Month: May 2022

Improve Borderline Personality Disorder with Mindfulness

psyjdc Leave a comment

Improve Borderline Personality Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“DBT . . . is considered one of the best treatments for [Borderline Personality Disorder] in terms of documented success rates. . . [Borderline Personality Disorder] is effective in reducing psychiatric hospitalization, substance use, and suicidal behavior. . .  self-injurious behaviors, and the severity of borderline symptoms.” – Kristalyn Salters-Pedneault

 

Borderline Personality Disorder (BPD) is a very serious mental illness that is estimated to affect 1.6% of the U.S. population. It involves unstable moods, behavior, and relationships, problems with regulating emotions and thoughts, impulsive and reckless behavior, and unstable relationships. About ¾ of BPD patients engage in self-injurious behaviors.

 

One of the few treatments that appears to be effective for Borderline Personality Disorder (BPD) is Dialectical Behavior Therapy (DBT). It is targeted at changing the problem behaviors characteristic of BPD including self-injury. Behavior change is accomplished through focusing on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. The research regarding the effectiveness of DBT reduces for BPD patients has been accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Psychological therapies for people with borderline personality disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199382/ ) Storebø and colleagues review and summarize the published randomized controlled trials on the effectiveness of Dialectical Behavior Therapy (DBT). for the treatment of Borderline Personality Disorder (BPD). They found 25 randomized controlled trials.

 

They report that the published research found that Dialectical Behavior Therapy (DBT) compared to treatment as usual, wait-list controls, and no-treatment produced significantly greater reductions in Borderline Personality Disorder (BPD) severity, self-harm, anger, impulsivity, dissociation, psychotic-like symptoms, and emotional instability and significantly greater increases in psychological functioning. There were no significant differences in adverse events between DBT and controls.

 

The published research clearly demonstrates that Dialectical Behavior Therapy (DBT) is a safe and effective treatment for Borderline Personality Disorder (BPD).

 

“‘Dialectical’ means trying to understand how two things that seem opposite could both be true. For example, accepting yourself and changing your behaviour might feel contradictory. But DBT teaches that it’s possible for you to achieve both these goals together.” – Mind

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Storebø, O. J., Stoffers-Winterling, J. M., Völlm, B. A., Kongerslev, M. T., Mattivi, J. T., Jørgensen, M. S., Faltinsen, E., Todorovac, A., Sales, C. P., Callesen, H. E., Lieb, K., & Simonsen, E. (2020). Psychological therapies for people with borderline personality disorder. The Cochrane database of systematic reviews, 5(5), CD012955. https://doi.org/10.1002/14651858.CD012955.pub2

 

Abstract

Background

Over the decades, a variety of psychological interventions for borderline personality disorder (BPD) have been developed. This review updates and replaces an earlier review (Stoffers‐Winterling 2012).

Objectives

To assess the beneficial and harmful effects of psychological therapies for people with BPD.

Search methods

In March 2019, we searched CENTRAL, MEDLINE, Embase, 14 other databases and four trials registers. We contacted researchers working in the field to ask for additional data from published and unpublished trials, and handsearched relevant journals. We did not restrict the search by year of publication, language or type of publication.

Selection criteria

Randomised controlled trials comparing different psychotherapeutic interventions with treatment‐as‐usual (TAU; which included various kinds of psychotherapy), waiting list, no treatment or active treatments in samples of all ages, in any setting, with a formal diagnosis of BPD. The primary outcomes were BPD symptom severity, self‐harm, suicide‐related outcomes, and psychosocial functioning. There were 11 secondary outcomes, including individual BPD symptoms, as well as attrition and adverse effects.

Data collection and analysis

At least two review authors independently selected trials, extracted data, assessed risk of bias using Cochrane’s ‘Risk of bias’ tool and assessed the certainty of the evidence using the GRADE approach. We performed data analysis using Review Manager 5 and quantified the statistical reliability of the data using Trial Sequential Analysis.

Main results

We included 75 randomised controlled trials (4507 participants), predominantly involving females with mean ages ranging from 14.8 to 45.7 years. More than 16 different kinds of psychotherapy were included, mostly dialectical behaviour therapy (DBT) and mentalisation‐based treatment (MBT). The comparator interventions included treatment‐as‐usual (TAU), waiting list, and other active treatments. Treatment duration ranged from one to 36 months.

Psychotherapy versus TAU

Psychotherapy reduced BPD symptom severity, compared to TAU; standardised mean difference (SMD) −0.52, 95% confidence interval (CI) −0.70 to −0.33; 22 trials, 1244 participants; moderate‐quality evidence. This corresponds to a mean difference (MD) of −3.6 (95% CI −4.4 to −2.08) on the Zanarini Rating Scale for BPD (range 0 to 36), a clinically relevant reduction in BPD symptom severity (minimal clinical relevant difference (MIREDIF) on this scale is −3.0 points).

Psychotherapy may be more effective at reducing self‐harm compared to TAU (SMD −0.32, 95% CI −0.49 to −0.14; 13 trials, 616 participants; low‐quality evidence), corresponding to a MD of −0.82 (95% CI −1.25 to 0.35) on the Deliberate Self‐Harm Inventory Scale (range 0 to 34). The MIREDIF of −1.25 points was not reached.

Suicide‐related outcomes improved compared to TAU (SMD −0.34, 95% CI −0.57 to −0.11; 13 trials, 666 participants; low‐quality evidence), corresponding to a MD of −0.11 (95% CI −0.19 to −0.034) on the Suicidal Attempt Self Injury Interview. The MIREDIF of −0.17 points was not reached.

Compared to TAU, psychotherapy may result in an improvement in psychosocial functioning (SMD −0.45, 95% CI −0.68 to −0.22; 22 trials, 1314 participants; low‐quality evidence), corresponding to a MD of −2.8 (95% CI −4.25 to −1.38), on the Global Assessment of Functioning Scale (range 0 to 100). The MIREDIF of −4.0 points was not reached.

Our additional Trial Sequential Analysis on all primary outcomes reaching significance found that the required information size was reached in all cases.

A subgroup analysis comparing the different types of psychotherapy compared to TAU showed no clear evidence of a difference for BPD severity and psychosocial functioning.

Psychotherapy may reduce depressive symptoms compared to TAU but the evidence is very uncertain (SMD −0.39, 95% CI −0.61 to −0.17; 22 trials, 1568 participants; very low‐quality evidence), corresponding to a MD of −2.45 points on the Hamilton Depression Scale (range 0 to 50). The MIREDIF of −3.0 points was not reached.

BPD‐specific psychotherapy did not reduce attrition compared with TAU. Adverse effects were unclear due to too few data.

Psychotherapy versus waiting list or no treatment

Greater improvements in BPD symptom severity (SMD −0.49, 95% CI −0.93 to −0.05; 3 trials, 161 participants), psychosocial functioning (SMD −0.56, 95% CI −1.01 to −0.11; 5 trials, 219 participants), and depression (SMD −1.28, 95% CI −2.21 to −0.34, 6 trials, 239 participants) were observed in participants receiving psychotherapy versus waiting list or no treatment (all low‐quality evidence). No evidence of a difference was found for self‐harm and suicide‐related outcomes.

Individual treatment approaches

DBT and MBT have the highest numbers of primary trials, with DBT as subject of one‐third of all included trials, followed by MBT with seven RCTs.

Compared to TAU, DBT was more effective at reducing BPD severity (SMD −0.60, 95% CI −1.05 to −0.14; 3 trials, 149 participants), self‐harm (SMD −0.28, 95% CI −0.48 to −0.07; 7 trials, 376 participants) and improving psychosocial functioning (SMD −0.36, 95% CI −0.69 to −0.03; 6 trials, 225 participants). MBT appears to be more effective than TAU at reducing self‐harm (RR 0.62, 95% CI 0.49 to 0.80; 3 trials, 252 participants), suicidality (RR 0.10, 95% CI 0.04, 0.30, 3 trials, 218 participants) and depression (SMD −0.58, 95% CI −1.22 to 0.05, 4 trials, 333 participants). All findings are based on low‐quality evidence. For secondary outcomes see review text.

Authors’ conclusions

Our assessments showed beneficial effects on all primary outcomes in favour of BPD‐tailored psychotherapy compared with TAU. However, only the outcome of BPD severity reached the MIREDIF‐defined cut‐off for a clinically meaningful improvement. Subgroup analyses found no evidence of a difference in effect estimates between the different types of therapies (compared to TAU) .

The pooled analysis of psychotherapy versus waiting list or no treatment found significant improvement on BPD severity, psychosocial functioning and depression at end of treatment, but these findings were based on low‐quality evidence, and the true magnitude of these effects is uncertain. No clear evidence of difference was found for self‐harm and suicide‐related outcomes.

However, compared to TAU, we observed effects in favour of DBT for BPD severity, self‐harm and psychosocial functioning and, for MBT, on self‐harm and suicidality at end of treatment, but these were all based on low‐quality evidence. Therefore, we are unsure whether these effects would alter with the addition of more data.

Go to:

Plain language summary

Psychological therapies for people with borderline personality disorder

Background

People affected by borderline personality disorder (BPD) often have difficulties with controlling their impulses and emotions. They may have a poor self‐image, experience rapid changes in mood, harm themselves and find it hard to engage in harmonious interpersonal relationships. Different types of psychological treatments (‘talking treatments’) have been developed to help people with BPD. The effects of these treatments must be investigated to decide how well they work and if they can be harmful.

Objective

This review summarises what we currently know about the effect of psychotherapy in people with BPD.

Methods

We compared the effects of psychological treatments on people affected by BPD who did not receive treatment or who continued their usual treatment, were on a waiting list or received active treatment.

Findings

We searched for relevant research articles, and found 75 trials (4507 participants, mostly female, mean age ranging from 14.8 to 45.7 years). The trials examined a wide variety of psychological treatments (over 16 different types). They were mostly conducted in outpatient settings, and lasted between one and 36 months. Dialectical behaviour Therapy (DBT) and Mentalisation‐Based Treatment (MBT) were the therapies most studied.

Psychotherapy compared with usual treatment

Psychotherapy reduced the severity of BPD symptoms and suicidality and may reduce self‐harm and depression whilst also improving psychological functioning compared to usual treatment. DBT may be better than usual treatment at reducing BPD severity, self‐harm and improving psychosocial functioning. Similarly, MBT appears to be more effective than usual treatment at reducing self‐harm, suicidality and depression. However, these findings were all based on low‐quality evidence and therefore we are uncertain whether or not these results would change if we added more trials. Most trials did not report adverse effects, and those that did, found no obvious unwanted reactions following psychological treatment. The majority of trials (64 out of 75) were funded by grants from universities, authorities or research foundations. Four trials reported that no funding was received. For the remaining trials (7), funding was not specified.

Psychotherapy versus waiting list or no treatment

Psychotherapy was more effective than waiting list at improving BPD symptoms, psychosocial functioning, and depression, but there was no clear difference between psychotherapy, and waiting list for outcomes of self‐harm, and suicide‐related outcomes.

Conclusions

In general, psychotherapy may be more effective than usual treatment in reducing BPD symptom severity, self‐harm, suicide‐related outcomes and depression, whilst also improving psychosocial functioning. However, only the decrease in BPD symptom severity was found to be at a clinically important level. DBT appears to be better at reducing BPD severity, self‐harm, and improving psychosocial functioning compared to usual treatment and MBT appears more effective than usual treatment at reducing self‐harm and suicidality. However, we are still uncertain about these findings as the quality of the evidence is low.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199382/

 

Improve Depression by Changing the Brain with Mindfulness

psyjdc Leave a comment

Improve Depression by Changing the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based cognitive therapy is just as effective as medication in preventing depression relapse among adults with a history of recurrent depression, and in reducing depressive symptoms among those with active depression.” – Deborah Yip

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering, and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. It is unclear, however if MBCT is also effective in treating late life depression in the elderly.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy Regulates Brain Connectivity in Patients With Late-Life Depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882841/ ) Li and colleagues recruited older adults (over 60 years of age) with late life depression and randomly assigned them to receive 8 weekly sessions of Mindfulness-Based Cognitive Therapy (MBCT) with daily home practice or treatment as usual. They were measured before and after training and 3 months later for depression, anxiety, and cognitive function, they also underwent functional magnetic resonance imaging (fMRI).

 

They found that in comparison to baseline and the treatment as usual group, those that received Mindfulness-Based Cognitive Therapy (MBCT) had significantly lower depression after training and at the 3 month follow-up. In addition, the greater the amount of home meditation practice the greater the reductions in depression. They also found that after treatment there was a significant increase in functional connectivity between the amygdala and cerebral cortex. In addition, the greater the increase in functional connectivity, the greater the reductions in depression.

 

These findings suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for late life depression. But they also suggest that changes in the connectivity between brain areas may underlie the improvements in depression.

 

So, change the brain to improve late life depression with mindfulness.

 

“MBCT (combined with antidepressants or delivered alongside antidepressant tapering/discontinuation) is comparable to maintenance antidepressants alone in preventing subsequent relapse.” – Oxford Mindfulness Centre

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Li, H., Yan, W., Wang, Q., Liu, L., Lin, X., Zhu, X., Su, S., Sun, W., Sui, M., Bao, Y., Lu, L., Deng, J., & Sun, X. (2022). Mindfulness-Based Cognitive Therapy Regulates Brain Connectivity in Patients With Late-Life Depression. Frontiers in psychiatry, 13, 841461. https://doi.org/10.3389/fpsyt.2022.841461

 

Abstract

Late-life depression (LLD) is an important public health problem among the aging population. Recent studies found that mindfulness-based cognitive therapy (MBCT) can effectively alleviate depressive symptoms in major depressive disorder. The present study explored the clinical effect and potential neuroimaging mechanism of MBCT in the treatment of LLD. We enrolled 60 participants with LLD in an 8-week, randomized, controlled trial (ChiCTR1800017725). Patients were randomized to the treatment-as-usual (TAU) group or a MBCT+TAU group. The Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were used to evaluate symptoms. Magnetic resonance imaging (MRI) was used to measure changes in resting-state functional connectivity and structural connectivity. We also measured the relationship between changes in brain connectivity and improvements in clinical symptoms. HAMD total scores in the MBCT+TAU group were significantly lower than in the TAU group after 8 weeks of treatment (p < 0.001) and at the end of the 3-month follow-up (p < 0.001). The increase in functional connections between the amygdala and middle frontal gyrus (MFG) correlated with decreases in HAMA and HAMD scores in the MBCT+TAU group. Diffusion tensor imaging analyses showed that fractional anisotropy of the MFG-amygdala significantly increased in the MBCT+TAU group after 8-week treatment compared with the TAU group. Our study suggested that MBCT improves depression and anxiety symptoms that are associated with LLD. MBCT strengthened functional and structural connections between the amygdala and MFG, and this increase in communication correlated with improvements in clinical symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882841/

 

Mindfulness Training Produces no Harm

psyjdc Leave a comment

Mindfulness Training Produces no Harm

 

By John M. de Castro, Ph.D.

 

“the occurrence of AEs during or after meditation practices is not uncommon, and may occur in individuals with no previous history of mental health problems.” – M. Farias

 

People begin meditation with the misconception that meditation will help them escape from their problems. Nothing could be further from the truth. In fact, meditation does the exact opposite, forcing the meditator to confront their issues. In meditation, the practitioner tries to quiet the mind. But, in that relaxed quiet state, powerful, highly emotionally charged thoughts and memories are likely to emerge. The strength here is that meditation is a wonderful occasion to begin to deal with these issues. But often the thoughts or memories are overwhelming. At times, professional therapeutic intervention may be needed.

 

Many practitioners never experience these negative experiences or only experience very mild states. There are, however, few systematic studies of the extent of negative experiences. In general, the research has reported that unwanted (negative) experiences are quite common with meditators, but for the most part, are short-lived and mild. There is, however, a great need for more research into the nature of the experiences that occur during meditation.

 

In today’s Research News article “). Prevalence of harm in mindfulness-based stress reduction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889774/ ) Hirshberg and colleagues compared patients who had received treatment with Mindfulness-Based Stress Reduction (MBSR) program to those on a wait-list. MBSR was either delivered in community settings or was part of a formal randomized clinical trial and consisted of 8 weekly 2.5-hour sessions involving meditation, yoga, body scan, and group discussion with daily homework. They were measured before and after treatment for global psychological symptom severity and bothersome physical symptoms. They were also measured for anxiety, depression, interpersonal sensitivity, paranoid ideation, and psychoticism.

 

They found that Mindfulness-Based Stress Reduction (MBSR) significantly improved psychological and physical symptoms and only a small number of patients experienced increases in symptoms at a much lower proportion than control participants. There was not a single comparison in which MBSR led to greater harm than occurred in controls.

 

Hence, no evidence was found that mindfulness training led to harm greater than with no treatment while there was clear evidence for mindfulness training producing significantly lower levels of psychological and physical symptoms.

Mindfulness-Based Stress Reduction (MBSR) was clearly a safe and effective treatment to improve mental and physical well-being,

 

 

“Meditation isn’t magic. Like any other treatment for stress or mood disorders, it comes with side effects.” – Simon Spichak

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Hirshberg, M. J., Goldberg, S. B., Rosenkranz, M., & Davidson, R. J. (2020). Prevalence of harm in mindfulness-based stress reduction. Psychological medicine, 1–9. Advance online publication. https://doi.org/10.1017/S0033291720002834

 

Abstract

Background

Mindfulness meditation has become a common method for reducing stress, stress-related psychopathology and some physical symptoms. As mindfulness programs become ubiquitous, concerns have been raised about their unknown potential for harm. We estimate multiple indices of harm following Mindfulness-based Stress Reduction (MBSR) on two primary outcomes: global psychological and physical symptoms. In secondary analyses we estimate multiple indices of harm on anxiety and depressive symptoms, discomfort in interpersonal relations, paranoid ideation and psychoticism.

Methods

Intent-to-treat analyses with multiple imputation for missing data were used on pre- and post-test data from a large, observational dataset (n = 2155) of community health clinic MBSR classes and from MBSR (n = 156) and waitlist control (n = 118) participants from three randomized controlled trials conducted contemporaneous to community classes in the same city by the same health clinic MBSR teachers. We estimate change in symptoms, proportion of participants with increased symptoms, proportion of participants reporting greater than a 35% increase in symptoms, and for global psychological symptoms, clinically significant harm.

Results

We find no evidence that MBSR leads to higher rates of harm relative to waitlist control on any primary or secondary outcome. On many indices of harm across multiple outcomes, community MBSR was significantly preventative of harm.

Conclusions

Engagement in MBSR is not predictive of increased rates of harm relative to no treatment. Rather, MBSR may be protective against multiple indices of harm. Research characterizing the relatively small proportion of MBSR participants that experience harm remains important.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889774/

Improve the Symptoms of Type 2 Diabetes with Yoga Therapy

psyjdc Leave a comment

Iyengar Yoga Exercises For Diabetes Mellitus Type 2 - YouTube

Improve the Symptoms of Type 2 Diabetes with Yoga Therapy

By John M. de Castro, Ph.D.

 

“Yoga can do more than just relax your body in mind — especially if you’re living with diabetes. Certain poses may help lower blood pressure and blood sugar levels while also improving circulation, leading many experts to recommend yoga for diabetes management.” – Emily Cronkleton

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes, and the numbers are growing. Type-2 Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary lifestyle. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes.

 

In today’s Research News article “Impact of an Integrated Yoga Therapy Protocol on Insulin Resistance and Glycemic Control in Patients with Type 2 Diabetes Mellitus.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8798588/ ) Gowri and colleagues recruited adult patients with Type 2 diabetes and randomly assigned them to either receive twice weekly for 120 days sessions of yoga therapy or treatment as usual. Both groups received dietary advice. They were measured before treatment and 120 days later for body size and levels of insulin and lipids in the blood.

 

They found in comparison to baseline and the control group that the yoga therapy group had significantly lower body mass index (BMI), post-prandial and fasting blood glucose, HbA1c, insulin, insulin resistance, LDL cholesterol, and very-low density lipoproteins and higher levels of HDL cholesterol.

 

These are encouraging results that yoga therapy is a safe and effective treatment to improve the symptoms of type 2 diabetes. Future research should compare yoga therapy to other forms of exercise.

 

“Yoga therapy works predominantly by its ability to decrease the stress response, which in turn controls blood glucose levels. In addition, postures and other yogic techniques may benefit the function of abdominal organs like the pancreas via mechanical and energetic effects.” – Robyn Tiger

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Mangala Gowri, M., Rajendran, J., Srinivasan, A. R., Bhavanani, A. B., & Meena, R. (2022). Impact of an Integrated Yoga Therapy Protocol on Insulin Resistance and Glycemic Control in Patients with Type 2 Diabetes Mellitus. Rambam Maimonides medical journal, 13(1), e0005. https://doi.org/10.5041/RMMJ.10462

 

Abstract

Objective

Diabetes mellitus (DM), characterized by chronic hyperglycemia, is attributed to relative insulin deficiency or resistance, or both. Studies have shown that yoga can modulate parameters of insulin resistance. The present study explored the possible beneficial effects of integrated yoga therapy with reference to glycemic control and insulin resistance (IR) in individuals with diabetes maintained on standard oral medical care with yoga therapy, compared to those on standard oral medical care alone.

Methods

In this study, the subjects on yoga intervention comprised 35 type 2 diabetics, and an equal number of volunteers constituted the control group. Subjects ranged in age from 30 to 70 years, with hemoglobin A1c (HbA1c) test more than 7%, and were maintained on diabetic diet and oral hypoglycemic agents. Blood samples were drawn prior to and after 120 days of integrated yoga therapy intervention. Fasting blood glucose (FBG), post-prandial blood glucose (PPBG), HbA1c, insulin, and lipid profile were assessed in both the intervention and control groups.

Results

The intervention group revealed significant improvements in body mass index (BMI) (0.7 kg/m2 median decrease; P=0.001), FBG (20 mg/dL median decrease; P<0.001), PPBG (33 mg/dL median decrease; P<0.001), HbA1c (0.4% median decrease; P<0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (1.2 median decrease; P<0.001), cholesterol (13 mg/dL median decrease, P=0.006), triacylglycerol (22 mg/dL median decrease; P=0.027), low-density lipoprotein (6 mg/dL median decrease; P=0.004), and very-low-density lipoprotein levels (4 mg/dL median decrease; P=0.032). Increases in high-density lipoprotein after 120 days were not significant (6 mg/dL median increase; P=0.15). However, when compared to changes observed in patients in the control group, all these improvements proved to be significant.

Conclusion

Administration of integrated yoga therapy to individuals with diabetes leads to a significant improvement in glycemic control, insulin resistance, and key biochemical parameters.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8798588/

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

psyjdc Leave a comment

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“meditation involves endogenous opioid pathways, mediating its analgesic effect and growing resilient with increasing practice to external suggestion.” – Haggai Sharon

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers’ relapse and return to substance abuse.

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse, but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions and preventing relapses. Mindfulness-Oriented Recovery Enhancement (MORE) was developed to treat patients with opioid addictions. It involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886485/ ) Garland and colleagues recruited chronic pain patients being treated with opioid drugs who were misusing opioids. They were randomly assigned to receive 8 weekly 2-hour sessions of Mindfulness-Oriented Recovery Enhancement (MORE) or supportive psychotherapy. They were measured before and after treatment and 3, 6, and 9 months later for chronic pain, opioid misuse, daily opioid dose, opioid craving, anxiety, depression, perceived stress, and adverse events.

 

They found that at the 9 month follow up 45% of the Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids while only 24% of the supportive psychotherapy were no longer misusing. The MORE group also had significantly greater reductions in pain severity, opioid dosage, depression, and pain-related functional interference.

 

The finding support the ability of Mindfulness-Oriented Recovery Enhancement (MORE) to improve opioid misuse and improve the psychological well-being of chronic pain patients.

 

“That is not because pain is psychological. It’s because all pain is processed in the brain and mindfulness changes how the brain processes the signals of damage from the body,” – Eric Garland

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Garland, E. L., Hanley, A. W., Nakamura, Y., Barrett, J. W., Baker, A. K., Reese, S. E., Riquino, M. R., Froeliger, B., & Donaldson, G. W. (2022). Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial. JAMA internal medicine, 182(4), 407–417. https://doi.org/10.1001/jamainternmed.2022.0033

 

Key Points

Question

Does a mindfulness-based intervention reduce comorbid chronic pain and opioid misuse in the primary care setting more than supportive psychotherapy?

Findings

In this randomized clinical trial that included 250 adults with both chronic pain and opioid misuse, 45.0% of participants receiving Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids after 9 months of follow-up compared with 24.4% of participants receiving supportive group psychotherapy. Participants receiving MORE also reported significant improvements in chronic pain symptoms compared with those receiving supportive psychotherapy.

Meaning

In this study, MORE appeared to be an efficacious treatment for opioid misuse among adults with chronic pain.

Go to:

Abstract

Importance

Successful treatment of opioid misuse among people with chronic pain has proven elusive. Guidelines recommend nonopioid therapies, but the efficacy of mindfulness-based interventions for opioid misuse is uncertain.

Objective

To evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement (MORE) for the reduction of opioid misuse and chronic pain.

Design, Setting, and Participants

This interviewer-blinded randomized clinical trial enrolled patients from primary care clinics in Utah between January 4, 2016, and January 16, 2020. The study included 250 adults with chronic pain receiving long-term opioid therapy who were misusing opioid medications.

Interventions

Treatment with MORE (comprising training in mindfulness, reappraisal, and savoring positive experiences) or supportive group psychotherapy (control condition) across 8 weekly 2-hour group sessions.

Main Outcomes and Measures

Primary outcomes were (1) opioid misuse assessed by the Drug Misuse Index (self-report, interview, and urine screen) and (2) pain severity and pain-related functional interference, assessed by subscale scores on the Brief Pain Inventory through 9 months of follow-up. Secondary outcomes were opioid dose, emotional distress, and ecological momentary assessments of opioid craving. The minimum intervention dose was defined as 4 or more completed sessions of MORE or supportive group psychotherapy.

Results

Among 250 participants (159 women [63.6%]; mean [SD] age, 51.8 [11.9] years), 129 were randomized to the MORE group and 121 to the supportive psychotherapy group. Overall, 17 participants (6.8%) were Hispanic or Latino, 218 (87.2%) were White, and 15 (6.0%) were of other races and/or ethnicities (2 American Indian, 3 Asian, 1 Black, 2 Pacific Islander, and 7 did not specify). At baseline, the mean duration of pain was 14.7 years (range, 1-60 years), and the mean (SD) morphine-equivalent opioid dose was 101.0 (266.3) mg (IQR, 16.0-90.0 mg). A total of 203 participants (81.2%) received the minimum intervention dose (mean [SD], 5.7 [2.2] sessions); at 9 months, 92 of 250 participants (36.8%) discontinued the study. The overall odds ratio for reduction in opioid misuse through the 9-month follow-up period in the MORE group compared with the supportive psychotherapy group was 2.06 (95% CI, 1.17-3.61; P = .01). At 9 months, 36 of 80 participants (45.0%) in the MORE group were no longer misusing opioids compared with 19 of 78 participants (24.4%) in the supportive psychotherapy group. Mixed models demonstrated that MORE was superior to supportive psychotherapy through 9 months of follow-up for pain severity (between-group effect: 0.49; 95% CI, 0.17-0.81; P = .003) and pain-related functional interference (between-group effect: 1.07; 95% CI, 0.64-1.50; P < .001). Participants in the MORE group reduced their opioid dose to a greater extent than those in the supportive psychotherapy group. The MORE group also had lower emotional distress and opioid craving.

Conclusions and Relevance

In this randomized clinical trial, among adult participants in a primary care setting, the MORE intervention led to sustained improvements in opioid misuse and chronic pain symptoms and reductions in opioid dosing, emotional distress, and opioid craving compared with supportive group psychotherapy. Despite attrition caused by the COVID-19 pandemic and the vulnerability of the sample, MORE appeared to be efficacious for reducing opioid misuse among adults with chronic pain.

Improve Mental Health with Mantra-Based Meditation

psyjdc Leave a comment

Improve Mental Health with Mantra-Based Meditation

 

By John M. de Castro, Ph.D.

 

“Many people find that using a mantra can boost awareness and improve concentration. Since it helps you stay focused, it could lead to improved results from meditation.” – Timothy Legg

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. But many people have difficulty quieting the mind and maintaining concentration during meditation. Repeating a mantra during meditation has been thought to help prevent intrusive thoughts and improve concentration and focus during meditation. There have been a number of studies of the psychological benefits of mantra-based meditations. It makes sense then to summarize what has been learned.

 

In today’s Research News article “Effectiveness of Mantra-Based Meditation on Mental Health: 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/PMC8949812/ ) Álvarez-Pérez and colleagues review, summarize, and perform a meta-analysis of the effects of mantra-based meditations on mental health. They found 51 published research studies.

 

They report that the published research studies found that mantra-based meditations produced significant reduction in anxiety, depression, perceived stress, post-traumatic stress disorder (PTSD) symptoms, and psychopathology, and significant increases in health-related quality of life. All of these effects had small to moderate effect sizes.

 

So, the published research demonstrate that mantra-based meditations produce significant improvements in mental health.

 

“Mantra meditation is not magic, but the results can be magical.”— Thomas Ashley-Farrand”

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Álvarez-Pérez, Y., Rivero-Santana, A., Perestelo-Pérez, L., Duarte-Díaz, A., Ramos-García, V., Toledo-Chávarri, A., Torres-Castaño, A., León-Salas, B., Infante-Ventura, D., González-Hernández, N., Rodríguez-Rodríguez, L., & Serrano-Aguilar, P. (2022). Effectiveness of Mantra-Based Meditation on Mental Health: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 19(6), 3380. https://doi.org/10.3390/ijerph19063380

 

Abstract

Background: Meditation is defined as a form of cognitive training that aims to improve attentional and emotional self-regulation. This systematic review aims to evaluate the available scientific evidence on the effectiveness and safety of mantra-based meditation techniques (MBM), in comparison to passive or active controls, or other active treatment, for the management of mental health symptoms. Methods: MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were consulted up to April 2021. Randomised controlled trials regarding meditation techniques mainly based on the repetition of mantras, such as transcendental meditation or others, were included. Results: MBM, compared to control conditions, was found to produce significant small-to-moderate effect sizes in the reduction of anxiety (g = −0.46, IC95%: −0.60, −0.32; I2 = 33%), depression (g = −0.33, 95% CI: −0.48, −0.19; I2 = 12%), stress (g = −0.45, 95% CI: −0.65, −0.24; I2 = 46%), post-traumatic stress (g = −0.59, 95% CI: −0.79, −0.38; I2 = 0%), and mental health-related quality of life (g = 0.32, 95% CI: 0.15, 0.49; I2 = 0%). Conclusions: MBM appears to produce small-to-moderate significant reductions in mental health; however, this evidence is weakened by the risk of study bias and the paucity of studies with psychiatric samples and long-term follow-up.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949812/

Psychedelic Drug Treatments have Little or No Adverse Side Effects

psyjdc Leave a comment

Psychedelic Drug Treatments have Little or No Adverse Side Effects

 

By John M. de Castro, Ph.D.

 

“Flashbacks and psychosis can happen to anyone, but research has shown that they are more often observed in patients with a history of psychological problems.” – Buddy T

 

Psychedelic substances such as peyote, mescaline, LSD, Bufotoxin, ayahuasca and psilocybin 

have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. More recently hallucinogenic drugs such as MDMA (Ecstasy) and Ketamine have been similarly used. People find the experiences produced by these substances extremely pleasant. eye opening, and even transformative. They often report that the experiences changed them forever. Psychedelics and hallucinogens have also been found to be clinically useful as they markedly improve mood, increase energy and enthusiasm and greatly improve clinical depression.

 

Even though the effects of psychedelic substances have been experienced and reported on for centuries, only very recently have these effects come under rigorous scientific scrutiny. There are anecdotes of dangerous side effects produced by psychedelic drugs. There has been a number of research studies of adverse events associated with psychedelic drugs. It makes sense to summarize what has been learned.

 

In today’s Research News article “Adverse effects of psychedelics: From anecdotes and misinformation to systematic science.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905125/ ) Schlag and colleagues review and summarize the published research studies regarding adverse events associated with psychedelic drugs including LSD, psilocybin, mescaline, DMT, and ayahuasca.

 

They report that there are few, if any, psychological risks associated with the use of psychedelic drugs mainly emanating from the challenging nature of the experiences. There is little evidence of psychosis of persistent hallucinations. They also report that the physiological safety of psychedelic drugs is well established and in fact they have been described as ‘one of the safest known classes of CNS drugs.’

 

There has accumulated considerable evidence that carefully controlled experiences with psychedelic drugs have considerable psychological benefits and there is evidence that they are safe and effective.

 

‘One significant, but rare, consequence of chronic use of psychedelic drugs is the development of a disorder known as hallucinogen-induced persistent perception disorder. This disorder occurs when individuals who no longer use these drugs experience flashbacks weeks, months, or even years after their last use.” –  American Addiction Centers

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Schlag, A. K., Aday, J., Salam, I., Neill, J. C., & Nutt, D. J. (2022). Adverse effects of psychedelics: From anecdotes and misinformation to systematic science. Journal of psychopharmacology (Oxford, England), 36(3), 258–272. https://doi.org/10.1177/02698811211069100

 

Abstract

Background:

Despite an increasing body of research highlighting their efficacy to treat a broad range of medical conditions, psychedelic drugs remain a controversial issue among the public and politicians, tainted by previous stigmatisation and perceptions of risk and danger.

Objective:

This narrative review examines the evidence for potential harms of the classic psychedelics by separating anecdotes and misinformation from systematic research.

Methods:

Taking a high-level perspective, we address both psychological and psychiatric risks, such as abuse liability and potential for dependence, as well as medical harms, including toxicity and overdose. We explore the evidence base for these adverse effects to elucidate which of these harms are based largely on anecdotes versus those that stand up to current scientific scrutiny.

Results:

Our review shows that medical risks are often minimal, and that many – albeit not all – of the persistent negative perceptions of psychological risks are unsupported by the currently available scientific evidence, with the majority of reported adverse effects not being observed in a regulated and/or medical context.

Conclusions:

This highlights the importance for clinicians and therapists to keep to the highest safety and ethical standards. It is imperative not to be overzealous and to ensure balanced media reporting to avoid future controversies, so that much needed research can continue.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905125/

 

Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

psyjdc Leave a comment

Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

 

By John M. de Castro, Ph.D.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated. Mindfulness training including Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating OCD.  A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for obsessive-compulsive disorder (OCD),

 

In today’s Research News article “A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/ ) and colleagues recruited patients with Obsessive-Compulsive Disorder (OCD) and either treated them with drugs (SSRIs) or with Acceptance and Commitment Therapy (ACT) twice weekly for 1 hour for 4 weeks. They were measured before and after treatment and 3 months later for depression, anxiety, perceived stress, and quality of life.

 

They found that in comparison to baseline both groups had significant decreases in depression and significant increases in quality of life and these improvements were maintained the 3-month follow-up. Hence, Mindfulness training is as effective as drugs in treating Obsessive-Compulsive Disorder (OCD).

 

Since mindfulness training, unlike drugs, doesn’t have significant side effects, it would appear to be the preferred treatment for Obsessive-Compulsive Disorder (OCD),

 

“The struggle of the OCD sufferer is one in which certain internal experiences (thoughts, etc.) are viewed as unacceptable, whereas others are allowed to pass by without critique. Mindfulness suggests a different perspective on the presence of these internal experiences, that they be simply noticed, not judged or pushed away.” – Sheppard Pratt

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Ebrahimi, A., Nasre Esfahan, E., Akuchekian, S., Izadi, R., Shaneh, E., & Mahaki, B. (2022). A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 27, 9. https://doi.org/10.4103/jrms.jrms_449_21

 

Abstract

Background:

Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.

Materials and Methods:

A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other’s work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).

Results:

Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.

Conclusion:

ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/

 

Improve Sexual Function in Women with Breast Cancer with Mindfulness

psyjdc Leave a comment

Improve Sexual Function in Women with Breast Cancer with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is extraordinary; it is as if they replace you with someone else. Positive thinking increased my willingness to return to life.” – International Society for Sexual Medicine

 

Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery. Mindfulness practices have been shown to improve the residual symptoms in cancer survivors. The Mindfulness-Based Stress Reduction (MBSR) program is a mindfulness training program that includes meditation practice, body scan, yoga, and discussion along with daily home practice. MBSR has been shown to be beneficial for cancer patients in general and also specifically for the symptoms of breast cancer survivors. So, it makes sense to further explore the effectiveness of MBSR training for the treatment of sexual function in breast cancer survivors.

 

In today’s Research News article “Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799961/ ) Chang and colleagues recruited breast cancer survivors and provided them with either a 6-weeks of a Mindfulness-Based Stress Reduction (MBSR) program or treatment as usual. They were measured before and after for sexual function, anxiety, depression, perceived stress, and quality of life.

 

They found that Mindfulness-Based Stress Reduction (MBSR) produce significant increases in sexual arousal, lubrication, orgasm, and satisfaction and significant reductions in anxiety and perceived stress.

 

Because of the nature of the treatments for breast cancer, sexual confidence and performance may be challenged. It is very important to these women’s well-being that they return to normal engagement in sex. It is very encouraging that mindfulness training appears to improve sexual satisfaction in these women after treatment. This, in turn, markedly improves their mental health.

 

“Mindfulness-based stress reduction interventions are highly beneficial for reducing depression, fatigue, and stress in the short term. . . Breast cancer survivors are recommended to practice MBSR as part of their daily care routine.” – Yun-Chen Chang

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Chang, Y. C., Lin, G. M., Yeh, T. L., Chang, Y. M., Yang, C. H., Lo, C., Yeh, C. Y., & Hu, W. Y. (2022). Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 30(5), 4315–4325. https://doi.org/10.1007/s00520-021-06540-y

 

Abstract

Purpose

There have been few studies using mindfulness-based stress reduction (MBSR) to improve sexual function in Asian women with breast cancer. This study aimed to evaluate the impact of mindfulness intervention on female sexual function, mental health, and quality of life in patients with breast cancer.

Methods

Fifty-one women with breast cancer were allocated into 6-week MBSR (n=26) sessions or usual care (n=25), without differences in group characteristics. The research tools included the Female Sexual Function Index (FSFI), the Depression Anxiety Stress Scales-21 (DASS-21), and the EuroQol instrument (EQ-5D). The Greene Climacteric Scale (GCS) was used to verify the foregoing scale. The effects of MBSR were evaluated by the differences between the post- and pre-intervention scores in each scale. Statistical analyses consisted of the descriptive dataset and Mann-Whitney ranked-pairs test.

Results

Although MBSR did not significantly improve sexual desire and depression in patients with breast cancer, MBSR could improve parts of female sexual function [i.e., Δarousal: 5.73 vs. -5.96, Δlubrication: 3.35 vs. -3.48, and Δsatisfaction: 8.48 vs. 1.76; all p <.005], with a range from small to medium effect sizes. A significantly benefits were found on mental health [Δanxiety: -10.92 vs.11.36 and Δstress: -10.96 vs.11.40; both p <.001], with large effect sizes, ranging from 0.75 to 0.87.

Conclusion

Our study revealed that MBSR can improve female sexual function and mental health except for sexual desire and depression in women with breast cancer. Medical staff can incorporate MBSR into clinical health education for patients with breast cancer to promote their overall quality of life.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799961/

Improve the Psychological Well-Being of Patients with Cardiovascular Disease with Tai Chi

psyjdc Leave a comment

Improve the Psychological Well-Being of Patients with Cardiovascular Disease with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi involves a series of graceful, gentle movements that can get your heart rate up while also relaxing your mind. It’s been called meditation in motion.” – Cleveland Heart Lab

 

Cardiovascular disease is the number one killer. A myriad of treatments has been developed including a variety of surgical procedures and medications. In addition, lifestyle changes have proved to be effective including quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Unfortunately, for a variety of reasons, 60% of cardiovascular disease patients decline engaging in these lifestyle changes, making these patients at high risk for another attack.

 

Contemplative practices have been shown to be safe and effective alternative treatments for cardiovascular disease. Practices such as meditation, tai chi, and yoga, have been shown to be helpful for heart health and to reduce the physiological and psychological responses to stress. They have also been shown to be effective in maintaining cardiovascular health and the treatment of cardiovascular disease. The research has been accumulating. So, it makes sense to pause and take a look at what has been learned.

 

In today’s Research News article “Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725570/ ) Yang and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of Tai Chi practice for patients with cardiovascular disease. They identified 37 published trials.

 

They report that the published research found that Tai Chi practiced improved the psychological well-being of the patients including decreases in perceived stress, anxiety, depression, bodily pain and increases in mental health, self-efficacy, and mood.

 

Hence practicing Tai Chi improves the mental health and quality of life of patients with cardiovascular disease.

 

“practicing tai chi may help to modestly lower blood pressure. It’s also proved helpful for people with heart failure, who tend to be tired and weak as a result of the heart’s diminished pumping ability. The slow movements involve both the upper and lower body, which safely strengthens the heart and major muscle groups without undue strain.” – Harvard Health

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Yang, G., Li, W., Klupp, N., Cao, H., Liu, J., Bensoussan, A., Kiat, H., Karamacoska, D., & Chang, D. (2022). Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review. BMC complementary medicine and therapies, 22(1), 3. https://doi.org/10.1186/s12906-021-03482-0

 

Abstract

Background

Psychological risk factors have been recognised as potential, modifiable risk factors in the development and progression of cardiovascular disease (CVD). Tai Chi, a mind-body exercise, has the potential to improve psychological well-being and quality of life. We aim to assess the effects and safety of Tai Chi on psychological well-being and quality of life in people with CVD and/or cardiovascular risk factors.

Methods

We searched for randomised controlled trials evaluating Tai Chi for psychological well-being and quality of life in people with CVD and cardiovascular risk factors, from major English and Chinese databases until 30 July 2021. Two authors independently conducted study selection and data extraction. Methodological quality was evaluated using the Cochrane Risk of Bias tool. Review Manager software was used for meta-analysis.

Results

We included 37 studies (38 reports) involving 3525 participants in this review. The methodological quality of the included studies was generally poor. Positive effects of Tai Chi on stress, self-efficacy, and mood were found in several individual studies. Meta-analyses demonstrated favourable effects of Tai Chi plus usual care in reducing anxiety (SMD − 2.13, 95% confidence interval (CI): − 2.55, − 1.70, 3 studies, I2 = 60%) and depression (SMD -0.86, 95% CI: − 1.35, − 0.37, 6 studies, I2 = 88%), and improving mental health (MD 7.86, 95% CI: 5.20, 10.52, 11 studies, I2 = 71%) and bodily pain (MD 6.76, 95% CI: 4.13, 9.39, 11 studies, I2 = 75%) domains of the 36-Item Short Form Survey (scale from 0 to 100), compared with usual care alone. Tai Chi did not increase adverse events (RR 0.50, 95% CI: 0.21, 1.20, 5 RCTs, I2 = 0%), compared with control group. However, less than 30% of included studies reported safety information.

Conclusions

Tai Chi seems to be beneficial in the management of anxiety, depression, and quality of life, and safe to practice in people with CVD and/or cardiovascular risk factors. Monitoring and reporting of safety information are highly recommended for future research. More well-designed studies are warranted to determine the effects and safety of Tai Chi on psychological well-being and quality of life in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725570/