Depression

Mindfulness Training Improves Anxiety and Depression in Japanese Patients

psyjdc Leave a comment

Mindfulness Training Improves Anxiety and Depression in Japanese Patients

 

By John M. de Castro, Ph.D.

 

“meditation was never conceived of as a treatment for any health problem. Rather, it is a path one travels on to increase our awareness and gain insight into our lives.” – Madhav Goyal

 

Many of the symptoms of psychological distress have been shown to be related to a lack of mindfulness, a focus on the present moment. Anxiety is often rooted in a persistent dread of future negative events while depression and rumination are rooted in the past, with persistent replaying of negative past events. Since mindfulness is firmly rooted in the present it is antagonistic toward anything rooted in the past or future. Hence, high levels of mindfulness cannot coexist with anxiety and rumination. In addition, high mindfulness has been shown to be related to high levels of emotion regulation and positive emotions. So, mindfulness would appear to be an antidote to psychological distress. Indeed, mindfulness has been shown to reduce psychological distress, including anxiety and depression.

 

Most psychotherapies were developed to treat disorders in affluent western populations and may not be sensitive to the unique situations, cultures, and education levels of diverse populations. Hence, there is a need to investigate the effectiveness of psychological treatments with diverse populations. One increasingly popular treatment is mindfulness training. These include meditation, tai chi, qigong, yoga, guided imagery, prayer, etc. There are indications that mindfulness therapies may be effective in diverse populations. But there is a need for further investigation with different populations.

 

In today’s Research News article “Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378713/), Takahashi and colleagues recruited Japanese patients who suffered from anxiety or depression and provided them with an 8-week,  once a week for 2 hours, group mindfulness training that was a combination of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT). They also practiced at home daily. They were measured before and after training and 2 months later for mindfulness, depression, anxiety, mind wandering, self-compassion, and behavioral activation.

 

They found that after mindfulness training there were significant reductions in anxiety and depression and significant increases in mindfulness and self-compassion that were maintained 2 months later. They also found that the greater the changes in the levels of mindfulness and self-compassion produced by the training, the greater the reductions in anxiety and depression. Hence, the mindfulness training produced lasting improvements in the mental health of Japanese patients suffering from anxiety or depression.

 

This study lacked a control group and is thus open to alternative confounding interpretations. But mindfulness training has been shown over a large number of well-controlled studies to improve self-compassion and to reduce anxiety and depression. So, the current improvements in mental health were also likely to be due to the mindfulness training. The major contribution of this research, however, is to add to the generalizability of mindfulness training’s ability to improve mental health by demonstrating that it is effective with Japanese patients with anxiety or depression.

 

So, mindfulness training improves anxiety and depression in Japanese patients.

 

“Mindfulness has been shown to help with people living with depression and anxiety. Americans often think a pill is the only way to fix things, but . . .  it doesn’t require any money to meditate so it seems like a purer way for people to live with these disorders.” – Katie Lindsley

 

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

 

Takahashi, T., Sugiyama, F., Kikai, T., Kawashima, I., Guan, S., Oguchi, M., … Kumano, H. (2019). Changes in depression and anxiety through mindfulness group therapy in Japan: the role of mindfulness and self-compassion as possible mediators. BioPsychoSocial medicine, 13, 4. doi:10.1186/s13030-019-0145-4

 

Abstract

Background

Mindfulness-based interventions are increasingly being implemented worldwide for problems with depression and anxiety, and they have shown evidence of efficacy. However, few studies have examined the effects of a mindfulness-based group therapy based on standard programs for depression and anxiety until follow-up in Japan. This study addresses that gap. Furthermore, this study explored the mechanisms of action, focusing on mindfulness, mind wandering, self-compassion, and the behavioral inhibition and behavioral activation systems (BIS/BAS) as possible mediators.

Methods

We examined 16 people who suffered from depression and/or anxiety in an 8-week mindfulness group therapy. Measurements were conducted using questionnaires on depression and trait-anxiety (outcome variables), mindfulness, mind wandering, self-compassion, and the BIS/BAS (process variables) at pre- and post-intervention and 2-month follow-up. Changes in the outcome and process variables were tested, and the correlations among the changes in those variables were explored.

Results

Depression and anxiety decreased significantly, with moderate to large effect sizes, from pre- to post-intervention and follow-up. In process variables, the observing and nonreactivity facets of mindfulness significantly increased from pre- to post-intervention and follow-up. The nonjudging facet of mindfulness and self-compassion significantly increased from pre-intervention to follow-up. Other facets of mindfulness, mind wandering, and the BIS/BAS did not significantly change. Improvements in some facets of mindfulness and self-compassion and reductions in BIS were significantly correlated with decreases in depression and anxiety.

Conclusions

An 8-week mindfulness group therapy program may be effective for people suffering from depression and anxiety in Japan. Mindfulness and self-compassion may be important mediators of the effects of the mindfulness group therapy. Future studies should confirm these findings by using a control group.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378713/

 

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

psyjdc Leave a comment

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“It turns out that 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. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, fear, and anxiety and depression. The evidence is accumulating. So, it is timely to review and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/), Cillessen and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials (RCTs) on the effectiveness of mindfulness training in treating the symptoms of cancer and its treatment. They found 29 RCTs that included a total of 3224 participants.

 

The summary of the published research reflected that mindfulness training produced significant reductions in psychological distress in the cancer patients including reductions in anxiety, depression, fatigue, and fear of cancer reoccurrence with small to moderate effects sizes. These improvements were found both immediately after treatment and also at follow-up from 3 to 24 months later. Further they found that mindfulness trainings that adhered to the protocols for Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) had the greatest effect sizes.

 

It has been repeatedly demonstrated that mindfulness training is effective in reducing psychological distress including reductions in anxiety, depression, fatigue, and fear in a wide variety of individuals with and without disease states. The present meta-analysis demonstrates the effectiveness of mindfulness training for the relief of psychological and physical suffering of cancer patients. It does not affect the disease process. Rather, it reduces the patients psychological suffering and does so for a prolonged period of time.

 

So, improve the physical and psychological health of cancer patients with mindfulness.

 

“patients who practice mindfulness begin to feel better despite their medical problems. Physical symptoms don’t necessarily go away, but that’s not the aim of mindfulness. Rather, the goal is to help you find a different perspective and a new way of coping with your illness.” – Eric Tidline

 

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

 

Cillessen, L., Johannsen, M., Speckens, A., & Zachariae, R. (2019). Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psycho-oncology, 28(12), 2257–2269. doi:10.1002/pon.5214

 

Abstract

Objective

Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.

Methods

Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.

Results

Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges’s g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.

Conclusions

MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/

 

Be Better Parents with Online Mindful Parenting

psyjdc Leave a comment

Be Better Parents with Online Mindful Parenting

 

By John M. de Castro, Ph.D.

 

“Managing our own emotions and behaviors is the key to teaching kids how to manage theirs. . . Unfortunately, when you’re stressed out, exhausted, and overwhelmed, you can’t be available for your child.” – Jill Cedar

 

Raising children, parenting, is very rewarding. But it can also be challenging. Children test parents frequently. They test the boundaries of their freedom and the depth of parental love. They demand attention and seem to especially when parental attention is needed elsewhere. They don’t always conform to parental dictates or aspirations for their behavior. The challenges of parenting require that the parents be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. It improves the ability to maintain attention and focus in the face of high levels of distraction.

 

Mindful parenting involves the parents having emotional awareness of themselves and compassion for the child and having the skills to pay full attention to the child in the present moment, to accept parenting non-judgmentally and be emotionally non-reactive to the child. Mindful parenting has been shown to have positive benefits for both the parents and the children.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many parents can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in 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 online trainings in reducing parental stress and improving parenting.

 

In today’s Research News article “A Randomized Control Trial Evaluating an Online Mindful Parenting Training for Mothers With Elevated Parental Stress.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650592/), Potharst and colleagues recruited mothers who were high in perceived stress and reported parenting problems. The mothers were randomly assigned to either receive an online mindful parenting program or to a wait list control condition. The online mindful parenting program consisted of 8 weekly session with instructions and exercises on meditation, mindful parenting, and self-compassion. They were measured before and after the training and 10 weeks later after the wait list group had received the intervention for parental stress, overreactive parenting discipline, mindful parenting, self-compassion, anxiety, and depression. In addition, both parents rated the child for child aggressive behavior and emotional reactivity.

 

They found that the online mindful parenting program in comparison to baseline and the wait-list control group produced significant reductions in anxiety, depression, overreactive parenting discipline, parental role restriction and child emotional reactivity and significant increases in self-compassion.

 

These results suggest that an online mindful parenting program can be successfully implemented and that it significantly improves the psychological health of the mothers, their parenting, and the child’s behavior. Mindful parenting has been previously shown to have positive benefits for both the parents and the children. The contribution of the present study is in demonstrating that mindful parenting can be successfully conducted online with stressed mothers. This greatly increases the ability to roll out this effective program to a much wider audience at low cost.

 

Parenting is difficult and stressful enough under the best of conditions. It is encouraging to find a relatively simple, convenient and inexpensive program that can help the parents to become better parents and to ease their psychological burden.

 

So, be better parents with online mindful parenting.

 

“It seems there’s no one right way to parent mindfully. Happily, there are many right ways. Sometimes “It’s as simple as practicing paying full attention to our kids, with openness and compassion, and maybe that’s enough at any moment.” – Juliann Garey

 

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

 

Potharst, E. S., Boekhorst, M., Cuijlits, I., van Broekhoven, K., Jacobs, A., Spek, V., … Pop, V. (2019). A Randomized Control Trial Evaluating an Online Mindful Parenting Training for Mothers With Elevated Parental Stress. Frontiers in psychology, 10, 1550. doi:10.3389/fpsyg.2019.01550

 

Abstract

Objectives

The prevalence of maternal stress in early years of parenting can negatively impact child development. Therefore, there is a need for an early intervention that is easily accessible and low in costs. The current study examined the effectiveness of an 8-session online mindful parenting training for mothers with elevated levels of parental stress.

Methods

A total of 76 mothers were randomized into an intervention (n = 43) or a waitlist control group (n = 33). The intervention group completed pretest assessment prior to the online intervention. Participants completed a post intervention assessment after the 10 weeks intervention and a follow-up assessment 10 weeks later. The waitlist group completed waitlist assessment, followed by a 10-week waitlist period. After these 10 weeks, a pretest assessment took place, after which the waitlist group participants also started the intervention, followed by the posttest assessment. Participating mothers completed questionnaires on parental stress (parent-child interaction problems, parenting problems, parental role restriction) and other maternal (over-reactive parenting discipline, self-compassion, symptoms of depression and anxiety) and child outcomes (aggressive behavior and emotional reactivity) while the non-participating parents (father or another mother) were asked to also report on child outcomes.

Results

The online mindful parenting intervention was shown to be significantly more effective at a 95% level than a waitlist period with regard to over-reactive parenting discipline and symptoms of depression and anxiety (small and medium effect sizes), and significantly more effective at a 90% level with regard to self-compassion, and mother-rated child aggressive behavior and child emotional reactivity (small effect sizes). The primary outcome, parental stress, was found to have a 95% significant within-group effect only for the subscale parental role restriction (delayed small effect size improvement at follow-up). No significant improvements on child outcomes were found for the non-participating parent.

Conclusion

To conclude, the results provide first evidence that an online mindful parenting training may be an easily accessible and valuable intervention for mothers with elevated levels of parental stress.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650592/

 

Reduce Depression Produced by Internet Addiction with Mindfulness

psyjdc Leave a comment

Reduce Depression Produced by Internet Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As we get more connected to our wireless technology, we appear to run the risk of damaging our brains’ wiring, and disconnecting from the face-to-face interaction that our social and psychological systems need. With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another.” – Mitch Abblett

 

Over the last few decades the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore the consequences of internet addiction and the relationship of mindfulness with internet addiction and its consequences.

 

In today’s Research News article “Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865207/), Chi and colleagues recruited middle school students (aged 11 to 15 years) and had them complete a questionnaire measuring internet addiction, depression, positive youth development (measuring positive psychological qualities), and mindfulness.

 

They found that 20% of the youths showed symptoms of internet addiction and 24% showed symptoms of depression. They also observed that the higher the levels of mindfulness, the lower the levels of depression and internet addiction and the higher the levels of positive youth development. On the other hand, the higher the levels of internet addiction the lower the levels of mindfulness and positive youth development and the higher the levels of depression. They also found mediation. The positive relationship between internet addiction and depression was present when mindfulness was low but not when it was high. Similarly, the negative relationship between depression and positive youth development was present when mindfulness was low but not when it was high.

 

These results are correlative and caution must be exercised in concluding causation. Nevertheless, the results replicate previous findings of mindfulness being negatively related to depression and internet addiction and positively related to positive psychological qualities. But the present findings add to these understandings by demonstrating that being addicted to the internet is related to higher depression and lower positive psychological qualities. Importantly, they found that mindfulness moderates the relationships between depression and both internet addiction and positive psychological qualities. High levels of mindfulness appear to prevent internet addiction from producing depression and from depression reducing positive psychological qualities.

 

Internet addiction is a growing problem especially in youths. These results are encouraging though that mindfulness not only is related to less internet addiction but also appears to blunt the relationships of internet addiction with depression and positive psychological qualities. This suggests that training in mindfulness with youths may help prevent addiction to the internet and its consequent effects on depression and youth development. Testing this remains for future research.

 

So, reduce depression produced by internet addiction with mindfulness.

 

“when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioural addictions and for improving psychological health more generally.” – Mark Griffiths

 

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

 

Chi, X., Liu, X., Guo, T., Wu, M., & Chen, X. (2019). Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model. Frontiers in Psychiatry, 10, 816. doi:10.3389/fpsyt.2019.00816

 

Abstract

Research has revealed that Internet addiction is a risk factor for adolescents’ development of depressive symptoms, although the underlying mechanisms are largely unknown. The present study examines the mediating role of positive youth development and the moderating role of mindfulness to determine the association between Internet addiction and depression. A sample of 522 Chinese adolescents completed measures related to Internet addiction, positive youth development, mindfulness, depression, and their background information, for which the results reveal that positive youth development mediates the relation between Internet addiction and depression. Moreover, the associations between both Internet addiction and depression as well as positive youth development and depression are moderated by mindfulness. These two effects were stronger for adolescents with low mindfulness than for those with high mindfulness. The present study contributes to a more thorough understanding of how and when Internet addiction increases the risk of depression in adolescents, suggesting that Internet addiction may affect adolescent depression through positive youth development and that mindfulness can alleviate the negative effect of Internet addiction or a low level of psychological resources on depression. The implications for research and practice are finally discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865207/

 

Improve the Psychological Health of Patients with Early Psychosis with Mindfulness

psyjdc Leave a comment

Improve the Psychological Health of Patients with Early Psychosis with Mindfulness

 

By John M. de Castro, Ph.D.

 

“for people with psychosis without severe social anxiety, learning mindfulness strategies in a group format is greatly appreciated and offers clear benefits—in terms of participants being more active, less depressed and less anxious.” – Tania Lecomte

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments.

 

Mindfulness training has been shown to be beneficial for patients with psychosis. Implementing interventions early in the disease progression may maximize the benefits. It would be even better to intervene before full-blown symptoms emerge. Research in this area is accumulating. Hence, it makes sense to review and summarize the studies to assess the state of the understanding of the effectiveness of early intervention with mindfulness training in patients at risk for or in early stages of psychosis.

 

In today’s Research News article “Clinical Effects of Mindfulness-Based Intervention in Patients With First Episode Psychosis and in Individuals With Ultra-High Risk for Transition to Psychosis: A Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837071/ ), Vignaud and colleagues reviewed and summarized the 9 published research studies on the effectiveness of mindfulness training for the treatment of patients at ultra-high risk (1 article) for or in early stages (8 articles) of psychosis.

 

They report that the 9 published research studies found that mindfulness training was safe and effective and produced significant improvements in anxiety, depression and quality of life in these patients. There were insufficient studies assessing the positive and negative symptoms of psychosis to reach any conclusions. It would be useful for future studies to examine in more depth the positive and negative symptoms of psychosis.

 

It is well established that mindfulness training produces improvements in anxiety and depression and improves the quality of life in diverse types of patients. The findings of the present review suggest that it has these same benefits for patients at risk for or in early stages of psychosis. It was disappointing that the currently available findings did not include long-term follow-up. It would be important to establish whether mindfulness interventions early in the disease progression might reduce the deterioration that normally occurs over time.

 

So, improve the psychological health of patients with early psychosis with mindfulness.

 

“mindfulness, is effective in alleviating distress in individuals with psychosis who are hearing voices.” – Batya Swift Yasgur

 

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

 

Vignaud, P., Reilly, K. T., Donde, C., Haesebaert, F., & Brunelin, J. (2019). Clinical Effects of Mindfulness-Based Intervention in Patients With First Episode Psychosis and in Individuals With Ultra-High Risk for Transition to Psychosis: A Review. Frontiers in psychiatry, 10, 797. doi:10.3389/fpsyt.2019.00797

 

Abstract

Objectives: Recent clinical studies and meta-analyses have reported the clinical effects of mindfulness-based interventions as a complementary treatment for patients with schizophrenia, but their possible efficacy in patients with first episode of psychosis (FEP) and in individuals with ultra-high risk (UHR) of transition to psychosis is less clear. Here, we investigated the current evidence on the usefulness of mindfulness-based interventions in these two populations.

Methods: We conducted a systematic search of the literature according to the PRISMA guidelines.

Results: Among the 102 references retrieved, 9 responded to the inclusion criteria (8 in FEP patients and 1 in UHR individuals). In FEP patients, mindfulness interventions are well-tolerated and have a satisfactory level of adherence. The clinical benefits consist primarily of reduced anxiety and sadness and improved quality of life. None of the studies reported any increase in positive symptoms.

Conclusion: Future sham-controlled studies with large sample sizes are needed to definitively conclude on the clinical interest of mindfulness-based interventions in FEP patients and UHR individuals as well as to understand their underlying mechanisms of action.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837071/

 

Improve Psychological Well-Being with Meditation

psyjdc Leave a comment

Improve Psychological Well-Being with Meditation

 

By John M. de Castro, Ph.D.

 

“Taking a few minutes to meditate every day with the goal of becoming more mindful, or focused on and accepting of the present, is a great way to relieve stress. But it’s even more powerful than you think. Mindfulness meditation helps ease mental health conditions like depression and anxiety.” – Amy Marturana Winderl

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

There is a vast array of techniques for the development of mindfulness. They include a variety of forms of meditation, yoga, mindful movements, contemplative prayer, and combinations of practices. In addition, there are many sub-forms of each; e.g. meditation can be practiced in focused, open monitoring, or compassion techniques. The relative effectiveness of these techniques in promoting psychological adjustment and mental health needs to be further explored.

 

In today’s Research News article “Religiosity and Meditation Practice: Exploring Their Explanatory Power on Psychological Adjustment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445895/), Montero-Marin and colleagues recruited both male and female adults (aged 18-74 years) online and had them complete measures of religious beliefs, amounts of meditation and prayer practice, happiness, depression, positive and negative emotions, and emotional overproduction.

 

They found that the greater the amounts of lifetime practice of focused meditation and the longer the sessions the greater the levels of happiness and positive emotions and the lower the levels of depression, negative emotions and emotional overproduction. Similarly, the greater the amounts of lifetime practice of open monitoring meditation the greater the levels of happiness and positive emotions and the lower the levels of depression, negative emotions and emotional overproduction. Finally, the greater the amounts of lifetime practice of compassion meditation the greater the levels of happiness and positive emotions. Age was not a significant factor. There were no similar relationships with the amounts of prayer or religious beliefs.

 

The findings are correlational and as such no conclusions regarding causation can be reached. But the findings suggest that meditation practice is associated with the practitioners’ psychological well-being. It is interesting that religious beliefs were not associated with well-being and that there were no significant relationships found between prayer practice and measures of well-being. Prior research suggests that spirituality rather then religiosity is associated with positive well-being. The present study, however, did not include measures of spirituality. It would be expected that the degree to which religious beliefs and prayer were spiritual practices rather than religious recitals would be important in determining the relationships of beliefs and practice with well-being.

 

Although there are different patterns of significant relationships between the different meditation techniques and measures of well-being, there were no direct statistical comparisons conducted. So, no conclusions can be reached regarding the differential effectiveness of the different meditation techniques. In general, it would appear that meditation practice, including focused, open monitoring, and compassion types is related to greater well-being regardless of age, gender, or health status.

 

So, improve psychological well-being with meditation.

 

 

“While I could point to lots of research outlining the impressive benefits of meditation, I think it always works best if people do the experiment for themselves. Spend just a little time practising every day and see what a difference it makes in your life.” – Black Dog Institute

 

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

 

Montero-Marin, J., Perez-Yus, M. C., Cebolla, A., Soler, J., Demarzo, M., & Garcia-Campayo, J. (2019). Religiosity and Meditation Practice: Exploring Their Explanatory Power on Psychological Adjustment. Frontiers in psychology, 10, 630. doi:10.3389/fpsyg.2019.00630

 

Abstract

There has been increased interest in the relationships between religiosity, meditation practice and well-being, but there is lack of understanding as to how specific religious components and distinct meditation practices could influence different positive and negative psychological adjustment outcomes. The aim of this study was to assess the explanatory power of religious beliefs and the practice of prayer, focused attention (FA), open monitoring (OM), and compassion meditation (CM) on psychological adjustment, taking into consideration a number of practice-related variables such as session length, frequency of practice and lifetime practice. Psychological adjustment was assessed by means of happiness, positive affect, depression, negative affect, and emotional overproduction. A cross-sectional design was used, with a final sample comprising 210 Spanish participants who completed an online assessment protocol. Hierarchical regressions were performed, including age, sex and psychotropic medication use in the first step as possible confounders, with the addition of religious beliefs and the practice of prayer, FA, OM, and CM in the second step. FA session length was related to all psychological adjustment outcomes: happiness (ΔR2 = 0.09, p = 0.002; β = 0.25, p = 0.001), positive affect (ΔR2 = 0.09, p = 0.002; β = 0.18, p = 0.014), depression (ΔR2 = 0.07, p = 0.004; β = -0.27, p < 0.001), negative affect (ΔR2 = 0.08, p = 0.007; β = -0.27, p < 0.001) and emotional overproduction (ΔR2 = 0.07, p = 0.013; β = -0.23, p = 0.001). CM session length was related to positive affect (β = 0.18, p = 0.011). CM practice frequency was associated with happiness (ΔR2 = 0.06, p = 0.038; β = 0.16, p = 0.041). Lifetime practice of FA was related to happiness (ΔR2 = 0.08, p = 0.007; β = 0.21, p = 0.030) and OM to emotional overproduction (ΔR2 = 0.08, p = 0.037; β = -0.19, p = 0.047). Religious beliefs and prayer seemed to be less relevant than meditation practices such as FA, OM, and CM in explaining psychological adjustment. The distinct meditation practices might be differentially related to distinct psychological adjustment outcomes through different practice-related variables. However, research into other forms of institutional religiosity integrating social aspects of religion is required.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445895/

 

Improve Chronic Fatigue Syndrome with Seated Yoga

psyjdc Leave a comment

Improve Chronic Fatigue Syndrome with Seated Yoga

 

By John M. de Castro, Ph.D.

 

“The benefits of yoga, in general, include loosening up muscles, joints, and connective tissues, and improving strength and balance. But is it right for ME/CFS, with post-exertional malaise plus other problematic symptoms such as dizziness and muscle pain? We don’t have a lot of research on yoga for ME/CFS, but what we do have suggests that it just might be.” – Adrienne Dellwo

 

Chronic Fatigue Syndrome (CFS) occurs in about 0.2% of the population. It produces a profound, prolonged, and debilitating tiredness. When severe, it can produce a chronic and extreme tiredness, so severe that sufferers can become bed-bound or need to use a wheel-chair. It produces muscle pain, brain fog and dizziness, poor memory, disturbed sleep and trouble with digestion. Unfortunately, there are no known cures for CFS. The usual treatments for fatigue are targeted at symptom relief and include exercise and drugs. As an alternative to these traditional treatments, mindfulness training has been shown to reduce fatigue. The mindfulness practice of Yoga also includes exercise and it has been shown to be an effective treatment for the symptoms of Chronic Fatigue Syndrome (CFS). But the mechanism is not known of how yoga may be affecting the symptoms of CFS.

 

In today’s Research News article “The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836361/), Oka and colleagues recruited adults with Chronic Fatigue Syndrome (CFS) and randomly assigned them to receive either 20 minute, twice a week, for 2 months seated yoga practice with daily home practice or to no further treatment. Both groups continued to receive pharmacotherapy. They were measured before and after treatment for fatigue, anxiety, depression, and alexithymia. In addition, blood was drawn and assayed for DHEA-S, PRL, and TNF-α. Heart rate variability was also measured with and electrocardiogram (EKG).

 

They found that in comparison to baseline and the control group, the seated yoga group had a large and significant decrease in fatigue and depression. Further they found that the greater the decrease in fatigue for the seated yoga group, the greater the decrease in TNF-α, in the high frequency component of heartrate variability, and in alexithymia.

 

These results suggest that seated yoga is effective in reducing fatigue and depression in patients with Chronic Fatigue Syndrome (CFS). The correlation analysis suggests that the reduction in fatigue is associated with decreases in inflammation (TNF-α) and an increase in the ability to sense emotions (decreased alexithymia). The correlations do not indicate causation. So, it is not clear if the changes in fatigue produced the reductions in inflammation and alexithymia, or the reverse, or a third factor is responsible. But it is clear that seated yoga practice improves fatigue and depression in patients with CFS.

 

This is important as Chronic Fatigue Syndrome (CFS) is relatively common and debilitating and pharmacological treatments are most often ineffective. The fact that yoga practice can improve the symptoms of CFS is encouraging. In addition, the fact that the yoga practice was performed in a seated position makes it better suited to patients with fatigue who lack the energy for more intense yoga practice. The results of this small pilot study further provide justification for performing a large randomized controlled trial. Seated yoga practice may be able to at least in part reduce the physical and psychological problems produced by CFS.

 

So, improve chronic fatigue syndrome with seated yoga.

 

“isometric yoga together with conventional therapy was more effective in relieving fatigue than was conventional therapy alone in patients with CFS who did not respond adequately to conventional therapy.” – Takakazu Oka

 

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

 

Oka, T., Tanahashi, T., Lkhagvasuren, B., & Yamada, Y. (2019). The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study. BioPsychoSocial medicine, 13, 28. doi:10.1186/s13030-019-0168-x

 

Abstract

Background

In a previous randomized controlled trial, we found that practicing seated isometric yoga regularly for 2 months improved the fatigue of patients with chronic fatigue syndrome (CFS) who are resistant to conventional therapy. The aim of this pilot study was to investigate the possible mechanisms behind this finding by comparing blood biomarkers, autonomic nervous function, and psychological indices before versus after an intervention period of seated isometric yoga practice.

Methods

Fifteen patients with CFS who did not show satisfactory improvements after at least 6 months of conventional therapy practiced seated isometric yoga (biweekly 20-min sessions with a yoga instructor and daily practice at home) for 2 months. The longitudinal effects of seated isometric yoga on fatigue, blood biomarkers, autonomic function, and psychological state were investigated by comparing the following parameters before and after the intervention period: Fatigue severity was assessed by the Chalder fatigue scale (FS) score. Levels of the blood biomarkers cortisol, DHEA-S, TNF-α, IL-6, prolactin, carnitine, TGF-β1, BDNF, MHPG, HVA, and α-MSH were measured. The autonomic nervous functions assessed were heart rate (HR) and HR variability. Psychological indices included the 20-item Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS).

Results

Practicing seated isometric yoga for 2 months resulted in significant reductions in the Chalder FS (P = 0.002) and HADS-depression (P = 0.02) scores. No significant changes were observed in any other parameter evaluated. The change in Chalder FS score was not correlated with the change in HADS-depression score. However, this change was positively correlated with changes in the serum TNF-α levels (P = 0.048), the high frequency component of HR variability (P = 0.042), and TAS-20 scores (P = 0.001).

Conclusions

Regular practice of seated isometric yoga for 2 months reduced the fatigue and depressive symptom scores of patients with CFS without affecting any other parameters we investigated. This study failed to identify the markers responsible for the longitudinal fatigue-relieving effect of seated isometric yoga. However, considering that the reduced fatigue was associated with decreased serum TNF-α level and TAS-20 scores, fatigue improvement might be related to reduced inflammation and improved alexithymia in these patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836361/

 

Indications That the Mental Health of Relatives of Long-Missing Persons Can be Improves with Mindfulness

psyjdc Leave a comment

Indications That the Mental Health of Relatives of Long-Missing Persons Can be Improves with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness for grief is not about whitewashing your pain, or “getting over” your loss. It is about learning how to stay present, cultivate compassion, and make wise choices that will help you cope with this new normal known as life after loss.” – Mindfulness and Grief Institute

 

Grief is a normal, albeit complex, process that follows a loss of a significant person or situation in one’s life. This can involve the death of a loved one, a traumatic experience, termination of a relationship, relationship to a long-missing person, etc. Exactly what transpires depends upon the individual and the nature of the loss. It involves physical, emotional, psychological and cognitive processes. In about 15% of people grief can be overly intense or long and therapeutic intervention may become necessary.

 

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. This would seem to be an ideal treatment protocol to treat the intense emotions that occur when a loved one goes missing.

 

In today’s Research News article “Cognitive behavioural therapy and mindfulness for relatives of missing persons: a pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642737/), Lenferink and colleagues recruited “adults who experienced the disappearance of a spouse, family member, or friend more than 3 months.” They were randomly assigned to a wait-list or to receive 8 weekly sessions of an adapted form of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after training for grief, Post-Traumatic Stress Disorder (PTSD) symptoms, depressive symptoms, mindfulness, and presumed causes for disappearance.

 

This was a small pilot trial and as such there were insufficient participants to assess statistical reliability of the results. But the study proved that employing Mindfulness-Based Cognitive Therapy (MBCT) for people with long-missing relatives was feasible and acceptable. They found that on average following MBCT there were increases in mindfulness and decreases in grief, PTSD symptoms, and depressive symptoms.

 

These findings are encouraging although far from definitive. They demonstrate that providing Mindfulness-Based Cognitive Therapy (MBCT) treatment for relatives of missing persons is possible and appears to help relieve the suffering of these relatives. This suggests that a larger randomized controlled clinical trial should be attempted. These relatives of missing persons are suffering from grief, depression, and PTSD symptoms and MBCT may help ease this suffering.

 

So, there are indications that the mental health of relatives of long-missing persons can be improves with mindfulness.

 

“The pure practice of mindfulness is to bring your attention to exactly what is — whether that is pain or bliss, peace or torment — each moment, as it arises. At its core, mindfulness does not try to talk you out of anything, nor does it judge what you feel. It’s not a prescription for happiness. Mindfulness is meant to help you acknowledge the truth of the moment you’re in, even, or especially, when that moment hurts.” – Megan Devine

 

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

 

Lenferink, L., de Keijser, J., Wessel, I., & Boelen, P. A. (2019). Cognitive behavioural therapy and mindfulness for relatives of missing persons: a pilot study. Pilot and feasibility studies, 5, 93. doi:10.1186/s40814-019-0472-z

 

Abstract

Objectives

Relatives of long-term missing persons need to deal with uncertainties related to the disappearance. These uncertainties may give rise to ruminative thinking about the causes and consequences of the loss. Focusing on tolerating uncertainties in treatment of relatives of missing persons might foster recovery. Adding mindfulness to cognitive behavioural therapy might serve this aim. The feasibility and potential effectiveness of cognitive behavioural therapy with mindfulness were evaluated in a pilot study. We aimed to detect changes in symptom levels and mindfulness from pre-treatment to 1 week, 12 weeks, and 24 weeks post-treatment.

Method

Dutch adults who experienced the disappearance of a significant other more than 3 months earlier and scored above clinical thresholds for psychological distress were eligible to participate. Participants were recruited from January 2015 to July 2016. Participants in the immediate treatment group started treatment after 1 week after randomization, whereas waiting list controls started the treatment after 12 weeks of waiting. Data from self-report measures as well as clinical diagnostic interviews (tapping persistent complex bereavement disorder, major depressive disorder, and posttraumatic stress disorder) were gathered among 17 relatives of missing persons with elevated symptom levels.

Results

The response rate (31.7%) was low, and dropout rate (47.1%) high. Cognitive behavioural therapy with mindfulness coincided with changes in psychopathology levels (Hedges’ g 0.35–1.09) and mindfulness (Hedges’ g − 0.10–0.41). Participants completing the treatment were satisfied with treatment quality and reported high treatment compliance.

Conclusions

Because of the limited research about effective treatments for relatives of missing persons and promising results of small and/or uncontrolled trials examining the effect of mindfulness-based treatment to target grief-related complaints, it seems valuable to continue investigating the effects of cognitive behavioural therapy with mindfulness on reducing post-loss psychopathology in future research. However, in order to increase the feasibility of future trials among relatives of missing persons, we recommend collaborating internationally and/or extending duration of recruitment phase, to maximize the sample size.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642737/

 

Mindfulness Produces Long-Term Reductions in Depression and Depression Relapse

psyjdc Leave a comment

Mindfulness Produces Long-Term Reductions in Depression and Depression Relapse

 

By John M. de Castro, Ph.D.

 

“Instead of getting sucked into our emotions or our thoughts, which is what happens when we’re depressed or anxious, we see them as those thoughts again, or those feelings again, and that disempowers them.” – Daniel Goleman

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant 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. 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. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Attention Bias Modification (ABM) involves simple computerized training to increase attention to positive stimuli. It is not known if ABM might supplement Acceptance and Commitment Therapy (ACT) to further decrease depression relapse rates. In today’s Research News article “Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727662/), Østergaard and colleagues examined the combination of Acceptance and Commitment Therapy (ACT) and  Attention Bias Modification (ABM) to reduce depression relapse.

 

They recruited participants who had a history of depression but were not currently in a depressive episode. They were randomly assigned to receive a single session of either Attention Bias Modification (ABM) training or a control condition that was very similar except that attention to both positive and negative stimuli were equally reinforced. They were then assigned to either receive 8 once a week, 2.5 hour session of Acceptance and Commitment Therapy (ACT) or no treatment. Participants were measured before and after training and each month over the subsequent year for depression, depression relapse, and feasibility and acceptability of treatments.

 

They found that Attention Bias Modification (ABM) did not significantly affect depression or relapse. On the other hand, Acceptance and Commitment Therapy (ACT) with or without prior Attention Bias Modification (ABM) training produced significant reductions in both self-report and clinician reported levels of depression that continued to decline over the year follow-up period. They also found that over the 12-month follow-up 79% of the participants who received ACT training did not have another depressive episode while only 55% of the control participants did not have a relapse. Hence, ACT significantly reduces depression levels and depression relapse over a year following treatment.

 

These are impressive results. Acceptance and Commitment Therapy (ACT) is not only a safe and effective mindfulness-based treatment to reduce depression and depression relapse in people with a history of depression but also has a sustained impact lasting for at least a year following treatment. It is unusual for studies to have such long-term follow-up. It is important that ACT has such sustained benefits.

 

So, produce long-term reductions in depression and depression relapse with mindfulness.

 

“Mindfulness is a valuable practice for improving the cognitive symptoms of depression, such as distorted thinking and distractibility. It helps individuals recognize these more subtle symptoms, realize that thoughts are not facts and refocus their attention to the present.” –  Margarita Tartakovsky

 

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

 

Tom Østergaard, Tobias Lundgren, Ingvar Rosendahl, Robert D. Zettle, Rune Jonassen, Catherine J. Harmer, Tore C. Stiles, Nils Inge Landrø, Vegard Øksendal Haaland. Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up. Front Psychol. 2019; 10: 1995. Published online 2019 Aug 29. doi: 10.3389/fpsyg.2019.01995

 

Abstract

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants with a history of depression, currently in remission (N = 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N = 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727662/

 

Help Withdraw from Antidepressant Drugs with Mindfulness

psyjdc Leave a comment

Help Withdraw from Antidepressant Drugs with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness can help you deal with emotional symptoms of SSRI withdrawal. Techniques such as meditation and deep breathing can help you reduce levels of irritability by reminding you to slow down and step back from a situation before you react.” – Sarah Fader

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. It is usually treated with antidepressant 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.

 

It seems reasonable to use antidepressant drugs initially in the treatment of depression but then withdraw the drugs. But withdrawal effects can occur. Symptoms of antidepressant withdrawal are anxiety, insomnia or vivid dreams, headaches, dizziness, tiredness, irritability, flu-like symptoms, including achy muscles and chills, nausea, electric shock sensations, return of depression symptoms. Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs. And can help with antidepressant withdrawal.

 

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. MBCT has been found to be effective in treating depression. Hence, there is a need to study the application of MBCT to assist in the withdrawal of antidepressant medication.

 

In today’s Research News article “Managing Antidepressant Discontinuation: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342590/), Maund and colleagues review and summarize the published research studies of the effectiveness of various therapies including Mindfulness-Based Cognitive Therapy (MBCT) to assist in the withdrawal of patients from antidepressants. They found 15 published randomized controlled trials with 3 employing MBCT.

 

They report that the randomized controlled trials found that tapering off antidepressant drugs was far more successful than abrupt withdrawal and that psychological therapies significantly assisted in the success of the process, with successful cessation rates of 40% to 95% compared to 6% to 7% when the physician sent a letter recommending withdrawal. Mindfulness-Based Cognitive Therapy (MBCT) was found to have successful cessation rates of 55% to 75%. MBCT also did not increase relapse/recurrence rates with 44% to 48% relapse.

 

There were only three randomized controlled trials that employed Mindfulness-Based Cognitive Therapy (MBCT) to aid in antidepressant withdrawal and there were no studies that included discontinuation symptoms. So, conclusions must be tempered and measured. But the published research suggests that MBCT is is safe and effective in improving the likelihood of successful withdrawal from antidepressants without increasing the likelihood of relapse.

 

So, help withdraw from antidepressant drugs with mindfulness.

 

“Psychiatric medication is designed to alleviate suffering. Mindfulness can function in this way too. However, psychiatric medication is not generally designed to promote flourishing. . . . Mindfulness can alleviate distress, but it can also lead us states of flourishing and a sense of the deep completeness of the moment.” – Matthew Brensilver

 

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

 

Maund, E., Stuart, B., Moore, M., Dowrick, C., Geraghty, A., Dawson, S., & Kendrick, T. (2019). Managing Antidepressant Discontinuation: A Systematic Review. Annals of family medicine, 17(1), 52–60. doi:10.1370/afm.2336

 

Abstract

PURPOSE

We aimed to determine the effectiveness of interventions to manage antidepressant discontinuation, and the outcomes for patients.

METHODS

We conducted a systematic review with narrative synthesis and meta-analysis of studies published to March 2017. Studies were eligible for inclusion if they were randomized controlled trials, quasi-experimental studies, or observational studies assessing interventions to facilitate discontinuation of antidepressants for depression in adults. Our primary outcomes were antidepressant discontinuation and discontinuation symptoms. Secondary outcomes were relapse/recurrence; quality of life; antidepressant reduction; and sexual, social, and occupational function.

RESULTS

Of 15 included studies, 12 studies (8 randomized controlled trials, 2 single-arm trials, 2 retrospective cohort studies) were included in the synthesis. None were rated as having high risk for selection or detection bias. Two studies prompting primary care clinician discontinuation with antidepressant tapering guidance found 6% and 7% of patients discontinued, vs 8% for usual care. Six studies of psychological or psychiatric treatment plus tapering reported cessation rates of 40% to 95%. Two studies reported a higher risk of discontinuation symptoms with abrupt termination. At 2 years, risk of relapse/recurrence was lower with cognitive behavioral therapy plus taper vs clinical management plus taper (15% to 25% vs 35% to 80%: risk ratio = 0.34; 95% CI, 0.18–0.67; 2 studies). Relapse/recurrence rates were similar for mindfulness-based cognitive therapy with tapering and maintenance antidepressants (44% to 48% vs 47% to 60%; 2 studies).

CONCLUSIONS

Cognitive behavioral therapy or mindfulness-based cognitive therapy can help patients discontinue antidepressants without increasing the risk of relapse/recurrence, but are resource intensive. More scalable interventions incorporating psychological support are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342590/