Depression

Improve Anxiety and Depression in Children and Adolescents with Yoga Practice

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Improve Anxiety and Depression in Children and Adolescents with Yoga Practice

 

By John M. de Castro, Ph.D.

 

“Yoga appears to be a promising complementary therapy and stress-management tool for children and adolescents, with very low reports of adverse effects. Yoga, as a therapeutic intervention, has positive effects on psychological functioning, especially in children coping with emotional, mental, and behavioral health problems.” – Pediatrics

 

Childhood and adolescence can be difficult times, fraught with challenges. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child or adolescent can feel overwhelmed and unable to cope with all that is required.

 

Mindfulness training for children and adolescents has been shown to have very positive effects. These include academic, cognitive, psychological, and social domains. Mindfulness training has been shown to improve emotion regulation and to benefit the psychological and emotional health of adolescents. Importantly, mindfulness training with children and adolescents appears to improve the self-concept, improves attentional ability and reduces stress. Yoga is a mindfulness practice that includes physical exercise. This may be better suited to children and adolescents than quiet meditation practices. The research findings on the psychological benefits of yoga practice for children and adolescents is accumulating. So, it makes sense to step back and review what has been learned.

 

In today’s Research News article “Yoga as an Intervention for the Reduction of Symptoms of Anxiety and Depression in Children and Adolescents: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082809/), James-Palmer and colleagues review, summarize, and perform a meta-analysis of the effects of yoga practice on anxiety and depression in children and adolescents (< 18 years of age). They identified 27 published research studies.

 

They report that the studies generally showed reductions in symptoms of anxiety and marginal reductions in symptoms of depression. The studies did not produce clear-cut positive results. On the other hand, in adults, yoga practice produces clear and significant improvements in depression and anxiety. One difference may be the durations of yoga practice. In the reviewed studies the majority of studies that failed to find significant improvements employed less than 6 weeks of yoga practice. Studies in adults frequently include 6 months or so of practice.

 

Regardless, the results of the published research are promising and suggest that yoga practice is a safe and effective treatment to relieve anxiety and depression in children and adolescents. The findings justify conducting larger well controlled studies in the future that employ longer durations of yoga practice.

 

So, improve anxiety and depression in children and adolescents with yoga practice.

 

“Being healthy is important for all children and can be especially important for children with depression or anxiety. In addition to getting the right treatment, leading a healthy lifestyle can play a role in managing symptoms of depression or anxiety.” – Centers for Disease Control and Prevention

 

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

 

James-Palmer, A., Anderson, E. Z., Zucker, L., Kofman, Y., & Daneault, J. F. (2020). Yoga as an Intervention for the Reduction of Symptoms of Anxiety and Depression in Children and Adolescents: A Systematic Review. Frontiers in pediatrics, 8, 78. https://doi.org/10.3389/fped.2020.00078

 

Abstract

Purpose: The purpose of this review is to evaluate the implementation and effectiveness of yoga for the reduction of symptoms of anxiety and depression in youth. To our knowledge, there are no systematic reviews to date looking at the reduction of symptoms of both anxiety and depression.

Methods: Numerous scientific databases were searched up to November 2018 for experimental studies assessing changes in symptoms of anxiety and/or depression in youths following yoga interventions. Quality and level of evidence were assessed, and information was synthesized across studies.

Results: Twenty-seven studies involving youth with varying health statuses were reviewed. Intervention characteristics varied greatly across studies revealing multiple factors that may impact intervention efficacy, however 70% of the studies overall showed improvements. For studies assessing anxiety and depression, 58% showed reductions in both symptoms, while 25% showed reductions in anxiety only. Additionally, 70% of studies assessing anxiety alone showed improvements and 40% of studies only assessing depression showed improvements.

Conclusion: The studies reviewed, while of weak to moderate methodological quality, showed that yoga, defined by the practice of postures, generally leads to some reductions in anxiety and depression in youth regardless of health status and intervention characteristics.

Keywords: child, adolescent, anxiety disorder, depressive disorder, mental health, complementary therapies, exercise, yoga

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082809/

 

Improve Psychological Well-Being at Work with a Mindfulness App

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Improve Psychological Well-Being at Work with a Mindfulness App

By John M. de Castro, Ph.D.

“Mindfulness is not about living life in slow motion. It’s about enhancing focus and awareness both in work and in life. It’s about stripping away distractions and staying on track with individual, as well as organizational, goals.” Jacqueline Carter

 

Work is very important for our health and well-being. We spend approximately 25% of our adult lives at work. Indeed, the work environment has even become an important part of our social lives, with friendships and leisure time activities often attached to the people we work with. But, more than half of employees in the U.S. and nearly 2/3 worldwide are unhappy at work. This is partially due to work-related stress which is epidemic in the western workplace. Almost two thirds of workers reporting high levels of stress at work. This stress can result in impaired health and can result in burnout; producing fatigue, cynicism, and professional inefficacy.

 

To help overcome unhappiness, stress, and burnout, mindfulness practices have been implemented in the workplace. These mindfulness practices have been shown to markedly reduce the physiological and psychological responses to stress. As a result, it has become very trendy for business to incorporate meditation into the workday to help improve employee well-being, health, and productivity.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with busy employee schedules and at locations that may not be convenient. As an alternative, apps for smartphones 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. But the question arises as to the effectiveness of these apps in inducing mindfulness and reducing stress and improving psychological well-being in employees in real-world work settings.

 

In today’s Research News article “Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215525/), Bostock and colleagues recruited healthy adults in the workplace and randomly assigned them to either a wait-list control condition or to 45 days of daily mindfulness training with the “Headspace” app for their smartphones. They were measured before and after the intervention and 8 weeks later for blood pressure and daily well-being at 5 different times during the day, psychological well-being, anxiety, depression, job strain, job status, workplace social support, and mindfulness.

 

They found that in comparison to baseline and the wait-list controls the participants who used the mindfulness training app had significantly higher levels of psychological well-being, daily positive emotions, and workplace social support and significantly lower levels of blood pressure, anxiety, depression, and job strain. They found that these benefits only occurred in participants who completed 10 or more practice sessions. Most of these improvements were maintained at the 8-week follow-up.

 

The research design contained a control condition but the condition was not active. This leaves open the possibility of placebo effects, demand characteristics, and experimenter bias. Employees that used the app less than 10 times, however, could be seen as an active control and they did not show improvements. Nevertheless, the results suggest that using a mindfulness training smartphone app can improve the psychological well-being of employees in the workplace. Since they can receive the training at their own convenience and schedule, it is especially applicable to busy real-world work environments. The low cost of this training suggests that it can be used over large numbers of employees, at diverse locations.

 

So, improve psychological well-being at work with a mindfulness app.

 

“mindfulness and mindfulness-based practices improve self-regulation of thoughts, emotions, and behaviors, linking them to both performance and employee well-being in the workplace.” Theresa Glomb

 

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

 

Bostock, S., Crosswell, A. D., Prather, A. A., & Steptoe, A. (2019). Mindfulness on-the-go: Effects of a mindfulness meditation app on work stress and well-being. Journal of occupational health psychology, 24(1), 127–138. https://doi.org/10.1037/ocp0000118

 

Abstract

We investigated whether a mindfulness meditation program delivered via a smartphone application (app) could improve psychological well-being, reduce job strain, and reduce ambulatory blood pressure during the workday. Participants were 238 healthy employees from two large UK companies that were randomized to a mindfulness meditation practice app or a wait-list control condition. The app offered 45 pre-recorded 10–20 minute guided audio meditations. Participants were asked to complete one meditation per day. Psychosocial measures, and blood pressure throughout one working day, were measured at baseline and 8 weeks later; a follow-up survey was also emailed to participants 16 weeks after the intervention start. Usage data showed that during the 8-week intervention period, participants randomized to the intervention completed an average of 17 meditation sessions (range 0 to 45 sessions). The intervention group reported significant improvement in well-being, distress, job strain, and perceptions of workplace social support compared to the control group. In addition, the intervention group had a marginally significant decrease in self-measured workday systolic blood pressure from pre to post intervention. Sustained positive effects in the intervention group were found for well-being and job strain at the 16-week follow-up assessment. This trial suggests that short guided mindfulness meditations delivered via smartphone and practiced multiple times per week can improve outcomes related to work stress and well-being, with potentially lasting effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6215525/

 

Lower Depression is Associated with Buddhism in Thailand

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Lower Depression is Associated with Buddhism in Thailand

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

So, lower depression is associated with Buddhism in Thailand.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Improve a Biological Marker of Aging, Telomeres, with Meditation

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Improve a Biological Marker of Aging, Telomeres, with Meditation

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Improve Mood with Tai Chi or Qigong Practice

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Improve Mood with Tai Chi or Qigong Practice

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

So, improve mood with Tai Chi or Qigong Practice.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Improve Depression During the Perinatal Period with Mindfulness

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Improve Depression During the Perinatal Period with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

So, improve depression during the perinatal period with mindfulness.

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Improve College Student Well-Being with Online Mindfulness

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Improve College Student Well-Being with Online Mindfulness

 

By John M. de Castro, Ph.D.

 

“Student life can be stressful, but that doesn’t mean students have to let stress take over their lives. By incorporating mindfulness and meditation into daily routines, students can not only relieve the pressure, but also improve their memory, focus and ultimately their grades.” – Kenya McCullum

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on university students to excel so that they can get the best jobs after graduation. This stress might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and school performance.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with reducing the physical and psychological reactions to stress and increasing resilience in the face of stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students.

 

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.

 

In today’s Research News article “An Eight-Week, Web-Based Mindfulness Virtual Community Intervention for Students’ Mental Health: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055779/) Ahmad and colleagues examine the effectiveness of an online mindfulness virtual community to improve well-being in college students. They recruited college students and randomly assigned them to a wait list control condition or to receive an 8-week web-based program called Mindfulness Virtual Community that was developed to specifically address the students’ needs. It was implemented in either a full or partial version. The full Mindfulness Virtual Community included 12 modules of mindfulness practice and psychoeducation for student-specific stresses, discussion forums, and group live videoconferences. The partial version contained only the 12 modules. They were measured at baseline and in the middle and end of the 8-week program for anxiety, depression, stress, quality of life, life satisfaction, and mindfulness. They also self-reported their perceived academic performance and class absences.

 

They found that in comparison to baseline and the wait list control condition, both the full and partial Mindfulness Virtual Community interventions produced significant reductions in depression, perceived stress, and self-reported absences and significant increases in mindfulness, quality of life, and self-reported academic performance. Only the partial Mindfulness Virtual Community produced a significant reduction in anxiety.

 

These are encouraging results that suggest that a student-centered mindfulness training over the internet can be effective in improving the mental health of college students and perhaps their performance in school. College life can be difficult and stressful for the students with difficult adjustments and pressure to perform. The fact that mindfulness training can be of help in reducing the perceived levels of stress and improve the psychological health of the students may be very important for their eventual success. Indeed, their self-reported academic performance improved and they self-reported fewer absences, suggesting just such an improvement in success occurred.

 

The facts that this program was web-based and that the presentation of the video modules alone was effective indicates that this program can be implemented inexpensively to large numbers of students even in different colleges over wide geographical regions. Since it is web based the students can conveniently schedule this participation within their busy schedules. In addition, the training can occur anywhere. Hence, web-based mindfulness training may be an almost ideal solution to the psychological health problems encountered by college students.

 

So, improve college student well-being with online mindfulness.

 

“Learning how to meditate and be more mindful was one of the best things I’ve done as a student here. I’ve struggled with anxiety for many years, and became really overwhelmed by everything by my sophomore year. My grades started to fall as I slept less and tried to take on more and more. I’m so thankful for the skills I learned in this class. It’s not only made me a better student, but it’s also made me a happier person!”

 

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

 

Ahmad, F., El Morr, C., Ritvo, P., Othman, N., Moineddin, R., & MVC Team (2020). An Eight-Week, Web-Based Mindfulness Virtual Community Intervention for Students’ Mental Health: Randomized Controlled Trial. JMIR mental health, 7(2), e15520. https://doi.org/10.2196/15520

 

Abstract

Background

Innovative interventions are needed to address the increasing mental health needs of university students. Given the demonstrated anxiolytic and antidepressant benefits of mindfulness training, we developed an 8-week, Web-based Mindfulness Virtual Community (MVC) intervention informed by cognitive behavioral therapy (CBT) constructs.

Objective

This study investigated the efficacy of the MVC intervention in reducing symptoms of depression, anxiety, and stress among undergraduate students in Toronto, Canada. The secondary outcomes included quality of life, life satisfaction, and mindfulness.

Methods

The first 4 weeks of the full MVC intervention (F-MVC) comprised: (1) 12 video-based modules with psycho-education on students’ preidentified stressful topics and topically applied mindfulness practice; (2) anonymous peer-to-peer discussion forums; and (3) anonymous, group-based, professionally guided, 20-min live videoconferences. The second 4 weeks of F-MVC involved access only to video-based modules. The 8-week partial MVC (P-MVC) comprised 12 video-based modules. A randomized controlled trial was conducted with 4 parallel arms: F-MVC, P-MVC, waitlist control (WLC), and group-based face-to-face CBT; results for the latter group are presented elsewhere. Students recruited through multiple strategies consented and were randomized: WLC=40; F-MVC=40, P-MVC=39; all learned about allocation after consenting. The online surveys at baseline (T1), 4 weeks (T2), and 8 weeks (T3) included the Patient Health Questionnaire-9 item, Beck Anxiety Inventory, Perceived Stress Scale, Quality of Life Scale, Brief Multi-Dimensional Students Life Satisfaction Scale, and Five-Facet Mindfulness Questionnaire. Analyses employed generalized estimation equation methods with AR(1) covariance structures and were adjusted for possible confounders (gender, age, birth country, paid work, unpaid work, physical activities, self-rated health, and mental health counseling access).

Results

Of the 113 students who provided T1 data, 28 were males and 85 were females with a mean age of 24.8 years. Participants in F-MVC (n=39), P-MVC (n=35), and WLC (n=39) groups were similar in sociodemographic characteristics at T1. At T3 follow-up, per adjusted comparisons, there were statistically significant reductions in depression scores for F-MVC (score change −4.03; P<.001) and P-MVC (score change −4.82; P<.001) when compared with WLC. At T3, there was a statistically significant reduction in anxiety scores only for P-MVC (score change −7.35; P=.01) when compared with WLC. There was a statistically significant reduction in scores for perceived stress for both F-MVC (score change −5.32; P<.001) and P-MVC (score change −5.61; P=.005) compared with WLC. There were statistically significant changes at T3 for quality of life and mindfulness for F-MVC and P-MVC vs WLC but not for life satisfaction.

Conclusions

Internet-based mindfulness CBT–based interventions, such as F-MVC and P-MVC, can result in significant reductions in symptoms of depression, anxiety, and stress in a student population. Future research with a larger sample from multiple universities would more precisely test generalizability.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055779/

 

Lower Opioid Cravings are Associated with Lower Depression, Higher Self-Regulation, and Higher Mindfulness

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Lower Opioid Cravings are Associated with Lower Depression, Higher Self-Regulation, and Higher Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain.” – Science Daily

 

Substance abuse and addiction is a terrible problem, especially opioid pain relievers. Opioid addiction has become epidemic and is rapidly increasing affecting more than 2 million Americans and an estimated 15 million people worldwide. In the U.S more than 20,000 deaths yearly were attributed to an overdose of prescription opioids, and another 13,000 deaths from heroin overdose. These statistics, although startling are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictions. One way that mindfulness may produce these benefits is by reducing cravings for opioids. It may also do so by affecting the ability of the addict to regulate their emotions. Indeed, mindfulness has been shown to improve emotional regulation.

 

In today’s Research News article “Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients. Experimental and clinical psychopharmacology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355352/), Baker and Garland recruited non-cancer chronic pain patients who were taking opioid analgesics and had them complete self-report measures of mindfulness, opioid craving, and depression. They also measured their heart rates with an electrocardiogram (ECG) while looking at either neutral pictures or “opioid-related image (e.g., pills, pill bottles).” These data were analyzed to determine heart rate variability as a measure of the activity of the peripheral autonomic nervous system.

 

They found that the higher the levels of mindfulness the higher the levels of heart rate variability while looking at opioid-related pictures. And the lower the levels of depression and opioid cravings. Also, the higher the levels of depression, the higher the levels of opioid cravings. Employing a multivariate path analysis, they found that mindfulness was not associated with lower opioid cravings directly, but indirectly via mindfulness’ associations with heart rate variability and depression. That is, they found that mindfulness was associated with higher heart rate variability which was in turn associated with lower opioid cravings and also with lower depression which was in turn associated with lower opioid cravings.

 

Heart rate variability is thought to measure the nervous systems adjustments to the physiology involved in regulating its physical responses to stimuli. In other words, it’s a measure of self-regulation. The present results suggest that mindfulness is associated with greater self-regulation and this is associated with lower cravings for opioids. The results also suggest that depression is associated with higher cravings for opioids and that mindfulness interrupts this by being associated with lower depression.

 

These results are correlative and as such causation cannot be determined. Nevertheless, prior research has demonstrated causal links between mindfulness and lower cravings and depression. So, the present results likely result from causal connections. The findings also suggest the mechanism whereby mindfulness may lower cravings by contributing to the ability to regulate physical responses to opioid-related stimuli and by reducing depression. These results provide more support for the use of mindfulness training as a treatment for addictions.

 

So, lower opioid cravings are associated with lower depression, higher self-regulation, and higher mindfulness.

 

“people suffering from opioid addiction and chronic pain may have fewer cravings and less pain when adding mindfulness to the traditional methadone treatment.” – Grace Bullock

 

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

 

Baker, A. K., & Garland, E. L. (2019). Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients. Experimental and clinical psychopharmacology, 27(1), 55–63. https://doi.org/10.1037/pha0000225

 

Abstract

Prescription opioid misuse among chronic pain patients is associated with self-regulatory deficits, affective distress and opioid cue reactivity. Dispositional mindfulness has been associated with enhanced self-regulation, lower distress, and adaptive autonomic responses following drug cue exposure. We hypothesized that dispositional mindfulness might serve as a protective factor among opioid-treated chronic pain patients. We examined heart rate variability (HRV) during exposure to opioid cues and depressed mood as mediators of the association between dispositional mindfulness and opioid craving. Data were obtained from a sample of chronic pain patients (N=115) receiving long-term opioid pharmacotherapy. Participants self-reported opioid craving and depression, and HRV was measured during an opioid-cue dot probe task. Dispositional mindfulness was significantly positively correlated with HRV, and HRV was significantly inversely associated with opioid craving. Dispositional mindfulness was significantly negatively correlated with depression, and depression was significantly positively correlated with opioid craving. Path analysis revealed significant indirect effects of dispositional mindfulness on craving through both HRV and depression. Dispositional mindfulness may buffer against opioid craving among chronic pain patients prescribed opioids; this buffering effect may be a function of improved autonomic and affective responses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355352/

 

Online Mindfulness Training Improves Clinical Anxiety and Depression

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Online Mindfulness Training Improves Clinical Anxiety and Depression

 

By John M. de Castro, Ph.D.

 

“adding MMB [mindfulness training] to depression care led to greater reductions in depressive and anxious symptoms, higher rates of remission and higher levels of quality of life compared to patients receiving conventional depression care alone.” – Traci Pederson

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. They have been shown to be very helpful in treating anxiety and depression. The vast majority of the mindfulness training techniques, however, require a certified 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 programs have been developed to be implemented over the internet. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But, the question arises as to which forms of online mindfulness trainings are most effective for inducing mindfulness and improving the treatment of anxiety and depression.

 

In today’s Research News article “Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/), Kladnitski and colleagues recruited online adults with a variety of either depression or anxiety disorders and randomly assigned them to receive either a 17-week internet-based cognitive behavioral therapy, mindfulness enhanced internet-based cognitive behavioral therapy, internet-based mindfulness training, or treatment-as-usual. “The programs consisted of six comic-style, story-based lessons, downloadable lesson summaries, reflective worksheets, and extra support materials including frequently asked questions and troubleshooting of common difficulties.” They were measured before, during, and after treatment and 3 months later for psychological illnesses, anxiety, depression, psychological distress, and functional impairment.

 

They found compared to baseline and the treatment-as-usual control group, there were large and highly significant decreases in anxiety, depression, functional impairment and psychological distress. These improvements were present both at the end of treatment and at the 3-month follow-up. There were no significant differences between the effectiveness of the 3 interventions. There were no adverse events reported. At the 3-month follow-up 60% to 73% of the treated participants improved to the point that they no longer met the criteria for a clinical diagnosis of an anxiety or depressive disorder.

 

It is interesting that the 3 different treatments did not differ in effectiveness. Each has been previously been demonstrated to be effective in treating anxiety and depressive disorders and it appears that their efficacy is almost equivalent. This suggests that patients can self-select the treatment that most appeals to them, improving completion rates, compliance, and perhaps effectiveness.

 

These are exciting and important findings. It has been previously demonstrated that mindfulness training can alleviate the symptoms of anxiety and depression. The advance here is in demonstrating that therapy delivered over the internet is safe, effective, and lasting in treating anxiety or depressive disorders. Internet delivery of treatment can be implemented conveniently, at low cost. and over wide areas making the therapy available to large numbers of patients who previously could not access treatment.

 

So, online mindfulness training improves clinical anxiety and depression.

 

“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

 

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

 

Kladnitski, N., Smith, J., Uppal, S., James, M. A., Allen, A. R., Andrews, G., & Newby, J. M. (2020). Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial. Internet Interventions, 20, 100310. https://doi.org/10.1016/j.invent.2020.100310

 

Abstract

Aim

To examine the efficacy of transdiagnostic internet-delivered cognitive behavioural therapy (iCBT), mindfulness-enhanced iCBT, and stand-alone online mindfulness training compared with a usual care control group (TAU) for clinical anxiety and depression.

Method

Individuals (N = 158) with a DSM-5 diagnosis of a depressive and/or anxiety disorder were randomised to one of the three clinician-guided online interventions, or TAU over a 14-week intervention period. The primary outcomes were self-reported depression (PHQ-9) and anxiety (GAD-7) severity at post-treatment. Secondary outcomes included adherence rates, functional impairment (WHODAS-II), general distress (K−10), and diagnostic status at the 3-month follow-up (intervention groups).

Results

All three programs achieved significant and large reductions in symptoms of depression (g = 0.89–1.53), anxiety (g = 1.04–1.40), and distress (g = 1.25–1.76); and medium to large reductions in functional impairment (g = 0.53–0.98) from baseline to post-treatment and 3-month follow-up. Intention-to-treat linear mixed models showed that all three online programs were superior to usual care at reducing symptoms of depression (g = 0.89–1.18) and anxiety (g = 1.00–1.23).

Conclusion

Transdiagnostic iCBT, mindfulness-enhanced iCBT and online mindfulness training are more efficacious for treating depression and anxiety disorders than usual care, and represent an accessible treatment option for these disorders.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044661/

 

Mindfulness Improves Depression in Real-World Healthcare Applications

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Mindfulness Improves Depression in Real-World Healthcare Applications

 

By John M. de Castro, Ph.D.

 

“Rather than try to avoid or eliminate sadness or other negative emotions, one learns to change their relationship with these emotions by practicing meditation and other mindfulness exercises.” – Psychology Today

 

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 is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior.

 

There has been considerable research demonstrating that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression. Most of the work has been done in controlled research situations. At this point an examination is needed of how effective MBCT is when employed routinely in healthcare settings.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995449/), Tickell and colleagues extracted the data from 1554 participants in group Mindfulness-Based Cognitive Therapy (MBCT) programs. They obtained data on the patients sociodemographic status, depression levels and attendance at MBCT sessions.

 

On average the patients attended 6.37 of the 8 MBCT sessions. They report that after the Mindfulness-Based Cognitive Therapy (MBCT) program there was significant reductions in depression with small to medium effect sizes. Of those participants who were clinically depressed 45% were recovered and 34% were reliably recovered after MBCT. There were no differences in improvement in depression for different ages or genders.

 

These results were not from highly controlled randomized clinical trials. Rather they were from real-world clinical applications of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of depression. There is ample evidence from controlled trials that mindfulness training and MBCT in particular are effective in reducing depression. The strength of the current study is that it demonstrates that when MBCT is implemented by clinicians in typical treatment settings it is also effective in reducing depression.

 

So, mindfulness improves depression in real-world healthcare applications.

 

“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

 

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

 

Tickell, A., Ball, S., Bernard, P., Kuyken, W., Marx, R., Pack, S., Strauss, C., Sweeney, T., & Crane, C. (2020). The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services. Mindfulness, 11(2), 279–290. https://doi.org/10.1007/s12671-018-1087-9

 

Abstract

Depression is common with a high risk of relapse/recurrence. There is evidence from multiple randomised controlled trials (RCTs) demonstrating the efficacy of mindfulness-based cognitive therapy (MBCT) for the prevention of depressive relapse/recurrence, and it is included in several national clinical guidelines for this purpose. However, little is known about whether MBCT is being delivered safely and effectively in real-world healthcare settings. In the present study, five mental health services from a range of regions in the UK contributed data (n = 1554) to examine the impact of MBCT on depression outcomes. Less than half the sample (n = 726, 47%) entered with Patient Health Questionnaire (PHQ-9) scores in the non-depressed range, the group for whom MBCT was originally intended. Of this group, 96% sustained their recovery (remained in the non-depressed range) across the treatment period. There was also a significant reduction in residual symptoms, consistent with a reduced risk of depressive relapse. The rest of the sample (n = 828, 53%) entered treatment with PHQ-9 scores in the depressed range. For this group, 45% recovered (PHQ-9 score entered the non-depressed range), and overall, there was a significant reduction in depression severity from pre-treatment to post-treatment. For both subgroups, the rate of reliable deterioration (3%) was comparable to other psychotherapeutic interventions delivered in similar settings. We conclude that MBCT is being delivered effectively and safely in routine clinical settings, although its use has broadened from its original target population to include people experiencing current depression. Implications for implementation are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995449/