contemplative practice

Improve Mental and Physical Health in Anxious, Depressed Patients with Mindfulness and Qigong

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Improve Mental and Physical Health in Anxious, Depressed Patients with Mindfulness and Qigong

 

By John M. de Castro, Ph.D.

 

“You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

 

Anxiety disorders are the most common mental illness, affecting 40 million adults in the U.S., 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. Depression often co-occurs with anxiety disorders. Anxiety and depression are generally treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety and depression. 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. Mindfulness has also been shown to be effective for depression. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been shown to be very effective. In addition, mind-body practices such as qigong have also been shown to be effective for anxiety and depression. Recently, qigong practice has been combined with Cognitive Behavioral Therapy (CBT) to treat anxiety and depression. The relative efficacy of MBCT and qigong-Based Cognitive Therapy has not been tested.

 

In today’s Research News article “A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734764/ ) Chan and colleagues recruited adults who had been diagnosed with either an anxiety disorder or depression and randomly assigned them to either a no-treatment control condition or to receive 8 weekly 2 hour sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or Qigong-Based Cognitive Therapy (a combination of Qigong practice along with Cognitive Behavioral Therapy). They were measured before and after training and 8 weeks later for physical and mental health, anxiety, depression, perceived stress, sleep quality, and self-efficacy.

 

They found that in comparison to baseline and the no-treatment control, the participants who received either Mindfulness-Based Cognitive Therapy (MBCT) or Qigong-Based Cognitive Therapy had significantly reduced anxiety, depression, and perceived stress, and significantly increased sleep quality and self-efficacy. These improvements were either sustained or even greater still at the 8-week follow-up. The decreases in anxiety and depression were significantly greater in the Qigong group than in the MBCT group. But the MBCT group had significantly greater improvements in overall mental health than the Qigong group while the Qigong group had significantly greater improvements in physical health than the MBCT group.

 

These are interesting results and to my knowledge the first direct comparison of the effects of Mindfulness-Based Cognitive Therapy (MBCT) and Qigong-Based Cognitive Therapy on patients with anxiety and depression. MBCT has been previously established to significantly improve anxiety, depression, perceived stress, sleep, and self-efficacy and Qigong has similarly been established to significantly improve anxiety, depression, perceived stress, sleep, and self-efficacy. So, the improvements observed in the current study relative to the no-treatment group are expected. What is new is the findings that MBCT is superior for the improvement of mental health while Qigong is superior for the improvement of physical health in patients with diagnosed anxiety and depression.

 

So, improve mental and physical health in anxious, depressed patients with mindfulness and qigong.

 

“depression and anxiety scores were significantly decreased after participation in an 8-week mindfulness group therapy for depressive and anxious people.” – Tora Takahashi

 

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

 

Chan, S., Chan, W., Chao, J., & Chan, P. (2020). A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders. BMC psychiatry, 20(1), 590. https://doi.org/10.1186/s12888-020-02994-2

 

Abstract

Background

The goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy versus health qigong-based cognitive therapy versus waitlist control among individuals with mood disorders.

Methods

A total of 187 individuals with mood disorders were randomized and allocated into mindfulness-based cognitive therapy, health qigong-based cognitive therapy, or waitlist control groups. All participants were assessed at three time points with regard to depressive and anxiety symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data.

Results

Mindfulness-based cognitive therapy and health qigong-based cognitive therapy both produced greater improvements on all outcome measures as compared with waitlist control. Relatively, more reductions of mood symptoms were observed in the health qigong-based cognitive therapy group as compared with the mindfulness-based cognitive therapy group. Health qigong-based cognitive therapy is more conducive to physical health status whereas mindfulness-based cognitive therapy has more favorable mental health outcomes. Individual growth curve models indicated that alterations in perceived stress was the common predictor of mood changes in both intervention groups.

Conclusions

The predominant emphasis on physical health in health qigong-based cognitive therapy makes it more acceptable and effective than mindfulness-based cognitive therapy as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734764/

 

Improve Chronic Low Back Pain with Mindfulness

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Improve Chronic Low Back Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“meditation and cognitive behavioral therapy often work better than pain meds and other medical treatments for chronic back pain.” – Nancy Shute

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses.

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. The research has been accumulating and it is useful to summarize what has been learned.

 

In today’s Research News article “A Systematic Review of Mindfulness Practices for Improving Outcomes in Chronic Low Back Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735497/ ) Smith and Langen review, and summarize the effectiveness of Mindfulness-Based Stress Reduction (MBSR) for the relief of chronic low back pain. MBSR is generally delivered as an 8-week program including training in meditation, body scan, and yoga along with group discussion and daily home practice.

 

They identified 12 published research studies. They report that the published studies found that Mindfulness-Based Stress Reduction (MBSR) significantly reduced pain severity and improved the quality of life of patients with chronic low back pain. These improvements were still present at long-term follow-up. Hence, mindfulness training appears to a safe and effective treatment for the symptoms of chronic low back pain.

 

Mindfulness-Based Stress Reduction (MBSR) is a complex of different practices. It is not known which of the components or which combination of components is necessary and sufficient to produce the pain reductions and quality of life improvement. But meditation practice by itself has been shown to reduce perceived pain and quality of life and yoga practice alone has also been shown to reduce perceived pain and quality of life. So, all of the components may be effective. It is not known, however, if their effects are additive so that the combination of practices produces greater benefits than the individual practices alone. This remains for future research to investigate.

 

So, improve chronic low back pain with mindfulness.

 

“meditation may help change the individual’s relationship to pain and other experiences, rather than focusing on changing the content of the experience itself (which, of note, may not be possible), and has the potential to uncouple the physical experience of pain from pain-related suffering.” –  Aleksandra Zgierska

 

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

 

Smith, S. L., & Langen, W. H. (2020). A Systematic Review of Mindfulness Practices for Improving Outcomes in Chronic Low Back Pain. International journal of yoga, 13(3), 177–182. https://doi.org/10.4103/ijoy.IJOY_4_20

 

Abstract

Background:

Chronic pain is a serious public health problem that affects people of all ages and backgrounds. Mindfulness-based stress reduction (MBSR) techniques offer an accessible treatment modality for chronic pain patients that may complement or replace pharmacological treatment. This article reviews the literature on the efficacy of MBSR training in patients with back chronic pain syndromes for the outcomes of pain measures, quality of life (QOL), mental health, and mindfulness.

Methods:

A systemized search was conducted in September of 2018 for studies published between 2008 and 2018 on mindfulness and chronic low back pain. Out of 50 articles on mindfulness and chronic pain, 12 empirical studies were selected for the inclusion in this review.

Results:

Subjective pain scores and QOL improved for chronic pain patients after mindfulness interventions, compared to control groups, in most of the studies reviewed. Limitations of the studies reviewed included the varied pain measurement instruments, the small sample sizes, and the inability to blind participants to MBSR intervention.

Conclusions:

MBSR interventions show significant improvements in chronic pain patients for pain measures, QOL, and mental health.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735497/

 

Improve the Brain for Better Emotions with Mindfulness

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Improve the Brain for Better Emotions with Mindfulness

 

By John M. de Castro, Ph.D.

 

“meditation affects the brain. . .  four regions of meditators’ brains associated with healthy brain function become more substantial, while one of the areas associated with undesirable behavior actually shrinks.” – Mindworks

 

Mindfulness 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. There are a number of ways that mindfulness practices produce these benefits, including changes to the brain and physiology.

 

The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. It is not clear, however, what effects brief mindfulness training might have on temperament and the brain.

 

In today’s Research News article “Brief Mindfulness Meditation Induces Gray Matter Changes in a Brain Hub.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704181/ ) Tang and colleagues recruited healthy meditation-naïve college students and randomly assigned them to receive 30 minutes for 20 consecutive days of either Integrative Body-Mind Training or relaxation training. Before and after training they were measured for temperament, including effortful control, negative affect, extraversion/surgency, and orienting sensitivity, and underwent brain scanning with Magnetic Resonance Imaging (MRI).

 

They found that in comparison to the relaxation group and the baseline after training the mindfulness group had a significant increase in the volume of the ventral posterior cingulate cortex in the brain. They also found that the greater the increase in the volume of the ventral posterior cingulate cortex the greater the decrease in negative emotions in the participant. So, 20 days of mindfulness training increased ventral posterior cingulate cortex volume which was, in turn, associated with lower levels of negative emotions.

 

The ventral posterior cingulate cortex is a component of the default mode network in the brain that is associated with emotion processing, self-referential thinking, and mind wandering. Mindfulness training has been shown previously to produce improvements in emotions including more positive and less negative emotions. This suggests that 20 days of mindfulness training reduces negative emotions by producing neuroplastic changes in the default mode network of the brain.

 

So, change the brain for better emotions with mindfulness.

 

“the brains of subjects thickened after an eight-week meditation course.” – Harvard Gazette

 

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

 

Tang, R., Friston, K. J., & Tang, Y. Y. (2020). Brief Mindfulness Meditation Induces Gray Matter Changes in a Brain Hub. Neural plasticity, 2020, 8830005. https://doi.org/10.1155/2020/8830005

 

Abstract

Previous studies suggest that the practice of long-term (months to years) mindfulness meditation induces structural plasticity in gray matter. However, it remains unknown whether short-term (<30 days) mindfulness meditation in novices could induce similar structural changes. Our previous randomized controlled trials (RCTs) identified white matter changes surrounding the anterior cingulate cortex (ACC) and the posterior cingulate cortex (PCC) within 2 to 4 weeks, following 5-10 h of mindfulness training. Furthermore, these changes were correlated with emotional states in healthy adults. The PCC is a key hub in the functional anatomy implicated in meditation and other perspectival processes. In this longitudinal study using a randomized design, we therefore examined the effect of a 10 h of mindfulness training, the Integrative Body-Mind Training (IBMT) on gray matter volume of the PCC compared to an active control—relaxation training (RT). We found that brief IBMT increased ventral PCC volume and that baseline temperamental trait—an index of individual differences was associated with a reduction in training-induced gray matter increases. Our findings indicate that brief mindfulness meditation induces gray matter plasticity, suggesting that structural changes in ventral PCC—a key hub associated with self-awareness, emotion, cognition, and aging—may have important implications for protecting against mood-related disorders and aging-related cognitive declines.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704181/

 

Improve Functional Fitness in Adults with Intellectual and Developmental Disabilities with Yoga

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Improve Functional Fitness in Adults with Intellectual and Developmental Disabilities with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga intervention may have the potential to enhance functional fitness in people with Intellectual and developmental disabilities.” – Kaitlin Mueller

 

Intellectual and developmental disabilities involve below average intelligence and relatively slow learning. They are quite common, affecting an estimated 10% of individuals worldwide. These disabilities present problems for the individual in learning mathematics, reading and writing. These difficulties, in turn, affect performance in other academic disciplines. The presence of intellectual disabilities can have serious consequences for the psychological well-being of the individual, including their self-esteem and social skills. In addition, anxiety, depression, and conduct disorders often accompany learning disabilities.

 

Adults with intellectual and developmental disabilities often show “physical decline in sensorimotor skills, coordination, muscular strength, flexibility, and balance in part due to physical inactivity.” So, it is important to increase physical activity in these adults. Yoga is a mindfulness practice and exercise that has been shown to be a safe and effective practice. So, yoga practice may be helpful for reducing the physical decline in adults with intellectual and developmental disabilities.

 

In today’s Research News article “Yoga for Functional Fitness in Adults with Intellectual and Developmental Disabilities.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336942/ ) Reina and colleagues recruited adults diagnosed with intellectual and developmental disabilities. They were provided a 7 week, twice a week for 1 hour, group yoga practice. They were measured before and after the program for functional fitness.

 

They found that after the program the participants had significant improvements in both lower and upper body strength, agility and balance. Non-significant improvements were also detected in lower-body flexibility, upper-body flexibility, and endurance. It should be kept in mind that this was a pilot study that did not include a control condition. So, there are a number of potential alternative explanations for the results. But previous controlled studies have demonstrated that yoga practice improves physical performance. So, it is likely that the present improvements were due to the yoga practice.

 

Hence, yoga practice appears to improve the functional fitness of adults with intellectual and developmental disabilities. This suggests that yoga is safe and effective practice for reducing the decline in physical ability that is common in adults with intellectual and developmental disabilities. It remains for future research to determine if these improvements spill over to improvements in other functional realms.

 

So, improve functional fitness in adults with intellectual and developmental disabilities with yoga.

 

“Yoga is an effective intervention to improve functional fitness in adults with and without disabilities,” – Clair Allison

 

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

 

Reina, A. M., Adams, E. V., Allison, C. K., Mueller, K. E., Crowe, B. M., van Puymbroeck, M., & Schmid, A. A. (2020). Yoga for Functional Fitness in Adults with Intellectual and Developmental Disabilities. International journal of yoga, 13(2), 156–159. https://doi.org/10.4103/ijoy.IJOY_57_19

 

Abstract

Background:

Yoga is an effective intervention to improve functional fitness in adults with and without disabilities, but little research exists regarding yoga’s impact on functional fitness for individuals with intellectual and developmental disabilities (IDDs).

Aims:

The purpose of this study was to examine the benefits of a group yoga intervention on the functional fitness of adults with IDDs.

Methods and Materials:

This yoga intervention included 12 sessions of yoga over 7 weeks (60-min sessions twice a week) at a special population recreation and leisure program. The functional fitness test was used to examine physical functioning before and after the yoga intervention.

Results and Conclusions:

Eight adults completed the baseline and posttest measures (age mean = 31; standard deviation = 6.55; 50% male). There were significant improvements in lower-body strength (9.00 ± 4.63 vs. 11.50 ± 3.16, P = 0.04, 28% improvement), upper-body strength (11.25 ± 3.54 vs. 14.25 ± 3.37, P = 0.018, 27% improvement), and agility and balance (9.29 ± 4.1 vs. 6.60 ± 1.54, P = 0.036, 29% improvement). Functional fitness often declines for people with IDD at a faster rate than the general population; thus, these significant changes indicate that a yoga intervention may enhance functional fitness for people with IDD. Clinicians or other healthcare providers might consider yoga as a means to improve functional fitness in adults with IDDs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336942/

Improve Rheumatoid Arthritis Symptoms with Yoga

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Improve Rheumatoid Arthritis Symptoms with Yoga

 

By John M. de Castro, Ph.D.

 

“Many people turn to yoga as a way to exercise gently, as well as to reduce tension and improve joint flexibility. Yoga also can help a person with arthritis build muscle strength and improve balance. In addition, yoga offers people with arthritis a form of exercise that is enjoyable enough to do regularly.” – Susan Bernstein

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis, symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. Due to complications associated with rheumatoid arthritis (RA), the lifespan for people with RA may be shortened by 10 years. This is due to a higher incidence of cardiovascular disease in rheumatoid arthritis (RA) patients, with the risk more than double that of non-RA individuals.

 

Obviously, there is a need to explore alternative treatments for rheumatoid arthritis. One possibility is contemplative practice. A variety of which including yoga practice have been shown to have major mental and physical benefits including a reduction in the inflammatory response and have been shown to improve arthritis. It is reasonable to take time to summarize what has been learned regarding the effectiveness of yoga practice for the treatment of rheumatoid arthritis.

 

In today’s Research News article “Yoga for Treating Rheumatoid Arthritis: 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/PMC7732597/ ) Ye and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of yoga practice for the treatment of rheumatoid arthritis. They identified 10 published trials that included a total of 840 participants.

 

They report that the published studies found that yoga in comparison to controls produced a significant reduction in pain that was equivalent to the effects of drugs. Yoga with additional medication was found to improve physical function and reduce disease activity (swollen joints) to a greater extent than medication alone. Finally, yoga in comparison to controls produced a significant increase in grip strength.

 

The findings of the published research suggest that yoga practice is beneficial for patients with rheumatoid arthritis. It appears to reduce pain and joint swelling and improve physical function and grip strength. No adverse events were reported. Hence, yoga is recommended to patients with rheumatoid arthritis.

 

So, improve rheumatoid arthritis symptoms with yoga.

 

“yoga classes will provide the opportunity to strengthen muscles, improve flexibility, increase your awareness of body posture, relax using breathing exercises. These benefits can lead to less arthritis pain, increased joint range-of-motion, and better joint function.” – Ron Miller

 

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

 

Ye, X., Chen, Z., Shen, Z., Chen, G., & Xu, X. (2020). Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Frontiers in medicine, 7, 586665. https://doi.org/10.3389/fmed.2020.586665

 

Abstract

Purpose: Rheumatoid arthritis (RA) is a pervasive inflammatory autoimmune disease that seriously impairs human health and requires more effective non-pharmacologic treatment approaches. This study aims to systematically review and evaluate the efficacy of yoga for patients with RA.

Methods: Medline (through PubMed), Cochrane Library, EMBASE (through SCOPUS), and Web of Science database were screened through for articles published until 20 July 2020. Randomized controlled trials (RCTs) of yoga in patients with RA were included. Outcomes measures were pain, physical function, disease activity, inflammatory cytokines, and grip strength. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.

Result: Ten trials including 840 patients with RA aged 30–70 years were identified, with 86% female participants. Meta-analysis revealed a statistically significant overall effect in favor of yoga for physical function (HAQ-DI) (5 RCTs; SMD = −0.32, 95% CI −0.58 to −0.05, I2 = 15%, P = 0.02), disease activity (DAS-28) (4 RCTs; SMD = −0.38, 95% CI −0.71 to −0.06, I2 = 41%, P = 0.02) and grip strength (2 RCTs; SMD = 1.30, 95% CI 0.47–2.13, I2 = 63%, P = 0.002). No effects were found for pain, tender joints, swollen joints count or inflammatory cytokines (i.e., CRP, ESR, IL-6, and TNF-α).

Summary: The findings of this meta-analysis indicate that yoga may be beneficial for improving physical function, disease activity, and grip strength in patients with RA. However, the balance of evidence showed that yoga had no significant effect in improving pain, tender joints, swollen joints count, and inflammatory cytokines in patients suffering from RA. Considering methodological limitations, small sample size, and low-quality, we draw a very cautious conclusion in the results of the estimate of the effect. High-quality and large-scale RCTs are urgently needed in the future, and the real result may be substantially different.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732597/

 

Reduce Menopausal Symptoms with Meditation

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Reduce Menopausal Symptoms with Meditation

 

By John M. de Castro, Ph.D.

 

‘midlife women with higher mindfulness scores experienced fewer menopausal symptoms,” – Dr. Richa Sood

 

Menopause occurs in the 40s and 50s in most women, on average at 51 years of age. It is a natural physical process that marks the end of the menstrual cycle. The symptoms that occur over the years preceding menopause include irregular periods, vaginal dryness, hot flashes, chills

night sweats, sleep problems, mood changes, weight gain and slowed metabolism, thinning hair and dry skin, and loss of breast fullness. This is a natural process that is healthy and needs to occur. So, treatments are designed for symptomatic relief and include drugs and hormone treatments. Mindfulness training including meditation is a more natural treatment that has been shown to improve the symptoms of menopause.

 

In today’s Research News article “A potential association of meditation with menopausal symptoms and blood chemistry in healthy women: A pilot cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478772/ ) Sung and colleagues recruited healthy adult women, 25-60 years of age, who were either long-term meditators or non-meditators. The particular meditation practice was a combination of focused meditation and mindful movement practice. The groups were divided into premenopausal and postmenopausal women. They were measured for menopausal symptoms, including psychological, somatic, and urogenital domains, and blood was drawn and assayed for HDL, glucose, triglyceride, total protein, creatinine, blood urea nitrogen, lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase;

 

They found overall that the meditation group was lower than the non-meditators in menopausal symptoms especially depression and irritability. In the premenopausal women there was significantly higher HDL levels in the meditation group while in the postmenopausal group there were significantly higher HDL and glucose levels in the non-meditators.

 

This is a cross-sectional pilot study and causation cannot be definitively assigned. But these results replicates previous findings from controlled studies that mindfulness practices produce reduced menopausal symptoms, depression, and irritability. So, it is likely that the present findings are due to a causal connection between meditation practice and reduced menopausal symptoms.

 

So, reduce menopausal symptoms with meditation.

 

“Among the different natural remedies available for managing middle age, meditation for menopause has some unique benefits. It is a totally natural, completely free way to approach navigating the hormonal rollercoaster of midlife.” – Karen Shopoff Rooff

 

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

 

Sung, M. K., Lee, U. S., Ha, N. H., Koh, E., & Yang, H. J. (2020). A potential association of meditation with menopausal symptoms and blood chemistry in healthy women: A pilot cross-sectional study. Medicine, 99(36), e22048. https://doi.org/10.1097/MD.0000000000022048

 

Abstract

Owing to hormonal changes, women experience various psychophysiological alterations over a wide age range, which may result in decreased quality of life as well as in increased risks of diseases, such as cardiovascular diseases. Although studies have been performed to research complementary methods, such as meditation, the research field still requires an adequate amount of studies for public health guidelines. This pilot cross-sectional study aims to investigate a potential association of meditation with menopausal symptoms and blood chemistry for healthy women. In this study, data of 65 healthy women (age range 25–67) including 33 meditation practitioners and 32 meditation-naïve controls were analyzed to compare the Menopausal Rating Scale scores and blood chemistry with 7 more dropouts in the blood chemistry. For blood chemistry, nine components including glucose (GLU) and high-density lipoprotein cholesterol (HDL) were measured. Two-way analysis of variance was performed by dividing the total participants into 2 groups: premenopausal and postmenopausal participants. Compared to the control group, the meditation group showed a trend of reductions in the Menopausal Rating Scale total score (P = .054) and its 2 subcomponents: depressive mood (P = .064) and irritability (P = .061). In HDL level, there was a significant interaction between group and menopausal state (P = .039) with following post hoc results: among the premenopausal participants, a significant increase in the meditation group compared to the control group (P = .005); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .030). In GLU level, there was a mild interaction between group and menopausal state (P = .070) with following post hoc results: among the postmenopausal participants, a trend of increase in the control group compared to the meditation group (P = .081); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .040). Our research suggests a potential association of practicing meditation with alleviations in menopausal symptoms and changes in blood chemistry, warranting further studies with a longitudinal study design and larger populations to understand the underlying causal relationships.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478772/

 

Improve Cardiac Health in Heart Failure Patients with Meditation

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Improve Cardiac Health in Heart Failure Patients with Meditation

 

By John M. de Castro, Ph.D.

 

“Not only can meditation improve how your heart functions, but a regular practice can enhance your outlook on life and motivate you to maintain many heart-healthy behaviors, like following a proper diet, getting adequate sleep, and keeping up regular exercise,” – John Denninger

 

Cardiovascular disease is the number one killer. A myriad of treatments have been developed for heart disease 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 to alter these lifestyle factors, making these patients at high risk for another attack.

 

Congestive heart failure (CHF) is a major type of cardiovascular disease. “CHF is a chronic progressive condition that affects the pumping power of your heart muscles. While often referred to simply as “heart failure,” CHF specifically refers to the stage in which fluid builds up around the heart and causes it to pump inefficiently” (Healthline). Heart failure is a very serious life-threatening condition. About 5.7 million adults in the United States have congestive heart failure. One in 9 deaths include heart failure as a contributing cause. The seriousness of heart failure is underscored by the fact that about half of people who develop heart failure die within 5 years of diagnosis. Hence, effective treatment is very important.

 

Mindfulness trainings such as meditation practice are known to help with a wide range of physical and psychological problems, including heart failure. So, it would make sense to further investigate the ability of meditation practice to the improve the health and longevity of patients with heart failure.

 

In today’s Research News article “Meditation for Improved Clinical Outcomes in Patients with Implantable Defibrillators for Heart Failure- Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533122/ ) Aditee and colleagues recruited adult patients with heart failure and an implantable cardioverter defibrillator. They were randomly assigned to receive either 6 months of focused meditation or treatment as usual. Breath following meditation was trained in 3 session during the first week and then once every 2 weeks for 6 months. They were encouraged to meditate at home daily. They were measured before and after training and then yearly for 7 years for a 6-minute walk, brain natriuretic peptide (BNP) levels, atrial fibrillation, mortality, heart failure hospitalization and ventricular arrhythmias.

 

They found that in comparison to baseline and the treatment as usual group, the meditation group had significantly fewer atrial fibrillations and ventricular tachycardias which remained true 7 years later. Although at the 7-year follow-up 67% in treatment as usual group vs 87.5% in meditation group were still alive, this difference was not statistically significant. Hence, meditation practice appears to improve cardiac function in heart failure patients.

 

This was a pilot study that was not sufficiently powered to detect small differences. So, the fact that cardiac function was significantly improved by meditation was particularly significant. Had a greater number of participants been included, the reduced mortality may have also been significant. Future studies should include an active control condition and a greater number of participants. Regardless, it is clear that meditation is good for heart failure patients. Since stress aggravates the condition, perhaps the improved cardiac function in the meditators was due to the known ability of meditation to improve the physiological and psychological responses to stress.

 

So, improve cardiac health in heart failure patients with meditation.

 

“Given the low costs and low risks of this intervention, meditation may be considered as an adjunct to guideline‐directed cardiovascular risk reduction.” – Glenn Levine

 

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

 

Aditee, D., Pankaj, M., Neil, B., Nayereh, P., Dali, F., & N Srivatsa, U. (2020). Meditation for Improved Clinical Outcomes in Patients with Implantable Defibrillators for Heart Failure- Pilot Study. Journal of atrial fibrillation, 12(6), 2314. https://doi.org/10.4022/jafib.2314

 

Abstract

Background

Sympathetic activation is associated with congestive heart failure (CHF) and leads to adverse clinical events. We hypothesized that meditation by reducing emotional reactivity would have beneficial effect in reducing arrhythmias compared to control patients.

Methods

Patients known to have CHF and implantable cardioverter defibrillators (ICD) were randomized to Vipassana meditation or usual care control group. Meditation group underwent meditation classes three times during the first week, thereafter every once two weeks. They were encouraged to practice meditation at least once everyday. The ICD was followed by clinic/ remote visits. Atrial (AA) and ventricular arrhythmias (VA) as well cardiac events were assessed in follow up. Chi square test was used to compare nominal variables and t test for continuous variables.

Results

Patients (n=25, 65% male, mean LVEF 25%, HTN 38%, Diabetes 12%, coronary artery disease 38%, NYHA class 2.2) were followed for 79 + 36 months. Comparing meditation vs control, survival was higher (88%vs 67%); there was less cumulative sustained AF episodes (mean 0.9, IQR 0-1 vs 2.5, IQR 2-4, p=0.045), sustained VT occurred (25% vs 55%, amiodarone use (none vs 44%), and VT ablation in 6.6% vs 33% in the meditation group.

Conclusions

In this first pilot study of meditation in CHF patients with ICD, during long term follow up, there is a trend for improved survival and reduced arrhythmias in patients randomized to meditation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533122/

 

Neurofeedback in Novice Meditators Can Alter Brain Activity like that Observed in Expert Meditators

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Neurofeedback in Novice Meditators Can Alter Brain Activity like that Observed in Expert Meditators

 

By John M. de Castro, Ph.D.

 

“Modern researchers and practitioners are finding a possible new solution to these challenges by using EEG biofeedback to increase awareness of subtle states of consciousness and speed the learning process.” – Jeff Tarrant

 

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. As a result, meditation training has been called the third wave of therapies. But meditation can be challenging to learn and many people become discouraged and drop the practice. But modern neuroscience has developed a tool called neurofeedback that can assist the meditator in improving the meditative experience.

 

In today’s Research News article “Closed-Loop Frontal Midlineθ Neurofeedback: A Novel Approach for Training Focused-Attention Meditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344173/ ) Brandmeyer and Delorme recruited healthy meditation-naïve adults and assigned them to either a neurofeedback group or to an age and gender matched active sham control group. Training occurred over 2 weeks in 8 sessions. All participants had their electroencephalogram (EEG) recorded while performing breath focused meditation while receiving feedback as to the level of theta activity (4-6 hz.) from the frontal midline. They were instructed to try to increase the level of frontal midline theta. The neurofeedback group received feedback based upon their own brain activity while the sham group received the feedback, not from their own brain activity but from the activity of their paired experimental participant. At the beginning and end of the 8 training sessions the participants were measured for executive functioning including memory, sustained attention, and focused attention.

 

They found that the neurofeedback produced a significant progressive increase in frontal midline theta power over the 8 sessions while the sham control had none. The neurofeedback group also had a significant improvement in short-term memory while the sham group had a significant deterioration in short-term memory. While the neurofeedback group was performing the short-term memory task, they had a significant increase in gamma activity in the EEG which was absent in the sham group.

 

A strength of the present study is that the control condition was active and the participants went through the same protocol as the neurofeedback participants with the sole difference being that the neurofeedback participants received feedback on their own brain activity while the sham group did not. This is an excellent control condition that accounts for many potential sources of confounding. So, the results can be interpreted as due to the neurofeedback and not some other spurious cause.

 

High levels of midline frontal theta power in the EEG is characteristic of experienced meditators. It can be speculated that the neurofeedback procedure by increasing midline frontal theta power produce brain activity in novices similar to that produced by years of meditation training. The improved short-term memory is also observed in expert meditators. This suggests that neurofeedback may be used to rapidly improve meditation. It remains for future studies to examine whether the increased midline frontal theta power is associated with increased depth of meditation. If so, this may be a method to rapidly improve meditation in novices.

 

So, neurofeedback in novice meditators can alter brain activity like that observed in expert meditators.

 

“Effective meditation practice is associated with several specific patterns of brain waves. This is one reason why neurofeedback is so effective, you can literally teach your brain to take on the right brain wave pattern for the style of meditation you are trying to practice.” – James V. Hardt

 

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

 

Brandmeyer, T., & Delorme, A. (2020). Closed-Loop Frontal Midlineθ Neurofeedback: A Novel Approach for Training Focused-Attention Meditation. Frontiers in human neuroscience, 14, 246. https://doi.org/10.3389/fnhum.2020.00246

 

Abstract

Cortical oscillations serve as an index of both sensory and cognitive processes and represent one of the most promising candidates for training and targeting the top-down mechanisms underlying executive functions. Research findings suggest that theta (θ) oscillations (3–7 Hz) recorded over frontal-midline electrodes are broadly associated with a number of higher-order cognitive processes and may serve as the mechanistic backbone for cognitive control. Frontal-midline theta (FMθ) oscillations have also been shown to inversely correlate with activity in the default mode network (DMN), a network in the brain linked to spontaneous thought processes such as mind-wandering and rumination. In line with these findings, we previously observed increased FMθ oscillations in expert meditation practitioners during reported periods of focused-attention meditation practice when compared to periods of mind-wandering. In an effort to narrow the explanatory gap by directly connecting observed neurophysiological activity in the brain to the phenomenological nature of reported experience, we designed a methodologically novel and adaptive neurofeedback protocol with the aim of modulating FMθ while having meditation novice participants implement breath-focus strategies derived from focused-attention mediation practices. Participants who received eight sessions of the adaptive FMθ-meditation neurofeedback protocol were able to significantly modulate FMθ over frontal electrodes using focused-attention meditation strategies relative to their baseline by the end of the training and demonstrated significantly faster reaction times on correct trials during the n-back working memory task assessed before and after the FMθ-meditation neurofeedback protocol. No significant differences in frontal theta activity or behavior were observed in the active control participants who received age and gender matched sham neurofeedback. These findings help lay the groundwork for the development of brain training protocols and neurofeedback applications that aim to train features of the mental states and traits associated with focused-attention meditation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344173/

 

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

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Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – 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. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients 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 their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients.

 

In today’s Research News article “Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/ ) Matis and colleagues review, summarize, and perform a meta-analysis on the published research studies on the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients. They identified 24 published research studies including at least 4 weeks of mindfulness training delivered over the internet.

 

They report that the published research studies found that mindfulness training delivered over the internet to cancer patients produced significant decreases in stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. In the few studies where long-term follow-up measures were obtained the effects were maintained.

 

These are very promising results that suggest that mindfulness training over the internet is a safe and effective treatment for the psychological issues common in cancer survivors. Mindfulness training, in general, has been shown in a large number of previous studies o be effective in reducing stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. So, the present study simply extends these findings to patients with cancer who receive mindfulness training over the internet.

 

These results are important as good mental health, particularly the ability to cope with stress, are predictors of good health outcomes. In addition, the fact that the interventions were provided over the internet allows for cost-effective and convenient delivery to patients. This makes participation and compliance more likely and effective. Hence, internet-based mindfulness training may help relieve the psychological suffering of patients diagnosed with cancer and should be included in their treatment plan.

 

So, improve the psychological health of cancer patients with mindfulness taught over the internet.

 

“Both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Matthew Stenger

 

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

 

Matis, J., Svetlak, M., Slezackova, A., Svoboda, M., & Šumec, R. (2020). Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. Journal of medical Internet research, 22(11), e20709. https://doi.org/10.2196/20709

 

Abstract

Background

eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.

Objective

This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.

Methods

In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.

Results

A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.

Conclusions

Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/

 

Improve Refractory Depression with Mindfulness

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Improve Refractory Depression with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness and other meditations, particularly combined with cognitive therapy, work just as well for anxiety or depression as the medications do, but they don’t have those side effects,” – Daniel Goleman

 

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 do not respond to treatment. This is called refractory depression.

 

Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Dialectical Behavior Therapy (DBT)  is a mindfulness-based therapeutic technique that produces behavior change by 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. DBT has been shown to be effective in treating depression. So, it makes sense, then, to study the effectiveness of Dialectical Behavior Therapy (DBT) for refractory depression.

 

In today’s Research News article “Refractory depression – mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282863/ ) Lynch and colleagues recruited adults with refractory major depressive disorder and randomly assigned them to either treatment as usual or to receive 29 weekly 1 hour sessions of Dialectical Behavior Therapy (DBT). They were measured before and after treatment and 5 months and 11 months later for depressive symptoms, psychosocial functioning, suicidal ideation, psychological inflexibility, emotional coping, and social support.

 

They found that compared to baseline both groups continuously improved with reduced depressive symptoms, but the group that received Dialectical Behavior Therapy (DBT) demonstrated significantly greater reductions but they were only statistically significant immediately after treatment but not at the 5 and 11 month follow ups. Also remission rates were higher in the DBT group. In addition, the DBT group had significantly greater psychological flexibility, emotional coping after treatment and all follow-up measurements.

 

These are interesting results that suggest that Dialectical Behavior Therapy (DBT) is an effective treatment for refractory major depressive disorder. In other words, it helps the patients who are not helped by any other treatments; the most difficult to treat patients. The fact that the relief of depressive symptoms is not significantly different from the treatment as usual group at the 5 and 11-month follow ups suggests that booster session may be necessary. But it should be recognized that the patients were markedly improved relative to their baselines. It was just that the treatment as usual group improved as well. So, the DBT produced a large and sustained reduction in depression in these refractory patients.

 

So, improve refractory depression with mindfulness.

 

“Meditation helped me realize that the misery I feel is temporary. It sucks, but if I can wade my way through it, I know I’ll probably have a better day tomorrow.” – Stacey Neglia

 

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

 

Lynch, T. R., Hempel, R. J., Whalley, B., Byford, S., Chamba, R., Clarke, P., Clarke, S., Kingdon, D. G., O’Mahen, H., Remington, B., Rushbrook, S. C., Shearer, J., Stanton, M., Swales, M., Watkins, A., & Russell, I. T. (2020). Refractory depression – mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms. The British journal of psychiatry : the journal of mental science, 216(4), 204–212. https://doi.org/10.1192/bjp.2019.53

 

Abstract

Background

Individuals with depression often do not respond to medication or psychotherapy. Radically open dialectical behaviour therapy (RO DBT) is a new treatment targeting overcontrolled personality, common in refractory depression.

Aims

To compare RO DBT plus treatment as usual (TAU) for refractory depression with TAU alone (trial registration: ISRCTN 85784627).

Method

RO DBT comprised 29 therapy sessions and 27 skills classes over 6 months. Our completed randomised trial evaluated RO DBT for refractory depression over 18 months in three British secondary care centres. Of 250 adult participants, we randomised 162 (65%) to RO DBT. The primary outcome was the Hamilton Rating Scale for Depression (HRSD), assessed masked and analysed by treatment allocated.

Results

After 7 months, immediately following therapy, RO DBT had significantly reduced depressive symptoms by 5.40 points on the HRSD relative to TAU (95% CI 0.94–9.85). After 12 months (primary end-point), the difference of 2.15 points on the HRSD in favour of RO DBT was not significant (95% CI –2.28 to 6.59); nor was that of 1.69 points on the HRSD at 18 months (95% CI –2.84 to 6.22). Throughout RO DBT participants reported significantly better psychological flexibility and emotional coping than controls. However, they reported eight possible serious adverse reactions compared with none in the control group.

Conclusions

The RO DBT group reported significantly lower HRSD scores than the control group after 7 months, but not thereafter. The imbalance in serious adverse reactions was probably because of the controls’ limited opportunities to report these.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282863/