Depression

Religion and Spirituality are Associated with Brain Difference is Individuals At-Risk for Major Depression

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Religion and Spirituality are Associated with Brain Difference is Individuals At-Risk for Major Depression

 

By John M. de Castro, Ph.D.

 

“There are two possible explanations. One is that a thicker cortex is more associated with being interested in spiritual questions, the connectedness of people, etc and is simultaneously protective against depression. The other is that a lifelong habit of meditating and/or contemplation of spirituality stimulates the metabolism and neurogeneration in areas of the brain that confer resilience to trauma and therefore reduce the risk of developing depression.” – Emily Deans

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. Spirituality has been promulgated as a solution to the challenges of life both in a transcendent sense and in a practical sense. 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 spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health.

 

One way that spirituality can have its effects on the individual is by altering the brain. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity.  Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread area. and have found that meditation practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits. So, religion and spirituality may be associated with changes in the nervous system.

 

In today’s Research News article “A diffusion tensor imaging study of brain microstructural changes related to religion and spirituality in families at high risk for depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379589/), Li and colleagues recruited adult (average 33 years old) offspring of patients with major depressive disorder (high risk) and offspring from individuals who have no psychiatric conditions (low risk). Their brains were scanned with a Magnetic Resonance Imaging (MRI) diffusion tensor imaging (DTI). They also completed a scale measuring the importance they ascribed to religion and spirituality.

 

They found that in participants who believed that religion / spirituality was of low importance but were of high risk for major depression had significantly decreased integrity and microstructure in white matter regions neighboring the precuneus, superior parietal lobe, superior and middle frontal gyrus, and bilateral insula, supplementary motor area, and postcentral gyrus. Participants who believed that religion / spirituality was of high importance and were of high risk for major depression had significantly decreased integrity and microstructure in white matter regions surrounding the left superior, and middle frontal gyrus, left superior parietal lobule, and right supplementary motor area.

 

These are complex findings that suggest that adults at high risk of developing major depression have lower integrity (functionality) of the connections between brain regions (white matter) potentially making them more susceptible for the development of major depression. These neural changes appear to be different depending upon the individuals’ beliefs of the importance of religion / spirituality. Religion / spirituality may be associated with reorganized connections that may be associated with protection from the development of major depression. This may be a mechanism by which religion / spirituality helps to protect individuals from developing major depression.

 

This is highly speculative and it will take much more research to test these ideas. But, nonetheless, the results suggest that how well the brain operates is damaged by having parents with major depressive disorder. But, being religious / spiritual may alter the disruptions of the brain protecting the individual from the development of a major depressive disorder.

 

“people with habitual spiritual practices show cortical thickening in the prefrontal cortex. Intriguingly, she says that individuals who live with chronic depression experience cortical thinning in the same brain region.” – Maria Cohut

 

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

 

Li, X., Weissman, M., Talati, A., Svob, C., Wickramaratne, P., Posner, J., & Xu, D. (2019). A diffusion tensor imaging study of brain microstructural changes related to religion and spirituality in families at high risk for depression. Brain and behavior, 9(2), e01209. doi:10.1002/brb3.1209

 

Abstract

Introduction

Previously in a three‐generation study of families at high risk for depression, we found that belief in the importance of religion/spirituality (R/S) was associated with thicker cortex in bilateral parietal and occipital regions. In the same sample using functional magnetic resonance imaging and electroencephalograph (EEG), we found that offspring at high familial risk had thinner cortices, increased default mode network connectivity, and reduced EEG power. These group differences were significantly diminished in offspring at high risk who reported high importance of R/S beliefs, suggesting a protective effect.

Methods

This study extends previous work examining brain microstructural differences associated with risk for major depressive disorder (MDD) and tests whether these are normalized in at‐risk offspring who report high importance of R/S beliefs. Diffusion tensor imaging (DTI) data were selected from 99 2nd and 3rd generation offspring of 1st generation depressed (high‐risk, HR) or nondepressed (low‐risk, LR) parents. Whole‐brain and region‐of‐interest analyses were performed, using ellipsoidal area ratio (EAR, an alternative diffusion anisotropy index comparable to fractional anisotropy). We examined microstructural differences associated with familial risk for depression within the groups of high and low importance of R/S beliefs (HI, LI).

Results

In the LI group, HR individuals showed significantly decreased EAR in white matter regions neighboring the precuneus, superior parietal lobe, superior and middle frontal gyrus, and bilateral insula, supplementary motor area, and postcentral gyrus. In the HI group, HR individuals showed reduced EAR in white matter surrounding the left superior, and middle frontal gyrus, left superior parietal lobule, and right supplementary motor area. Microstructural differences associated with familial risk for depression in precuneus, frontal lobe, and temporal lobe were nonsignificant or less significant in the HI group.

Conclusion

R/S beliefs may affect microstructure in brain regions associated with R/S, potentially conferring resilience to depression among HR individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379589/

 

Improve Physical and Mental Health in the Homebound Elderly with Qigong and Cognitive Behavioral Therapy

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Improve Physical and Mental Health in the Homebound Elderly with Qigong and Cognitive Behavioral Therapy

 

By John M. de Castro, Ph.D.

 

“tai chi provides plenty of health benefits at any age, but it is especially appropriate for seniors. It doesn’t require special equipment, it’s easy on the muscles and joints and it’s one of the best low-impact exercise programs out there.” – Perry Alleva

 

The aging process involves a systematic progressive decline in every system in the body, the brain included. This includes our mental abilities which decline with age including impairments in memory, attention, and problem-solving ability. It is inevitable and cannot be avoided. They’ve found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. Indeed, the brains of practitioners of meditation and yoga have been found to degenerate less with aging than non-practitioners. Tai Chi and Qigong have also been shown to be beneficial in slowing or delaying physical and mental decline with aging and to increase brain matter in the elderly.

 

Cognitive Behavioral Therapy (CBT) attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. This would also seem an appropriate therapy for the psychological and mental decline in the elderly. In today’s Research News article “The effect of Baduanjin qigong combined with CBT on physical fitness and psychological health of elderly housebound.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320153/), Jing and colleagues compare the effectiveness of Qigong practice and Cognitive Behavioral Therapy (CBT) and their combination for the treatment of physical and mental problems of the housebound elderly.

 

They recruited elderly (over 60 years of age) who were housebound (left the house once per week or fewer over a period of at least 6 months) and randomly assigned them to receive either Qigong practice, Cognitive Behavioral Therapy (CBT), or their combination. They received the intervention at home for 1 to 1.5 hours per visit twice a month for the first 3 months and once a month for the next three months. They were encouraged to practice at home daily. They were measured before, at 3 months, and after the intervention for pulmonary function, activities of daily living, subjective health, loneliness, depression, quality of life and the housebound scale.

 

They found at the end of the intervention that all groups had significant improvements in their lung function, their daily activities, subjective health, loneliness, depression, and quality of life. They also found that the combined Qigong and CBT group was significantly less housebound (lest the house more often), lonely, and depressed, and had significantly greater subjective health than either of the treatments separately.

 

The results are very positive but the lack of an active control condition leaves open the possibility of attention effects, placebo effects, and experimenter bias. Indeed. the housebound elderly would be expected to react very positively to home visits and this by itself could improve their mental state. But the results suggest that although Qigong practice and Cognitive Behavioral Therapy (CBT) are effective treatments to improve the physical and psychological state of the housebound elderly, the combination of the two produces even greater benefits. The fact that their benefits are additive suggests the Qigong practice and CBT work by differing mechanisms.

 

Qigong is gentle and safe, is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed alone, at home, and can be quickly learned. So, Qigong practices would appear to be an excellent gentle practice to treat housebound elderly individuals and its effectiveness can be significantly increased by combining it with and Cognitive Behavioral Therapy (CBT).

 

So, improve physical and mental health in the homebound elderly with Qigong and cognitive behavioral therapy.

 

“research into the benefits of tai chi for seniors indicates that with regular practice, individuals may relieve the symptoms of chronic pain, anxiety, and depression, improve coordination, reducing the number of falls, improve everyday physical functioning, which promotes independent living, reduce arthritis pain, joint stiffness, and high blood pressure, maintain a healthy bone density level to reduce breakage, improve overall fitness.” – Tracey Kelly

 

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

 

 

Jing, L., Jin, Y., Zhang, X., Wang, F., Song, Y., & Xing, F. (2018). The effect of Baduanjin qigong combined with CBT on physical fitness and psychological health of elderly housebound. Medicine, 97(51), e13654. doi:10.1097/MD.0000000000013654

 

Abstract

Background:

To investigate the effectiveness of Baduanjin qigong combined with cognitive-behavior therapy (CBT) on the physical fitness and psychological health of elderly housebound.

Materials and methods:

The 120 elderly housebound were randomly divided into 3 intervention groups: Baduanjin training, Baduanjin training combined with CBT, and CBT. The interventions were conducted by means of home visits over 6 months. Spirometry, SF-36 health survey of quality of life, and Lawton and Brody Instrumental Activities of Daily Living Scale (IADL) were used to collect physical health data, and self-evaluation of overall health status, self-evaluation of loneliness, and short-form geriatric depression scale (GDS-15) were used to collect mental health data at baseline, 3 months, and 6 months after intervention. Data was analyzed by repeated measures analysis of variance (rANOVA) and chi-squared test (χ2 test).

Results:

Forced vital capacity (FVC), maximum voluntary ventilation (MVV), quality of life (QOL), and self-reported health status were significantly increased (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group. Activities of daily living (ADL), self-evaluated loneliness, and level of depression were significantly lowered (P < .05) in the group receiving joint Baduanjin and CBT intervention at 3 months and 6 months, as compared to the Baduanjin only group or the CBT only group.

Conclusions:

Physical and psychological statuses of elderly housebound were significantly improved by Baduanjin training combined with CBT. The effect of the combined intervention exceeded that of CBT or Baduanjin alone.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320153/

 

Improve Depression, Anxiety, and Stress Symptoms and Lower Rumination with Mindfulness

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Improve Depression, Anxiety, and Stress Symptoms and Lower Rumination with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based practices have proved to be helpful in promoting mental well-being, especially by reducing the symptoms of depression and anxiety in various populations.” – Han Ding

 

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. There is a vast array of techniques for the development of mindfulness that include a variety of forms of meditation, yoga, mindful movements, contemplative prayer, and combinations of practices.

 

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. Another therapeutic technique is Compassion Focused Therapy (CFT). “It seeks to help individuals develop compassion for self and others . . . and includes cultivating mindfulness and body awareness. . . . MBCT puts the primary focus on cultivating mindfulness whereas CFT puts it on cultivating compassion toward self and others.”

 

In today’s Research News article “Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients With Depression, Anxiety, and Stress.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01099/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_999212_69_Psycho_20190528_arts_A), Frostadottir and colleagues recruited patients at a 4-week inpatient rehab clinic who were suffering from mild to moderate depression, anxiety, or stress symptoms. They were assigned to receive twice a week 2 hour sessions for 4 weeks of either Mindfulness-Based Cognitive Therapy (MBCT), Compassion Focused Therapy (CFT), or a wait-list control condition. They were measured before and after treatment and one month later for mindfulness, self-compassion, rumination, anxiety, depression, and stress.

 

They found that in comparison to baseline and the wait-list control group, the groups that received either Mindfulness-Based Cognitive Therapy (MBCT) or Compassion Focused Therapy (CFT) demonstrated significantly lower levels of rumination, anxiety, depression, and stress and significantly higher levels of mindfulness and self-compassion. These improvements were still present and significant at the 1-month follow-up. Those participants who were high in rumination had significantly higher posttreatment mindfulness for the MBCT group while CFT produced higher mindfulness regardless of rumination.

 

Since there wasn’t an active control group placebo effects and experimenter bias are possible alternative explanations for the changes. Other research however has routinely demonstrated that mindfulness training produces lower levels of anxiety, depression, stress symptoms, and rumination and higher levels of self-compassion and mindfulness. Hence, it is likely that the benefits seen in the present study were due to the interventions and not to artifact.

 

The results suggest that both Mindfulness-Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) are beneficial for the mental health of patients with mild to moderate depression, anxiety, or stress symptoms. Since, both therapies train mindfulness and both successfully increased mindfulness, it would appear that mindfulness training in general is beneficial to patients with mild to moderate mental health issues. So, the present study adds to the large literature demonstrating the benefits of mindfulness for psychological health.

 

So, improve depression, anxiety, and stress symptoms and lower rumination with mindfulness.

 

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

 

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

 

Frostadottir AD and Dorjee D (2019) Effects of Mindfulness Based Cognitive Therapy (MBCT) and Compassion Focused Therapy (CFT) on Symptom Change, Mindfulness, Self-Compassion, and Rumination in Clients With Depression, Anxiety, and Stress. Front. Psychol. 10:1099. doi: 10.3389/fpsyg.2019.01099

 

Objectives: Over the past decade there has been an increasing interest in exploring self-compassion as a related and complementary construct to mindfulness. Increases in self-compassion may predict clinical outcomes after MBCT and cultivation of compassion toward self and others is central to CFT. This pilot study compared the impact of MBCT applying implicit self-compassion instructions and CFT employing explicit self-compassion instructions on symptom change, mindfulness, self-compassion, and rumination.

Method: This non-randomized wait-list controlled study (N = 58) with two intervention arms (MBCT N = 20, CFT N = 18, Control N = 20) assessed the outcomes of clients with depression, anxiety, and stress symptoms from before to after the interventions and at one month follow up (MBCT N = 17, CFT N = 13, Control N = 13).

Results: Both treatments resulted in significant increases in mindfulness and self-compassion and decreases in rumination, depression, anxiety, and stress. Furthermore, MBCT enhanced mindfulness for people who were initially high in rumination, whereas CFT enhanced mindfulness across the board.

Conclusion: The findings suggest that both MBCT and CFT, and hence implicit or explicit self-compassion instructions, produce similar clinical outcomes with CFT enhancing mindfulness regardless of client’s rumination level.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01099/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_999212_69_Psycho_20190528_arts_A

 

Alter the Brain to Deal with Stress with Meditation and Yoga

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Alter the Brain to Deal with Stress with Meditation and Yoga

 

By John M. de Castro, Ph.D.

 

“Brain researchers have detected improvements in cognition and emotional well-being associated with meditation and yoga, as well as differences in how meditation and prayer affect the brain.” – Michaela Jarvis

 

There has accumulated a large amount of research demonstrating that mindfulness has significant benefits for psychological, physical, and spiritual wellbeing. One way that mindfulness practices may produce these benefits is by altering the brain. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, mindfulness practice appears to mold and change the brain, producing psychological, physical, and spiritual benefits.

 

In today’s Research News article “Meditation and yoga practice are associated with smaller right amygdala volume: the Rotterdam study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6302143/), Gotink and colleagues utilized the data on participants in the longitudinal Rotterdam Study who were 45 years of age and older  at the time of recruitment and at the time of measurement had a mean age of 64 years. They were interviewed to determine if the practiced meditation and yoga and whether these practices improved their coping with stress. They were also measured for body size, blood pressure, blood fat, diabetes, smoking, alcohol use, stress, anxiety, and depression. In addition, their brains were scanned with Magnetic Resonance Imaging (MRI).

 

They found that practitioners of meditation and yoga reported higher stress levels than non-practitioners, but reported that the practice helped them cope with the stress. In addition, meditation practitioners had higher depression levels than non-practitioners. It is possible that people who are under high levels of stress or are depressed tend to engage in meditation and yoga practices to help cope with it.

 

They also report that the practitioners had smaller volumes of the brain structures right side amygdala and left hippocampus. In addition, over a five-year period the practitioners had a significant decrease in amygdala volume. The amygdala is associated with negative emotions and its smaller volume may suggest fewer or weaker negative emotions in practitioners.

 

This was a cross-sectional study and causation cannot be determined. It is possible that people with certain types of brains are more likely to practice. It will require a randomized controlled trial to determine what effects yoga and meditation practice may have on the psychological state and nervous system volumes.

 

Alter the brain to deal with stress with meditation and yoga.

 

“Studies show that yoga increases relaxation in the brain, improves areas of the brain that help us manage pain, and protects us against age-related decline. Together, these benefits begin to reveal the scientifically validated effects of yoga practice on brain health.” – Angela Wilson

 

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

 

Gotink, R. A., Vernooij, M. W., Ikram, M. A., Niessen, W. J., Krestin, G. P., Hofman, A., … Hunink, M. (2018). Meditation and yoga practice are associated with smaller right amygdala volume: the Rotterdam study. Brain imaging and behavior, 12(6), 1631–1639. doi:10.1007/s11682-018-9826-z

 

Abstract

To determine the association between meditation and yoga practice, experienced stress, and amygdala and hippocampal volume in a large population-based study. This study was embedded within the population-based Rotterdam Study and included 3742 participants for cross-sectional association. Participants filled out a questionnaire assessing meditation practice, yoga practice, and experienced stress, and underwent a magnetic resonance scan of the brain. 2397 participants underwent multiple brain scans, and were assessed for structural change over time. Amygdala and hippocampal volumes were regions of interest, as these are structures that may be affected by meditation. Multivariable linear regression analysis and mixed linear models were performed adjusted for age, sex, educational level, intracranial volume, cardiovascular risk, anxiety, depression and stress. 15.7% of individuals participated in at least one form of practice. Those who performed meditation and yoga practices reported significantly more stress (mean difference 0.2 on a 1–5 scale, p < .001) and more depressive symptoms (mean difference 1.03 on CESD, p = .015). Partaking in meditation and yoga practices was associated with a significantly lower right amygdala volume (β = − 31.8 mm3, p = .005), and lower left hippocampus volume (β = − 75.3 mm3, p = .025). Repeated measurements using linear mixed models showed a significant effect over time on the right amygdala of practicing meditation and yoga (β = − 24.4 mm3, SE 11.3, p = .031). Partaking in meditation and yoga practice is associated with more experienced stress while it also helps cope with stress, and is associated with smaller right amygdala volume.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6302143/

 

Produce Long-Term Improvements in Depression and Insulin Resistance in Adolescents with Mindfulness

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Produce Long-Term Improvements in Depression and Insulin Resistance in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“So like with so many topics related to type 2 diabetes, insulin resistance can be avoided, and reversed, through living healthfully and mindfully.” – Defeat Diabetes Foundation

 

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

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. This suggests that mindfulness training may be able to reduce insulin resistance in adolescents at risk for Type II diabetes.

 

In today’s Research News article “One-Year Follow-Up of a Randomized Controlled Trial Piloting a Mindfulness-Based Group Intervention for Adolescent Insulin Resistance.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01040/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_990182_69_Psycho_20190516_arts_A), Shomaker and colleagues recruited overweight and obese adolescent girls (12-17 years of age) with a family history of Type II Diabetes. They were randomly assigned to receive a 6-week program of either a mindfulness-based intervention (MBI) or a cognitive behavioral therapy (CBT) depression prevention. They were measured before and after the interventions and 1-year later for mindfulness, insulin resistance, depression, body size, and body fat.

 

They found that 1 year after the interventions only the mindfulness group had significant improvement in insulin resistance. Although both groups had significant decreases in depression, the mindfulness group had significantly greater decreases than the CBT group. These findings are consistent with prior findings by this research group. But these results demonstrate that the effectiveness of mindfulness training is lasting. This suggests that mindfulness training should be recommended for adolescent girls who are overweight and obese and with a family history of Type II Diabetes. This may prevent the onset of type II diabetes in this at-risk group.

 

So, produce long-term improvements in depression and insulin resistance in adolescents with mindfulness.

 

“Research shows that meditation actually helps the body regulate blood sugar by using insulin more efficiently. The stress hormone cortisol is a major contributor to insulin resistance, and meditation leads to lower cortisol levels, which in turn allows insulin to do its job properly.” – Avi Craimer

 

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

 

Shomaker LB, Pivarunas B, Annameier SK, Gulley L, Quaglia J, Brown KW, Broderick P and Bell C (2019) One-Year Follow-Up of a Randomized Controlled Trial Piloting a Mindfulness-Based Group Intervention for Adolescent Insulin Resistance. Front. Psychol. 10:1040. doi: 10.3389/fpsyg.2019.01040

 

Introduction: To explore if a brief mindfulness-based intervention (MBI) leads to sustained, improved clinical outcomes in adolescents at-risk for type 2 diabetes (T2D).

Methods: Participants were 12–17y girls with overweight/obesity, elevated depression symptoms, and T2D family history participating in a randomized, controlled pilot trial of a six-session MBI vs. cognitive-behavioral therapy (CBT) group. At baseline and 1-year, mindfulness, depression, insulin resistance (IR), and body composition were assessed with validated instruments.

Results: One-year retention was 71% (n = 12) in MBI; 81% (n = 13) in CBT. At 1-year, depression decreased (Cohen’s d = 0.68) and IR decreased (d = 0.73) in adolescents randomized to MBI compared to those in CBT. There were no significant between-condition differences in mindfulness, adiposity, or BMI.

Discussion: One-year outcomes from this randomized, controlled pilot trial suggest that brief MBI may reduce depression and IR in at-risk adolescents. Replication and exploration of mechanisms within the context of a larger clinical trial are necessary.

https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01040/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_990182_69_Psycho_20190516_arts_A

 

Improve the Mental Health on Intensive Care Nurses with Mindfulness

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Improve the Mental Health on Intensive Care Nurses with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Nurses are particularly vulnerable to stress and burnout, with little time in their schedule to commit to self-care or intensive stress reduction programs” . . . on-the-job mindfulness-based intervention is viable for this nursing population. In addition to reductions in stress and burnout, participants also reported improved job satisfaction and self-compassion.” Mindful USC

 

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

 

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

 

In today’s Research News article “Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482227/), Lu and colleagues recruited intensive care nurses and had them complete measures of burnout, mindfulness, anxiety, depression, perceived stress, and subjective well-being. The measure of subjective well-being is a composite that includes a high level of satisfaction with life, more positive emotions, and fewer negative emotions.

 

They found that the higher the nurses’ levels of mindfulness the better the nurses’ mental health including lower levels of anxiety, depression, perceived stress, negative emotions and burnout and higher levels of subjective well-being, life satisfaction and positive emotions. They also found that the greater the levels of perceived stress the worse the nurses’ mental health including greater levels of burnout, negative emotions, anxiety, and depression, and lower levels of mindfulness, satisfaction with life, positive emotions, and life satisfaction. In addition, they found that mindfulness moderated the negative effects of perceived stress such that when mindfulness was high, perceived stress had a smaller relationship with emotional exhaustion, depression, anxiety, and negative affect and a larger relationship with positive affect.

 

In interpreting these results, it needs to be recognized that the study was correlational and as such causation cannot be determined. But previous research has already established that mindfulness produces reductions in burnout, anxiety, depression, perceived stress, and negative emotions and produces increases in life satisfaction, positive emotions, and subjective well-being. So, it is reasonable to conclude that the present findings were due to the causal effects of mindfulness. But the present findings add to this knowledge by showing that mindfulness not only directly improves the psychological state of the nurses but also acts to reduce the negative impact of stress.

 

These effects of mindfulness are important as burnout in high stress occupations like nursing is all too common. The results suggest that mindfulness training should be routinely administered to intensive care nurses to improve their well-being and mental health and reduce the likelihood that they will experience burnout.

 

So, improve the mental health on intensive care nurses with mindfulness.

 

Learning mindfulness also helped the ICU personnel to “become aware of what their individual stress response is” and to “practice flexibility in cultivating alternative ways” of dealing with chronic stress.” – Marianna Klatt

 

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

 

Lu, F., Xu, Y., Yu, Y., Peng, L., Wu, T., Wang, T., … Li, M. (2019). Moderating Effect of Mindfulness on the Relationships Between Perceived Stress and Mental Health Outcomes Among Chinese Intensive Care Nurses. Frontiers in psychiatry, 10, 260. doi:10.3389/fpsyt.2019.00260

 

Abstract

This study aimed to explore the potential moderating effect of mindfulness and its facets on the relationships among perceived stress and mental health outcomes (burnout, depression, anxiety, and subjective well-being) among Chinese intensive care nurses. A total of 500 Chinese intensive care nurses completed self-report measures of mindfulness, burnout syndromes, perceived stress, depression, anxiety, and subjective well-being. Correlation and hierarchical multiple regressions were applied for data analysis. Mindfulness moderated the effects of perceived stress on emotional exhaustion (the core component of burnout syndrome), depression, anxiety, positive affect, and negative affect but not on the other two dimensions of burnout and life satisfaction. Further analyses indicated that the ability to act with awareness was particularly crucial in improving the effects of perceived stress on depression. These results further broaden our understanding of the relationships between perceived stress and burnout, depression, anxiety, and subjective well-being by demonstrating that mindfulness may serve as a protective factor that alleviates or eliminates the negative effects of perceived stress on depression, anxiety, burnout syndrome, and subjective well-being and may instigate further research into targeted mindfulness interventions for Chinese intensive care nurses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482227/

 

Improve Cancer-Related Symptoms in Cancer Survivors with Tai Chi

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Improve Cancer-Related Symptoms in Cancer Survivors with Tai Chi

 

By John M. de Castro, Ph.D.

 

“In terms of the evidence that’s out there and the scientific literature, practices such as tai chi have been found to help improve patients’ quality of life. There are some studies showing that these types of mind-body practices can also have an impact on physiological functioning, improving aspects of immune function and decreasing stress hormones.” – Lorenzo Cohen

 

Receiving a diagnosis of cancer has a huge impact on most people. 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. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. It is estimated that 15 million adults and children with a history of cancer are alive in the United States today. But, surviving cancer carries with it a number of problems. “Physical, emotional, and financial hardships often persist for years after diagnosis and treatment. Cancer survivors are also at greater risk for developing second cancers and other health conditions.” National Cancer Survivors Day.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. They are very gentle and safe practices. The research is accumulating. So, it makes sense to take a step back and summarize what has been found in regard to Tai Chi practice for the treatment of cancer survivors.

 

In today’s Research News article “Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958892/), Wayne and colleagues review, summarize, and perform a meta-analysis of the effectiveness of Tai Chi practice in relieving cancer-related symptoms in cancer survivors. They identified 22 published research studies that included a total of 1571 cancer survivors. 15 of the studies were randomized controlled trials investigating survivors of a variety of cancers including breast, prostate lymphoma, lung, and multiple cancers.

 

They report that in general the research studies demonstrated a significant reduction in fatigue, sleep difficulty, depression , and quality of life resulting from Tai Chi practice. No significant improvements in pain were observed. No adverse events were reported. Hence, the research suggests that Tai Chi practice is a safe and effective treatment for cancer-related symptoms in cancer survivors. Tai Chi practice appears to benefit the mental and physical health of the survivors.

 

The results of the published research strongly suggests that Tai Chi  practice should be routinely prescribed for survivors of cancer. Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an excellent gentle practice to improve the well-being of cancer survivors.

 

So, improve cancer-related symptoms in cancer survivors with Tai Chi.

 

“Tai chi does not treat the cancer itself. Research suggests that tai chi can help lower blood pressure, reduce stress, ease pain and stiffness and improve sleep. Small studies have shown that regular tai chi may help with depression and improve self-esteem. These studies have also suggested that regular practice of tai chi can improve quality of life.” – Canadian Cancer Society

 

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

 

Wayne, P. M., Lee, M. S., Novakowski, J., Osypiuk, K., Ligibel, J., Carlson, L. E., & Song, R. (2017). Tai Chi and Qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. Journal of cancer survivorship : research and practice, 12(2), 256–267. doi:10.1007/s11764-017-0665-5

 

Abstract

Purpose

Summarize and critically evaluate the effects of Tai Chi and Qigong (TCQ) mind-body exercises on symptoms and quality of life (QOL) in cancer survivors.

Methods

A systematic search in 4 electronic databases targeted randomized and non-randomized clinical studies evaluating TCQ for fatigue, sleep difficulty, depression, pain, and quality of life (QOL) in cancer patients, published through August 2016. Meta-analysis was used to estimate effect sizes (ES, Hedges’ g) and publication bias for randomized controlled trials (RCTs). Methodological bias in RCTs was assessed.

Results

Our search identified 22 studies, including 15 RCTs that evaluated 1283 participants in total, 75% women. RCTs evaluated breast (n=7), prostate (n=2), lymphoma (n=1), lung (n=1), or combined (n=4) cancers. RCT comparison groups included active intervention (n=7), usual care (n=5), or both (n=3). Duration of TCQ training ranged from 3 to 12 weeks. Methodological bias was low in 12 studies and high in 3 studies. TCQ was associated with significant improvement in fatigue [ES=−0.53, p<.001], sleep difficulty [ES=−0.49, p=.018], depression [ES=−0.27, p=.001], and overall QOL [ES=0.33, p=.004]; a statistically non-significant trend was observed for pain [ES=−0.38, p=.136]. Random effects models were used for meta-analysis based on Q-test and I-squared criteria. Funnel plots suggest some degree of publication bias. Findings in non-randomized studies largely paralleled meta-analysis results.

Conclusions

Larger and methodologically sound trials with longer follow-up periods and appropriate comparison groups are needed before definitive conclusions can be drawn, and cancer- and symptom-specific recommendations can be made.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958892/

 

Improve Mental Health and Well-Being of College Students with Mindfulness

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Improve Mental Health and Well-Being of College Students with 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.” – Todd Braver

 

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 students to excel so that they can be admitted to the best universities and 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.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students. So, it would seem important to examine various techniques to relieve the stress and its consequent symptoms in college students.

 

In today’s Research News article “The Effects of Meditation, Yoga, and Mindfulness on Depression, Anxiety, and Stress in Tertiary Education Students: A Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491852/), Breedvelt and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of mindfulness practices for the mental health and well-being of college students. They identified 23 published studies employing a total of 1373 students.

 

They found that the published research reported that in comparison to baseline and no-treatment or wait-list control conditions mindfulness practices including meditation, mindfulness, and yoga practice produced significant reductions in anxiety, depression, and perceived stress. The effects were still present as much as 24 months later. They did not find any significant differences in the effectiveness of the various practices. These effects were most evident when mindfulness practices were compared to no-treatment or wait-list control conditions. When compared to active controls (drugs, exercise, Cognitive Behavioral Therapy) the effects were much smaller and non-significant.

 

The results suggest that there are many practices including mindfulness, exercise, or other therapies that are effective in improving the mental health of college students. Mindfulness practices are safe and effective treatments but so are other treatments. It would appear that it doesn’t matter so much what treatment is employed, but that some treatment occurs.

 

So, improve mental health and well-being of college students with mindfulness.

 

“a mindfulness intervention can help reduce distress levels in college students during a stressful exam week, as well as increase altruistic action in the form of donating to charity.” – J. Galante–

 

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

 

Breedvelt, J., Amanvermez, Y., Harrer, M., Karyotaki, E., Gilbody, S., Bockting, C., … Ebert, D. D. (2019). The Effects of Meditation, Yoga, and Mindfulness on Depression, Anxiety, and Stress in Tertiary Education Students: A Meta-Analysis. Frontiers in Psychiatry, 10, 193. doi:10.3389/fpsyt.2019.00193

 

Abstract

Background: Meditation, yoga, and mindfulness are popular interventions at universities and tertiary education institutes to improve mental health. However, the effects on depression, anxiety, and stress are unclear. This study assessed the effectiveness of meditation, yoga, and mindfulness on symptoms of depression, anxiety, and stress in tertiary education students.

Methods: We searched Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, PsycINFO and identified 11,936 articles. After retrieving 181 papers for full-text screening, 24 randomized controlled trials were included in the qualitative analysis. We conducted a random-effects meta-analysis amongst 23 studies with 1,373 participants.

Results: At post-test, after exclusion of outliers, effect sizes for depression, g = 0.42 (95% CI: 0.16–0.69), anxiety g = 0.46 (95% CI: 0.34–0.59), stress g = 0.42 (95% CI: 0.27–0.57) were moderate. Heterogeneity was low (I2 = 6%). When compared to active control, the effect decreased to g = 0.13 (95% CI: −0.18–0.43). No RCT reported on safety, only two studies reported on academic achievement, most studies had a high risk of bias.

Conclusions: Most studies were of poor quality and results should be interpreted with caution. Overall moderate effects were found which decreased substantially when interventions were compared to active control. It is unclear whether meditation, yoga or mindfulness affect academic achievement or affect have any negative side effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491852/

 

Improve Major Mental Illnesses with Mindfulness and Yoga

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Improve Major Mental Illnesses with Mindfulness and Yoga

 

By John M. de Castro, Ph.D.

 

“for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. Indeed, the scientific study of yoga demonstrates that mental and physical health are not just closely allied, but are essentially equivalent. The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.” – Harvard Health

 

There are vast numbers of people who suffer with mental illnesses. In the United states it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Hence, it appears that mindfulness practices are safe and effective treatments for a variety of psychiatric conditions including anxiety, depression, psychoses, addictions, etc..

 

Yoga practice is a mindfulness practice that includes beneficial exercise. There is accumulating research that mindfulness and yoga practices may be beneficial for patients with major mental illnesses. Hence it makes sense to step back and summarize what has been learned regarding the effectiveness of yoga practice for major mental illnesses.

 

In today’s Research News article “Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/), Sathyanarayanan and colleagues reviewed and summarized published research studies of the effects of mindfulness and yoga practices for the treatment of major mental illnesses including schizophrenia, psychosis, major depression, and bipolar disorder. They identified 49 published studies.

 

They report that the research finds that yoga practice is effective in improving the symptoms of schizophrenia including reducing emotional and social withdrawal, and improving flat emotions, rapport, spontaneity, and cognitive functions, including attention and cognitive flexibility. There were also significant improvements in social and occupational functioning, quality of life, achieving functional remission, subjective well-being, personal hygiene, life skills, interpersonal activities, and communication. Mindfulness-Based treatments were also effective in improving the symptoms of schizophrenia including stress, anxiety, depression, obsession, anger, impulsivity, lack of concentration, agoraphobic symptoms, awareness of the psychotic experiences and helps individuals to articulate their distress.

 

Yoga and mindfulness practices have been shown to significantly improve bipolar disorder including improvements in cognitive, emotional, and physical domains. Yoga and mindfulness practices have also been shown to improve the symptoms of major depressive disorder, including significant reductions in depression and anxiety and increases in activation. They have also been shown to reduce depression in Post-Traumatic Stress Disorder (PTSD).

 

In most of the reviewed studies the patients continued drug treatments and yoga and mindfulness trainings were provided in addition to the drug treatments. This suggests that both yoga and mindfulness practices are safe and effective adjunctive treatment for major mental illnesses. This is particularly significant as these illnesses are particularly difficult to treat. Hence, the additional benefits of yoga and mindfulness practices are very important and welcome in the treatment of these debilitating conditions.

 

So, improve major mental illnesses with mindfulness and yoga.

 

“Yoga is incredible in terms of stress management. It brings a person back to homeostasis [or equilibrium]. For people who have anxieties of many kinds, yoga helps lower their basic physiological arousal level.” – Eleanor Criswell

 

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

 

Sathyanarayanan, G., Vengadavaradan, A., & Bharadwaj, B. (2019). Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review. International journal of yoga, 12(1), 3–28. doi:10.4103/ijoy.IJOY_65_17

 

Abstract

Background:

Yoga has its origin from the ancient times. It is an integration of mind, body, and soul. Besides, mindfulness emphasizes focused awareness and accepting the internal experiences without being judgemental. These techniques offer a trending new dimension of treatment in various psychiatric disorders.

Aims:

We aimed to review the studies on the efficacy of yoga and mindfulness as a treatment modality in severe mental illnesses (SMIs). SMI includes schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD).

Methods:

We conducted a literature search using PubMed, Google Scholar, and Cochrane Library with the search terms “yoga,” “meditation,” “breathing exercises,” “mindfulness,” “schizophrenia spectrum and other psychotic disorders,” “depressive disorder,” and “bipolar disorder” for the last 10-year period. We also included relevant articles from the cross-references.

Results:

We found that asanas and pranayama are the most commonly studied forms of yoga for schizophrenia. These studies found a reduction in general psychopathology ratings and an improvement in cognition and functioning. Some studies also found modest benefits in negative and positive symptoms. Mindfulness has not been extensively tried, but the available evidence has shown benefits in improving psychotic symptoms, improving level of functioning, and affect regulation. In MDD, both yoga and mindfulness have demonstrated significant benefit in reducing the severity of depressive symptoms. There is very sparse data with respect to BD.

Conclusion:

Both yoga and mindfulness interventions appear to be useful as an adjunct in the treatment of SMI. Studies have shown improvement in the psychopathology, anxiety, cognition, and functioning of patients with schizophrenia. Similarly, both the techniques have been established as an effective adjuvant in MDD. However, more rigorously designed and larger trials may be necessary, specifically for BD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/

 

Improve Major Depressive Disorder with Mindfulness and Cognitive Therapy

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Improve Major Depressive Disorder with Mindfulness and Cognitive Therapy

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation may help to prevent major depressive disorder in people with subclinical depression.” – Jasmin Collier

 

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.

 

Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs. Cognitive Behavioral Therapy (CBT) has been particularly effective for depression. Cognitive Behavioral Therapy attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. Recently, mindfulness has been added to produce Mindfulness Based Cognitive Therapy (MBCT) and this also has been found to be effective in treating depression. It is important at this point to step back and review the published studies of the application of CBT and MBCT for the prevention of relapse in patients who are in remission from major depressive disorder.

 

In today’s Research News article “The effect of CBT and its modifications for relapse prevention in major depressive disorder: a systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389220/), Zhang and colleagues review, summarize, and perform a meta-analysis of the relative effectiveness of Cognitive Behavioral Therapy (CBT) and Mindfulness Based Cognitive Therapy (MBCT) for the prevention of relapse in patients who are in remission from major depressive disorder. They found 16 randomized controlled trials with adults who were in remission from diagnosed major depressive disorder.

 

They report that the research found that Cognitive Behavioral Therapy (CBT) was effective in preventing relapse of major depressive disorder in comparison to control conditions even at long-term (up to 6 years) follow-up. They also found that Mindfulness Based Cognitive Therapy (MBCT) was effective in preventing relapse of major depressive disorder in comparison to control conditions but only for patients who had at least 3 prior depressive episodes. They also report that MBCT had equivalent ability to antidepressant drugs for preventing relapses.

 

The published literature presents a clear case for the effectiveness of both Cognitive Behavioral Therapy (CBT) and Mindfulness Based Cognitive Therapy (MBCT) for the prevention of relapse of major depressive disorder. CBT would appear to be effective even for patients who had only one or two prior episodes while MBCT appeared to be effective for patients with a longer history of relapse. Since MBCT contains CBT it is surprising that while CBT was effective for patients with few relapses MBCT was not. This will require further research to clarify this apparent conundrum.

 

Regardless, it is clear from the published controlled research that CBT and MBCT have long-lasting effectiveness for preventing relapse in patients with major depressive disorder and are equivalent to the effectiveness of antidepressant drugs. They may be an excellent substitute for employing drugs. The results suggest that restructuring the aberrant thought processes characteristic of patients with depression is an effective way to prevent relapse. This further suggests that these aberrant thought processes may be an important contributor to causing depression relapse.

 

So, improve major depressive disorder with mindfulness and cognitive therapy.

 

“mindfulness training seems to be a feasible way for people with mild or subthreshold depression to protect against their symptoms getting worse. . . . Mindfulness training can “generate positive emotions by cultivating self-compassion and self-confidence through an upward spiral process,” – Amanda MacMillan

 

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

 

Zhang, Z., Zhang, L., Zhang, G., Jin, J., & Zheng, Z. (2018). The effect of CBT and its modifications for relapse prevention in major depressive disorder: a systematic review and meta-analysis. BMC psychiatry, 18(1), 50. doi:10.1186/s12888-018-1610-5

 

Abstract

Background

The risk of relapse in major depressive disorder (MDD) is associated with high worldwide disease burden. Cognitive behavioral therapy (CBT) and its modifications might be effective in relapse prevention. The aim of this review was to evaluate the efficacy of these treatments for reducing relapse of MDD.

Methods

The retrieval was performed in the databases of MEDLINE via Pubmed, EMBASE and PsycINFO via OVID, The Cochrane Library and four Chinese databases. Clinical trials registry platforms and references of relevant articles were retrieved as well. Hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to pool evidences.

Results

A total of 16 eligible trials involving 1945 participants were included. In the first 12 months, CBT was more efficacious than control in reducing the risk of developing a new episode of depression for MDD patients in remission (HR:0.50, 95%CI:0.35–0.72, I2 = 11%). Mindfulness-based cognitive therapy (MBCT) was more efficacious than control only among patients with 3 or more previous depressive episodes (HR:0.46, 95%CI:0.31–0.70, I2 = 38%). Besides, compared with maintenance antidepressant medication (m-ADM), MBCT was a more effective intervention (HR:0.76, 95%CI:0.58–0.98, I2 = 0%). These positive effects might be only maintained at two and nearly 6 years follow up for CBT.

Conclusion

The use of CBT for MDD patients in remission might reduce risk of relapse. Besides, the effect of MBCT was moderated by number of prior episodes and MBCT might only be effective for MDD patients with 3 or more previous episodes. Further exploration for the influence of previous psychological intervention is required.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389220/