing the feelings and thoughts completely allows for better coping. This can be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms.

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. So, it would make sense to investigate the relationship of spirituality to childhood trauma.

 

In today’s Research News article “Childhood Trauma Is Associated with the Spirituality of Non-Religious Respondents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068247/), Kosarkova and colleagues sampled the Czech population over 15 years of age and had them complete measures of childhood trauma, including emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect subscales, religiosity, spirituality, and religious conversion experiences.

 

They found that the higher the levels of spirituality in the non-religious but not the religious participants in the sample the greater the amounts of childhood trauma including emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. Hence, for the non-religious people childhood trauma of all varieties are associated with spirituality.

 

The present results are correlational and as such causation cannot be determined. It is equally likely that childhood trauma increases spirituality, spirituality increases childhood trauma, or some third factor was responsible for both. It can be speculated, though, that the individual experiencing trauma looks for a means to explain the reason for the trauma. Individuals who are religious may interpret it in a religious context and conclude that god has abandoned them and so become even less spiritual. On the other hand, non-religious individuals would not fault god for the trauma and thus could take refuge in spirituality as a coping mechanism. It remains for future research to investigate these possibilities.

 

“childhood violence survivors often mention the importance of spirituality in their survival and recovery as being a resource for healing, meaning making, and truth.” -Thelma Bryant-Davis

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Kosarkova, A., Malinakova, K., Koncalova, Z., Tavel, P., & van Dijk, J. P. (2020). Childhood Trauma Is Associated with the Spirituality of Non-Religious Respondents. International journal of environmental research and public health, 17(4), 1268. https://doi.org/10.3390/ijerph17041268

 

Abstract

Childhood trauma experience (CT) is negatively associated with many aspects of adult life. Religiosity/spirituality (R/S) are often studied as positive coping strategies and could help in the therapeutic process. Evidence on this is lacking for a non-religious environment. The aim of this study was to assess the associations of different types of CT with R/S in the secular conditions of the Czech Republic. A nationally representative sample (n = 1800, mean age = 46.4, SD = 17.4; 48.7% male) of adults participated in the survey. We measured childhood trauma, spirituality, religiosity and conversion experience. We found that four kinds of CT were associated with increased levels of spirituality, with odds ratios (OR) ranging from 1.17 (95% confidence interval 1.03–1.34) to 1.31 (1.18–1.46). Non-religious respondents were more likely to report associations of CT with spirituality. After measuring for different combinations of R/S, each CT was associated with increased chances of being “spiritual but non-religious”, with OR from 1.55 (1.17–2.06) to 2.10 (1.63–2.70). Moreover, converts were more likely to report emotional abuse OR = 1.46 (1.17–1.82) or emotional neglect with OR = 1.42 (1.11–1.82). Our findings show CT is associated with higher levels of spirituality in non-religious respondents. Addressing spiritual needs may contribute to the effectiveness of psychotherapeutic treatment of the victims.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068247/

 

Reduce Body Weight and Improve Health in the Obese with Mindfulness

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Reduce Body Weight and Improve Health in the Obese with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practice helps individuals develop skills for self-regulation by improving awareness of emotional and sensory cues, which are also important in altering one’s relationship with food.” – Sunil Daniel

 

Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, defined as a Body Mass Index (BMI) of 30 or above has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (BMI > 25). Obesity has been found to shorten life expectancy by eight years and extreme obesity by 14 years. This occurs because obesity is associated with cardiovascular problems such as coronary heart disease and hypertension, stroke, metabolic syndrome, diabetes, cancer, arthritis, and others.

 

Obviously, there is a need for effective treatments to obese individuals. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Mindfulness is known to be associated with lower risk for obesity, alter eating behavior and improve health in obesity. Mindfulness-Based Cognitive Therapy (MBCT)  involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. This suggests that MBCT may be an effective treatment for overeating and obesity alone or in combination with other therapies.

 

In today’s Research News article “Effectiveness of mindfulness based cognitive therapy on weight loss, improvement of hypertension and attentional bias to eating cues in overweight people.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031128/), Alamout and colleagues recruited women who were adult (aged 30-50) and overweight (BMI of 25-30) and randomly assigned them to receive either no treatment or a diet providing 800 Kcal less than their normal intake, or the diet plus once a week for 2 hours for 8 weeks Mindfulness-Based Cognitive Therapy (MBCT) along with daily home practice. They were measured before and after treatment and 4 weeks later for body size and blood pressure. Attention bias was measured by asking participants to respond as quickly as they can to words and pictures that were food related or neutral.

 

They found that after the intervention there was a significant reduction in body weight and body mass index in the diet groups in comparison to the no treatment control. But, the groups that received diet plus Mindfulness-Based Cognitive Therapy (MBCT) had significantly greater reductions that were maintained 4 weeks after treatment. Attentional bias toward food cues and both systolic and diastolic blood pressure were significantly reduced in the diet plus MBCT group only and these reductions were maintained 4 weeks after treatment.

 

These findings are interesting and potentially significant. Weight loss is difficult to attain and even more difficult to maintain after the cessation of treatment. The findings suggest that the addition of mindfulness training to diet therapy greatly enhances the benefits. It has been previously demonstrated that mindfulness training reduces blood pressure. The reductions in blood pressure observed in the present study suggest that the mindfulness training reduces the responses to stress. It has been shown that stress can promote food intake. So, the reduction in stress responding may make it easier to maintain the diet.

 

The combination of diet and mindfulness training appears to alter how overweight women respond to food related cues. This may, in part, be responsible for the increased effectiveness of diet plus mindfulness training. It may make it easier for the women to refrain from responding to food cues and thereby be better able to stay on the diet. In other words, it makes them less responsive to temptation.

 

So, reduce body weight and improve health in the obese with mindfulness.

 

“Adults with overweight or obesity who participated in mindfulness-based intervention experienced at least 3% weight loss that persisted through follow-up, with a reduction in disordered eating behaviors.” – Kimberly Carriere

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Alamout, M. M., Rahmanian, M., Aghamohammadi, V., Mohammadi, E., & Nasiri, K. (2019). Effectiveness of mindfulness based cognitive therapy on weight loss, improvement of hypertension and attentional bias to eating cues in overweight people. International journal of nursing sciences, 7(1), 35–40. https://doi.org/10.1016/j.ijnss.2019.12.010

 

Abstract

Objectives

Prevalence rates of overweight and obesity are dramatically ever-increasing across the world. Therefore, this study was to evaluate the effect of mindfulness-based cognitive therapy (MBCT) on weight loss, hypertension, and attentional bias towards food cues in a group of women affected with this condition.

Methods

A total of 45 participants were selected out of women referring to the Nutrition and Diet Therapy Clinic affiliated to Shahid Beheshti University of Medical Sciences, Iran, and then randomized into three groups of 15. The first experimental group was subjected to an energy-restricted diet therapy together with MBCT during 8 sessions, the second group took the diet therapy alone, and the third group received no intervention. Body mass index (BMI), hypertension, and attentional bias towards food cues were correspondingly evaluated before, at the end, and four weeks after the completion of the interventions.

Results

The results of this study revealed that MBCT, along with diet therapy, had been significantly more effective in weight loss, decrease in BMI, lower systolic blood pressure (SBP), and attentional bias towards food cues compared with the diet therapy alone (P ≤ 0.01). MBCT had no significant impact on the decline in diastolic blood pressure (DBP) in participants in the follow-up phase.

Conclusion

This study demonstrated that MBCT along with the conventional diet therapy was more effective in weight loss, decrease in BMI, hypertension control, as well as attentional bias towards food cues than the diet therapy alone.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7031128/

 

Improve Depression During the Perinatal Period with Mindfulness

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Improve Depression During the Perinatal Period with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Pregnancy is a challenging terrain for everyone to navigate. And if you are entering that space with some history of depression, it can be particularly challenging.” – Sona Dimidjian

 

The period of pregnancy is a time of intense physiological and psychological change. Anxiety, depression, and fear are quite common during pregnancy. More than 20 percent of pregnant women have an anxiety disorder, depressive symptoms, or both during pregnancy. A debilitating childbirth fear has been estimated to affect about 6% or pregnant women and 13% are sufficiently afraid to postpone pregnancy. It is difficult to deal with these emotions under the best of conditions but in combinations with the stresses of pregnancy can turn what could be a joyous experience of creating a human life into a horrible worrisome, torment.

 

The psychological health of pregnant women has consequences for fetal development, birthing, and consequently, child outcomes. Depression during pregnancy is associated with premature delivery and low birth weight. Hence, it is clear that there is a need for methods to treat depression, and anxiety during pregnancy. Since the fetus can be negatively impacted by drugs, it would be preferable to find a treatment that did not require drugs. Mindfulness training has been shown to improve anxiety and depression normally and to relieve maternal anxiety and depression during pregnancy.

 

Mindfulness practices have been found to help with coping with loss and its consequent grief.  Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021274/), Miklowitz and colleagues recruited women with major depressive or bipolar disorders who were either pregnant, within 1 year postpartum, or trying to get pregnant. They were provided with weekly 2-hour sessions for 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment and at 1 and 6 months later for psychological symptom severity, reoccurrence of major depression, mindfulness, and acceptability of treatment.

 

They found that in comparison to baseline, after Mindfulness-Based Cognitive Therapy (MBCT) there were significant reduction in depression and increases in mindfulness. The women on average moved from mildly to minimally depressed categories. These improvements were maintained 1 and 6 months later. The women who had major depressive disorder had significantly greater improvements in depression than the women with bipolar disorder.

 

These results suggest that Mindfulness-Based Cognitive Therapy (MBCT) is an effective treatment for depression in perinatal women with lasting benefits. This should help relieve the women’s suffering and help them to be better mothers to their children. MBCT has been shown to be effective for a wide variety of patients with depression. The present study increases the types of depression that are known to respond positively to MBCT.

 

So, improve depression during the perinatal period with mindfulness.

 

“mindfulness training could help improve mothers’ experience of labor and reduce the likelihood of postpartum depression.” – Jenn Knudsen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Miklowitz, D. J., Semple, R. J., Hauser, M., Elkun, D., Weintraub, M. J., & Dimidjian, S. (2015). Mindfulness-Based Cognitive Therapy for Perinatal Women with Depression or Bipolar Spectrum Disorder. Cognitive therapy and research, 39(5), 590–600. https://doi.org/10.1007/s10608-015-9681-9

 

Abstract

The perinatal period is a high-risk time for mood deterioration among women vulnerable to depression. This study examined feasibility, acceptability, and improvement associated with mindfulness-based cognitive therapy (MBCT) in perinatal women with major depressive disorder (MDD) or bipolar spectrum disorder (BSD). Following a diagnostic evaluation, 39 perinatal women with a lifetime history of MDD (n = 27) or BSD (n = 12) enrolled in an 8-week program of MBCT classes (2 h each) that incorporated meditation, yoga, and mood regulation strategies. Participants were pregnant (n = 12), planning pregnancy (n = 11), or up to 1-year postpartum (n = 16). Participants were self-referred and most had subthreshold mood symptoms. Assessments of depression, (hypo)mania, and anxiety were obtained by interview and self-report at baseline, post-treatment and at 1- and 6-month post-treatment. Women with a history of MDD were more likely to complete the classes than women with BSD. Of 32 women who completed the classes, 7 (21.9 %) had a major depressive episode during the 6-month post-treatment follow-up. On average, participants with MDD reported improvements in depression from pre- to post-treatment. Mood improvement was not observed in the BSD group. In the full sample, improvements in depression symptoms across time points were associated with increasing mindful tendency scores. This study was limited by its uncontrolled design, heterogeneous sample, and questionnaire-based assessment of mindfulness skills. MBCT may be an important component of care for perinatal women with histories of major depression. Its applicability to perinatal women with BSD is unclear.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021274/

 

Cost Effectively Improve Cancer Patients’ Quality of Life with Mindfulness

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Cost Effectively Improve Cancer Patients’ Quality of Life with Mindfulness

 

By John M. de Castro, Ph.D.

 

“People don’t ask to be diagnosed with cancer, but they’re given an opportunity to, in a real sense, experience the vividness and the exquisiteness of the moment.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. The effectiveness of mindfulness training for the psychological symptoms of cancer has been established. But whether it is cost-effective relative to other treatments has not been investigated.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many parents can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the cost effectiveness of these online trainings.

 

In today’s Research News article “Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027540/), Compen and colleagues recruited past or present cancer patients with high anxiety levels and randomly assigned them to be on a wait-list receiving treatment as usual or Mindfulness-Based Cognitive Therapy (MBCT) either delivered face-to-face or over the internet. Face-to-face MBCT occurred in 8 weekly 2.5-hour sessions with 45 minutes of daily practice at home. The internet version had similar content but was delivered asynchronously personally with email exchanges with therapists.

Costs were calculated by calculating the costs of normal treatment as usual as well as indirect costs from absenteeism, productivity losses etc. and the costs of delivering the services. Quality of life was assessed for each patient.

 

They found that the costs of delivery of Mindfulness-Based Cognitive Therapy (MBCT) was equivalent between face-to-face and internet delivery. The productivity losses and total costs were significantly less with both MBCT deliveries compared to treatment as usual. Quality of life was significantly higher with both MBCT deliveries and was maintained at a 9-month follow-up.

 

The results suggest that delivering Mindfulness-Based Cognitive Therapy (MBCT) either face-to-face or over the internet reduces total costs of treatment and work-related losses and improved the quality of life of cancer patients. This suggests that MBCT is a cost effective way of delivering treatment to cancer patients, making their lives better.

 

So, cost effectively improve cancer patients’ quality of life with mindfulness.

 

“Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity. – Erin Murphy-Wilczek

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Compen, F., Adang, E., Bisseling, E., van der Lee, M., & Speckens, A. (2020). Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients. Psycho-oncology, 29(2), 294–303. https://doi.org/10.1002/pon.5246

 

Abstract

Objective

It was previously determined that group‐based face‐to‐face Mindfulness‐Based Cognitive Therapy (MBCT) and individual internet‐based MBCT (eMBCT) are equally efficacious compared with treatment as usual (TAU) in reducing psychological distress. In this study, the incremental cost‐utility of both interventions compared with TAU was assessed.

Methods

This cost‐utility study included 245 self‐referred heterogeneous cancer patients with psychological distress who were randomized to MBCT, eMBCT or TAU. Healthcare costs and (informal) work‐related productivity losses were assessed by interview. Outcomes were expressed in EuroQol‐5D‐3L utility scores and quality‐adjusted life years (QALY). An economic evaluation with a time‐horizon of 3 months was conducted from the societal perspective in the intention‐to‐treat sample. In addition, secondary explorative analyses of costs and quality of life during the 9‐month follow‐up were conducted based on linear extrapolation of TAU.

Results

Paid work‐related productivity losses and societal costs were lower in both intervention conditions compared with TAU during the 3‐month intervention period. Moreover, quality of life (utility scores) improved in eMBCT versus TAU (Cohen’s d: .54) and MBCT versus TAU (.53). At a willingness to pay of €20000 per QALY, the mean incremental net monetary benefit was €1916 (SD=€783) in eMBCT and €2365 (SD=€796) in MBCT versus TAU. Exploration of costs demonstrated an equal pattern of eMBCT and MBCT being superior to TAU. Quality of life at 9‐month follow‐up remained improved in both interventions.

Conclusions

Results indicate that eMBCT and MBCT are cost‐saving treatments whilst simultaneously improving quality of life for distressed cancer patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027540/