Depression

Improve Sleep in Patients with Mental Disorders with Mindfulness

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Improve Sleep in Patients with Mental Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Not getting enough sleep skews our ability to regulate our emotions. In the long run, this can increase our risk of developing a mental health condition. In turn, conditions such as anxiety and depression may cause further sleep disruption.” – James Kingsland

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that meditation has positive benefits for the individual’s mental, physical, and spiritual life. Meditation appears to be beneficial both for healthy people and for people suffering from a myriad of mental and physical illnesses. One of these benefits appears to be improving sleep and relieving insomnia.

 

It has been shown that mental disorders such as anxiety and depression are associated with sleep problems and insomnia. The research on mindfulness training for sleep problems with patients with mental disorders has been accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Effects of mindfulness-based intervention programs on sleep among people with common mental disorders: 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/PMC9048455/ ) Chan and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials examining the effectiveness of mindfulness training for the treatment of sleep problems in patients with mental disorders. They found 10 published randomized controlled trials containing a total of 541 participants.

 

They report that the published studies found that mindfulness training significantly reduced sleep problems in patients with chronic anxiety or depression. It has been well established that mindfulness training reduces anxiety and depression. Although not addressed in the present study, it is possible that these improvements may at least in part result from improved sleep.

 

“mindfulness helps patients manage anger, worry, anxiety, and depression. These researchers theorized that mindfulness may improve sleep quality by supplying patients with the mental resources to calm down the nervous system in preparation for sleep.” – Danielle Pacheco

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Chan, S. H., Lui, D., Chan, H., Sum, K., Cheung, A., Yip, H., & Yu, C. H. (2022). Effects of mindfulness-based intervention programs on sleep among people with common mental disorders: A systematic review and meta-analysis. World journal of psychiatry, 12(4), 636–650. https://doi.org/10.5498/wjp.v12.i4.636

 

Abstract

BACKGROUND

Sleep problems are particularly prevalent in people with depression or anxiety disorder. Although mindfulness has been suggested as an important component in alleviating insomnia, no comprehensive review and meta-analysis has been conducted to evaluate the effects of different mindfulness-based intervention (MBI) programs on sleep among people with depression or anxiety disorder.

AIM

To compare the effects of different MBI programs on sleep among people with depression or anxiety disorder.

METHODS

Related publications in Embase, Medline, PubMed and PsycINFO databases were systematically searched from January 2010 to June 2020 for randomised controlled trials. Data were synthesized using a random-effects or a fixed-effects model to analyse the effects of various MBI programs on sleep problems among people with depression or anxiety disorder. The fixed-effects model was used when heterogeneity was negligible, and the random-effects model was used when heterogeneity was significant to calculate the standardised mean differences (SMDs) and 95% confidence intervals (CIs).

RESULTS

We identified 397 articles, of which 10 randomised controlled trials, involving a total of 541 participants, were included in the meta-analysis. Studies of internet mindfulness meditation intervention (IMMI), mindfulness meditation (MM), mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and mindfulness-based touch therapy (MBTT) met the inclusion criteria. The greatest effect sizes are reported in favour of MBTT, with SMDs of -1.138 (95%CI: -1.937 to -0.340; P = 0.005), followed by -1.003 (95%CI: -1.645 to -0.360; P = 0.002) for MBCT. SMDs of -0.618 (95%CI: -0.980 to -0.257; P = 0.001) and -0.551 (95%CI: -0.842 to -0.260; P < 0.0001) were reported for IMMI and MBSR in the pooling trials, respectively. Significant effects on sleep problem improvement are shown in all reviewed MBI programs, except MM, for which the effect size was shown to be non-significant.

CONCLUSION

All MBI programs (MBTT, MBCT, IMMI and MBSR), except MM, are effective options to improve sleep problems among people with depression or anxiety disorder.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048455/

 

Religiosity/Spirituality is Associated with Better Psychological Well-Being in Older Adults

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Religiosity/Spirituality is Associated with Better Psychological Well-Being in Older Adults

By John M. de Castro, Ph.D.

 

“Both religion and spirituality can have a positive impact on mental health. . .  Both religion and spirituality can help a person tolerate stress by generating peace, purpose and forgiveness.” – Luna Greenstein

 

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. 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. The research evidence has been accumulating. So, it makes sense to pause and summarize what has been learned.

 

In today’s Research News article “Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133607/ ) Coelho-Júnior and colleagues review, summarize, and perform a meta-analysis of the relationship of spirituality and religiosity with the mental health of older adults. They identified 62 published research studies with participants over the age of 60.

 

They report that the published studies found that religiosity/spirituality was associated with significantly lower levels of anxiety, depression, and fear of death and significantly higher levels of overall psychological well-being, satisfaction with life, meaning in life, and social relations. These findings are correlative so causation cannot be determined.

 

But it is clear the older people who are religious and/or spiritual are psychologically healthier.

 

“religious people live longer, on average, than non-religious people.” – Jeff Levin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Coelho-Júnior, H. J., Calvani, R., Panza, F., Allegri, R. F., Picca, A., Marzetti, E., & Alves, V. P. (2022). Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies. Frontiers in Medicine, 9, 877213. https://doi.org/10.3389/fmed.2022.877213

 

Abstract

Objectives

The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults.

Methods

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO.

Results

One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status.

Conclusion

Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133607/

 

Online Mindfulness Training Improves Psychological Well-Being

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Online Mindfulness Training Improves Psychological Well-Being

 

By John M. de Castro, Ph.D.

 

“online mindfulness interventions may be effective at improving mental health in the general population.” – Neil Bailey

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress.

 

The vast majority of the mindfulness training techniques, however, require a trained teacher. The participants must be available to attend multiple sessions at scheduled times that may or may not be compatible with their schedules and at locations that may not be convenient. As an alternative, training over the internet has been developed. This has 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 internet training in improving psychological well-being. The research has been accumulating and it makes sense to review and summarize what has been learned.

 

In today’s Research News article “Effects of Mindfulness Exercise Guided by a Smartphone App on Negative Emotions and Stress in Non-Clinical Populations: 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/PMC8825782/ ) Wu and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mindfulness training with smartphone apps for improving the psychological well-being of healthy individuals.

 

They identified 8 published research studies that included a total of 574 participants. They report that the published research studies found that mindfulness training on a smartphone produced small to moderate but significant reductions in negative emotions, depression and anxiety in healthy individuals.

 

Hence, the use of smartphone mindfulness apps improves psychological well-being.

 

“Online mindfulness training can enhance mindfulness, well-being, self-perceptions of emotional intelligence, and workplace performance.” – Ruby Nadler

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Wu, J., Ma, Y., Zuo, Y., Zheng, K., Zhou, Z., Qin, Y., & Ren, Z. (2022). Effects of Mindfulness Exercise Guided by a Smartphone App on Negative Emotions and Stress in Non-Clinical Populations: A Systematic Review and Meta-Analysis. Frontiers in public health, 9, 773296. https://doi.org/10.3389/fpubh.2021.773296

 

Abstract

Background

Studies have acknowledged that mindfulness exercise guided by a smartphone app has a positive impact on mental health and physical health. However, mindfulness guided by a smartphone app on mental health is still in its infancy stage. Therefore, we conducted a meta-analysis evaluating the effect of mindfulness intervention guided by a smartphone app on negative emotions and stress in a non-clinical population with emotional symptoms.

Methods

We searched major databases, namely, Web of Science, PubMed, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang, to identify all of the relevant studies published in English or Chinese from their inception until November 9, 2021. The methodological quality of the included studies was assessed with Cochrane risk-of-bias bias assessment tool. Two researchers independently conducted document retrieval, study selection, data extraction, and methodological quality evaluation.

Result

A total of eight studies were included in the study, with 574 subjects (experimental group: 348; control group: 226). A random effects model was selected to combine effect sizes. The results of the meta-analysis showed that mindfulness exercise guided by a smartphone app reduced negative emotions [standardized mean difference (SMD) = −0.232, 95% CI: −0.398 to −0.066, p = 0.006], depressive symptoms (SMD = −0.367, 95% CI: −0.596 to −0.137, p = 0.002), and anxiety symptoms (SMD = −0.490, 95% CI: −0.908 to −0.071, p = 0.022).

Conclusions

The findings indicate the potentially beneficial effect of mindfulness exercise guided by a smartphone app on symptoms of depression and anxiety among individuals in a non-clinical population with emotional symptoms. Considering the small number and overall methodological weakness of the included studies and lack of randomized controlled trials (RCTs), the results should be interpreted with caution, and future rigorously designed RCTs are warranted to provide more reliable evidence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8825782/

 

Improve College Student Psychological Well-Being with Mindfulness and Relaxation

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Improve College Student Psychological Well-Being with Mindfulness and Relaxation

 

By John M. de Castro, Ph.D.

 

“mindfulness helps focus by tuning out distractions, improving memory, decision-making and attention skills. . . It is not a panacea; it is not for everyone. However, it is very worth trying. It may be the next evolution in health care and well-being.” – Affordable Colleges

 

In the modern world education is a key for success. There is a lot of pressure on college students to excel so that they can get the best jobs after graduation. The pressure can lead to stress, anxiety, and depression which can impede the student’s mental health, well-being, and school performance. So it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient.

 

Contemplative practices including meditation, mindfulness training, exercise, Tai Chi and Qigong, and yoga practice have been shown to reduce the psychological and physiological responses to stress, relieve anxiety, and reduce depression .  A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be effective in improving the psychological well-being of college students.

 

In today’s Research News article “Effect of Acceptance and Commitment Therapy Combined with Music Relaxation Therapy on the Self-Identity of College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853795/ ) Yin recruited college students and assigned them to receive either  a 2-month program of Acceptance and Commitment Therapy (ACT) plus systematic muscle relaxation with music, or conventional self-identity intervention, including health education, regular communication, and regular follow-up. They were measured before and after the treatments for anxiety, depression, resilience, and quality of life.

 

They found that in comparison to baseline and the control condition Acceptance and Commitment Therapy (ACT) plus relaxation produced significant reductions in anxiety and depression and significant increases in resilience and quality of life. It cannot be determined if the combination of ACT and relaxation was necessary for the benefits or is each individually may have been effective.

 

So, improve college student psychological well-being with mindfulness and relaxation.

 

“mindfulness . . . can also be a great tool for students, reducing stress and increasing well-being and productivity.” – Rebecca Enderby

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Yin J. (2022). Effect of Acceptance and Commitment Therapy Combined with Music Relaxation Therapy on the Self-Identity of College Students. Journal of healthcare engineering, 2022, 8422903. https://doi.org/10.1155/2022/8422903

 

Abstract

This paper analyzes various effects of acceptance and commitment therapy combined with music relaxation therapy on the self-identity of the college students. Through open recruitment and following the principle of voluntary and confidential, 80 college students were selected from our school, and then they were divided into two groups: the control group (40 cases) and the observation group (40 cases). The observation group received acceptance and commitment therapy combined with music relaxation therapy. For the control group, conventional mental health interventions were administered. Two months after intervention, psychological status, mental resilience, and quality of life scores were compared between the two groups. Before intervention, there was no significant difference in SAS and SDS scores between the two groups (P > 0.05). After intervention, SAS and SDS scores were significantly higher than those in the control group, and the difference between the two groups was statistically significant (P < 0.05). Before intervention, there was no significant difference in the scores of toughness, strength, and optimism between the two groups (P > 0.05). After intervention, the scores of toughness, strength, and optimism in the two groups were all improved, and the scores of mental resilience in the observation group were higher than those in the control group, with statistical significance (P < 0.05). Before intervention, there was no significant difference in the quality of life scores between the observation group and the control group (P > 0.05). After intervention, the quality of life score of the observation group was higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). The combined application of acceptance and commitment therapy and music relaxation therapy can help college students to improve their mental state, improve their mental resilience, enhance their evaluation of life quality, improve their sense of self-identity, and reduce the probability of the occurrence of unhealthy emotions such as depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853795/

 

Different Mindfulness Facets Have Differing Associations with Depersonalization Symptoms

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Different Mindfulness Facets Have Differing Associations with Depersonalization Symptoms

 

By John M. de Castro, Ph.D.

 

“Depersonalization symptoms can be tough to deal with, especially when you’re experiencing them 24/7. But just remember they’re caused by anxiety, and they’re part of your body’s defense mechanism to protect you from a traumatic experience.” – Shaun O’Conner

 

Depersonalization is defined as “Depersonalization/derealization disorder involves a persistent or recurring feeling of being detached from one’s body or mental processes, like an outside observer of one’s life (depersonalization), and/or a feeling of being detached from one’s surroundings (derealization).” – Merck Manuals. It is not known what the relationship is between mindfulness and depersonalization. In some ways it would be expected that mindfulness would be the antithesis of depersonalization. But in others it may actually exacerbate it as there are similarities with spiritual awakening.

 

In today’s Research News article Mindfulness and Depersonalization: a Nuanced Relationship.(See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043097/ ) Levin and colleagues recruited healthy adults online and had them complete measures of depersonalization symptoms, anxiety, depression, perceived stress, and the five facets of mindfulness.

 

They found that the higher the levels of depersonalization symptoms the higher the levels of psychological distress and the observing and nonreactivity facets of mindfulness and the lower the levels of the acting with awareness and nonjudging facets. The relationships of depersonalization with the mindfulness facets were still significant even after controlling for the levels of psychological distress.

 

The reported relationships of depersonalization with the acting with awareness and nonjudging facets of mindfulness makes sense that they are clearly indicative of attachment with the outside environment. On the other hand, the positive relationships with observing internal experience and nonreactivity makes sense as they have internal focus and depersonalization involves detachment from the internal experiences. So, using mindfulness training as a treatment for depersonalization is probably not a good idea.

 

So, mindfulness has a complex relationship with depersonalization.

 

“Sufferers of depersonalization and long-term meditators make surprisingly similar reports about reductions in their experience of being agents of their actions and as owners of their thoughts and behaviors.” – George Deane

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Levin, K. K., Gornish, A., & Quigley, L. (2022). Mindfulness and Depersonalization: a Nuanced Relationship. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-022-01890-y

 

Abstract

Objectives

Although depersonalization has been described as the antithesis of mindfulness, few studies have empirically examined this relationship, and none have considered how it may differ across various facets of mindfulness, either alone or in interaction. The present study examined the relationship between symptoms of depersonalization and facets of dispositional mindfulness in a general population sample.

Methods

A total of 296 adult participants (139 male, 155 female, 2 other) were recruited online via Qualtrics and completed the Cambridge Depersonalisation Scale; Depression, Anxiety, and Stress Scale; and Five Facet Mindfulness Questionnaire.

Results

Controlling for general distress, depersonalization symptoms were positively associated with Observe, Describe, and Nonreactivity facets and negatively associated with Acting with Awareness and Nonjudgment facets. After controlling for intercorrelations among the facets, depersonalization symptoms remained significantly associated with higher Nonreactivity and lower Acting with Awareness. The overall positive relationship between depersonalization symptoms and the Observe facet was moderated by both Nonjudgment and Nonreactivity. Specifically, higher Observing was related to increased depersonalization symptoms at low levels of Nonjudgment and to decreased symptoms at low levels of Nonreactivity.

Conclusions

The current study provides novel insight into the relationship between depersonalization symptoms and various aspects of mindfulness. Experiences of depersonalization demonstrated divergent relationships with mindfulness facets, alone and in interaction. The results may inform theoretical models of depersonalization and mindfulness-based interventions for depersonalization.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9043097/

 

Improve Anxiety and the Gut Microbiome with Mindfulness

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Improve Anxiety and the Gut Microbiome with Mindfulness

 

By John M. de Castro, Ph.D.

 

“A healthy gut can be different iterations of bacteria for different people, because it is this diversity that maintains wellness.” – Jennifer Wolkin

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the sufferer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects, and these drugs are often abused. There are several psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

The GI tract contains intestinal micro-organisms, flora, bacteria, known as the microbiome, that have major effects throughout the body through the bacteria-intestinal-brain axis. This can affect overall health and well-being including anxiety. So, it would make sense to investigate the relationship of mindfulness practice with anxiety and intestinal micro-organisms.

 

Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating anxiety disorders. 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. But whether MBCT affects both anxiety and the microbiome has not been investigated.

 

In today’s Research News article “Gut Microbiota Associated with Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/ ) Wang and colleagues recruited young adults with high anxiety levels and a similar control group with normal anxiety levels. The high anxiety group were provided with 8 weekly 2.5 hour sessions of Mindfulness-Based Cognitive Therapy (MBCT). They were measured before and after treatment for anxiety, depression, resilience, and mindfulness. In addition, their feces were measured for microbiota.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) there were significant decreases in anxiety and depression and significant increases in resilience and mindfulness. The gut microbiome significantly differed between the high anxiety group and the controls before trteatment in that the high anxiety participants had less bacterial diversity in the gut. But after MBCT the bacterial diversity levels increased to the levels of the healthy controls.

 

Hence, mindfulness training improves the psychological health of highly anxious young adults and simultaneously normalizes the deficiency in the bacterial diversity in the gut.

 

Mindfulness training is good for both physical and mental health.

 

“During stress, an altered gut microbial population affects the regulation of neurotransmitters mediated by the microbiome and gut barrier function. Meditation helps regulate the stress response, thereby suppressing chronic inflammation states and maintaining a healthy gut-barrier function.” – Ayman Mukerji Househam

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Wang, Z., Liu, S., Xu, X., Xiao, Y., Yang, M., Zhao, X., Jin, C., Hu, F., Yang, S., Tang, B., Song, C., & Wang, T. (2022). Gut Microbiota Associated With Effectiveness And Responsiveness to Mindfulness-Based Cognitive Therapy in Improving Trait Anxiety. Frontiers in cellular and infection microbiology, 12, 719829. https://doi.org/10.3389/fcimb.2022.71982

 

Abstract

Objective

Mindfulness-based interventions have been widely demonstrated to be effective in reducing stress, alleviating mood disorders, and improving quality of life; however, the underlying mechanisms remained to be fully understood. Along with the advanced research in the microbiota-gut-brain axis, this study aimed to explore the impact of gut microbiota on the effectiveness and responsiveness to mindfulness-based cognitive therapy (MBCT) among high trait anxiety populations.

Design

A standard MBCT was performed among 21 young adults with high trait anxiety. A total of 29 healthy controls were matched for age and sex. The differences in gut microbiota between the two groups were compared. The changes in fecal microbiota and psychological indicators were also investigated before and after the intervention.

Results

Compared with healthy controls, we found markedly decreased bacterial diversity and distinctive clusters among high trait anxiety populations, with significant overgrowth of bacteria such as Streptococcus, Blautia, and Romboutsia, and a decrease in genera such as Faecalibacterium, Coprococcus_3, and Lachnoclostridium. Moreover, MBCT attenuated trait anxiety and depression, improved mindfulness and resilience, and increased the similarity of gut microbiota to that of healthy controls. Notably, a high presence of intestinal Subdoligranulum pre-MBCT was associated with increased responsiveness to MBCT. Decreases in Subdoligranulum post-MBCT were indicative of ameliorated trait anxiety. The tryptophan metabolism pathways were significantly over-represented among high responders compared to low responders.

Conclusion

The significantly increased diversity post-MBCT added evidence to gut-brain communication and highlighted the utility of mycobiota-focused strategies for promoting the effectiveness and responsiveness of the MBCT to improve trait anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908961/

 

Improve Psychological Health During Addiction Recovery with Qigong

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Improve Psychological Health During Addiction Recovery with Qigong

 

By John M. de Castro, Ph.D.

 

“For people in the early stages of recovery whose emotions may be all over the map, Tai Chi can help stabilize moods, provide mental focus and clarity, and smooth out the rough spots. “ – Pinnacle

 

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

 

Mindfulness practices have been shown to improve recovery from various addictions. Tai Chi is a mindfulness practice that has documented benefits for the individual’s psychological and physical health and well-being. Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. Since Tai Chi and Qigong are both mindfulness practices and gentle exercises, that may be an acceptable and effective treatment for patients recovering from addictions. Studies on the use of Tai Chi and Qigong practices to treat substance abuse have been accumulating and there is a need to pause and summarize what has been learned.

 

In today’s Research News article “The Impact of Qigong and Tai Chi Exercise on Drug Addiction: 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/PMC8957847/ ) Cui and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effects of Tai Chi and Qigong practice during substance abuse treatment. They identified 11 studies including a total of 1072 participants.

 

They report that the published research found that Tai Chi and Qigong practices during substance abuse treatment produced significant reduction in depression, and anxiety, and significant improvements in quality of life, and sleep quality. Qigong practice appears to be superior to Tai Chi practice in producing these benefits.

 

Hence, the published research suggests that Tai Chi and Qigong practices improve the psychological health of the patients during addiction recovery.

 

 

“Tai chi can also be continued in life following treatment. It can serve as an important part of an aftercare plan that enhances well-being and reduces the likelihood of relapse.” – Footprints to Recovery

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Cui, J., Liu, F., Liu, X., Li, R., Chen, X., & Zeng, H. (2022). The Impact of Qigong and Tai Chi Exercise on Drug Addiction: A Systematic Review and Meta-Analysis. Frontiers in psychiatry, 13, 826187. https://doi.org/10.3389/fpsyt.2022.826187

 

Abstract

Background

Previous preliminary studies have found that qigong exercises produced significant effects in healthy people and in various clinical populations. The purpose of this study was to systematically review the effects of qigong and tai chi exercise on individuals with drug addiction.

Methods

A systematic search of seven English databases and three Chinese databases was conducted to identify randomized controlled trials (RCTs) and non-randomized comparative studies (NRS) assessing the effects of qigong and tai chi on drug addiction. Study quality was assessed using the Checklist for the Evaluation of Non-Pharmaceutical Trial Reports (CLEAR-NPT).

Results

Two RCTs and nine NRS studies were included in this study, including a total of 1072 patients with drug addiction (age range, 27–43 years). The results showed that qigong and tai chi exercise had a significant overall effect on depression (SMD = −0.353, 95%CI [−0.548, −0.159]), anxiety (SMD = −0.541, 95%CI [−0.818, −0.264]), quality of life (SMD = 0.673, 95%CI [0.438, 0.907]), and sleep quality (SMD = −0.373, 95%CI [−0.631, −0.116]). The subgroup analysis found that qigong outperformed tai chi on the improving depression, anxiety, and sleep quality.

Conclusion

Existing studies suggest that qigong and tai chi are effective at improving depression, anxiety, and quality of life in drug users; however, the evidence from rigorous randomized controlled group trials is lacking.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957847/

 

Improve Depression by Changing the Brain with Mindfulness

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Improve Depression by Changing the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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

 

Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

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Reduce Opioid Dependence in Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Key Points

Question

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

Findings

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

Meaning

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

Go to:

Abstract

Importance

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

Objective

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

Design, Setting, and Participants

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

Interventions

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

Main Outcomes and Measures

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

Results

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

Conclusions and Relevance

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

Improve Mental Health with Mantra-Based Meditation

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Improve Mental Health with Mantra-Based Meditation

 

By John M. de Castro, Ph.D.

 

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

 

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

 

In today’s Research News article “Effectiveness of Mantra-Based Meditation on Mental Health: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949812/ ) Álvarez-Pérez and colleagues review, summarize, and perform a meta-analysis of the effects of mantra-based meditations on mental health. They found 51 published research studies.

 

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

 

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

 

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

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

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

 

Abstract

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

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