Depression

Mindfulness Changes Neural Activity and Improves Major Depressive Disorder

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Mindfulness Changes Neural Activity and Improves Major Depressive Disorder

 

By John M. de Castro, Ph.D.

 

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. . . MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

 

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 commonly 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 not known how MBCT produces its effects on major depression.

 

One way to observe the effects of MBCT on neural activity is to measure changes in the electroencephalogram (EEG), the rhythmic electrical activity that can be recorded from the scalp. The recorded activity can be separated into frequency bands. Delta activity consists of oscillations in the 0.5-3 cycles per second band. Theta activity in the EEG consists of oscillations in the 4-8 cycles per second band. Alpha activity consists of oscillations in the 8-12 cycles per second band. Beta activity consists of oscillations in the 15-25 cycles per second band while Gamma activity occurs in the 35-45 cycles per second band. Changes in these brain activities can be compared during different depths of meditation.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy in Recurrent MDD Patients With Residual Symptoms: Alterations in Resting-State Theta Oscillation Dynamics Associated With Changes in Depression and Rumination.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936084/ ) Wang and colleagues recruited patients with major depressive disorder being treated with drugs but with residual symptoms. They were provided with an 8-week program of Mindfulness-Based Cognitive Therapy (MBCT). Before and after training they were measured for mindfulness, depression, and rumination and had their resting state electroencephalogram (EEG) recorded.

 

After completing Mindfulness-Based Cognitive Therapy (MBCT) there were significant reductions in depression which produced an 88% remission rate. There were also significant increases in mindfulness and reductions in brooding rumination. In addition, there was a significant increase in the theta rhythm power in the electroencephalogram (EEG). Finally, the greater the increase in theta power the greater the reductions in depression and rumination.

 

Hence, they found that Mindfulness-Based Cognitive Therapy (MBCT) is effective in treating depression even in patients under treatment with drugs. They also found that these improvements were related to increased theta power in the electroencephalogram (EEG). So, MBCT appears to change brain activity along with depression. The changes in the neural activity may be a mechanism by which MBCT helps improve depression symptoms.

 

“mindfulness is added to the standard depression treatment protocols, relapse rates decline.” – Sara Altshul

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Wang, J., Ren, F., Gao, B., & Yu, X. (2022). Mindfulness-Based Cognitive Therapy in Recurrent MDD Patients With Residual Symptoms: Alterations in Resting-State Theta Oscillation Dynamics Associated With Changes in Depression and Rumination. Frontiers in psychiatry, 13, 818298. https://doi.org/10.3389/fpsyt.2022.818298

 

Abstract

Many patients with major depressive disorder (MDD) suffer from residual symptoms. Rumination is a specific known risk factor for the onset, severity, prolongation, and relapse of MDD. This study aimed to examine the efficacy and EEG substrates of mindfulness-based cognitive therapy (MBCT) in alleviating depression and rumination in an MDD population with residual symptoms. We recruited 26 recurrent MDD individuals who had residual symptoms with their current antidepressants to participate in the 8-week MBCT intervention. We evaluated the efficacy and changes in the dynamics of resting-state theta rhythm after the intervention, as well as the associations between theta alterations and improvements in depression and rumination. The participants showed reduced depression, enhanced adaptive reflective rumination, and increased theta power and phase synchronization after MBCT. The increased theta-band phase synchronizations between the right occipital regions and the right prefrontal, central, and parietal regions were associated with reduced depression, while the increase in theta power in the left parietal region was associated with improvements in reflective rumination. MBCT could alleviate depression and enhance adaptive, reflective rumination in recurrent MDD individuals with residual symptoms through the modulation of theta dynamics in specific brain regions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936084/

 

Meditation is an Effective Treatment for a Variety of Medical Conditions

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Meditation is an Effective Treatment for a Variety of Medical Conditions

 

By John M. de Castro, Ph.D.

 

“Mindfulness is not a cure-all. . . . There have been thousands of studies showing that there are psychological and physical benefits to mindfulness meditation, but the intention . . . is not to cure the disease or fully treat the symptoms, but to treat the whole person — and that includes their mental and emotional well-being — so they can live in greater health and joy.” – Men’s Health

 

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. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

Over the last few decades, a vast amount of research has been published on the benefits of meditation on the mental and physical health of the practitioners. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Systematic Review for the Medical Applications of Meditation in Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8834867/ ) Kim and colleagues review and summarize the 104 published randomized controlled trials on the benefits of meditation practices on mental and physical well-being.

 

They report that the published research found that different studies report varying results but the most common significant benefits of meditation practice were improvements in fatigue, sleep quality, quality of life, stress, PTSD symptoms, blood pressure, intraocular pressure, and depression. In general yoga-based practices produced slightly better results than mindfulness based techniques,

 

Hence, meditation practices have been found to help improve mental and physical well-being.

 

“meditation can improve mental health and reduce symptoms associated with chronic conditions.” – Ashley Welch

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Kim, D. Y., Hong, S. H., Jang, S. H., Park, S. H., Noh, J. H., Seok, J. M., Jo, H. J., Son, C. G., & Lee, E. J. (2022). Systematic Review for the Medical Applications of Meditation in Randomized Controlled Trials. International journal of environmental research and public health, 19(3), 1244. https://doi.org/10.3390/ijerph19031244

 

Abstract

Background: Meditation has been increasingly adapted for healthy populations and participants with diseases. Its beneficial effects are still challenging to determine due to the heterogeneity and methodological obstacles regarding medical applications. This study aimed to integrate the features of therapeutic meditation in randomized controlled trials (RCTs). Methods: We conducted a systematic review of RCTs with meditation for populations with diseases using the PubMed database through June 2021. We analyzed the characteristics of the diseases/disorders, participants, measurements, and their overall benefits. Results: Among a total of 4855 references, 104 RCTs were determined and mainly applied mindfulness-based (51 RCTs), yoga-based (32 RCTs), and transcendental meditation (14 RCTs) to 10,139 patient-participants. These RCTs were conducted for participants with a total of 45 kinds of disorders; the most frequent being cancer, followed by musculoskeletal and connective tissue diseases and affective mood disorder. Seven symptoms or signs were frequently assessed: depressive mood, feeling anxious, quality of life, stress, sleep, pain, and fatigue. The RCTs showed a higher ratio of positive outcomes for sleep (73.9%) and fatigue (68.4%). Conclusions: This systematic review produced the comprehensive features of RCTs for therapeutic meditation. These results will help physicians and researchers further study clinical adaptations in the future as reference data.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8834867/

 

Improve Inflammatory and Stress Responses with Yoga

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Improve Inflammatory and Stress Responses with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga could slow the harmful physical effects of stress and inflammaging.” – Harvard Health

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. Indeed, the presence of chronic inflammation is associated with reduced longevity.

 

So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent. Of course, it is far better to prevent chronic inflammation in the first place than to treat it later. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “The role of yoga in inflammatory markers. Brain, behavior, & immunity – health.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842003/ ) Estevan and colleagues review and summarize the published research studies of the effects of yoga practice on the inflammatory response.

 

They report that the published research found that yoga practice reduces the inflammatory response and stress hormones in a wide variety of conditions such a COPD, obesity cancer, and depression. So, the research suggests that yoga practice is an effective treatment to reduce the chronic inflammation.

 

“Often, the precursor to illness is chronic inflammation. . . . Yoga — of various styles, intensities, and durations — reduced the biochemical markers of inflammation across several chronic conditions.” – Sarah Ezrin

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Estevao C. (2022). The role of yoga in inflammatory markers. Brain, behavior, & immunity – health, 20, 100421. https://doi.org/10.1016/j.bbih.2022.100421

 

Abstract

Yoga is an ancient system for integrating the mind, body, and spirit. In the hatha yoga ashtanga tradition (the eight limb Patanjali Yoga), three of the limbs are meditation, breathwork (pranayama) and physical postures (asana), which are widely practised in yoga classes. The benefits of yoga for mental and physical health are rooted in the practice’s origins: in yoga, stress is said to be the root of all diseases.

The established fields of psychoneuroimmunology and immunopsychiatry study the interplay between the immune system and mood or mental states. This mini-review has shifted the emphasis from research that focuses on yoga’s benefits for stress, the most commonly studied outcome of yoga research, to a summary of the research on the effects of yoga practices on the immune system. The current literature bears strong evidence for the benefits of yoga on the levels of circulating cortisol and classical inflammatory markers, such as C-reactive protein (CRP) and cytokines such as interleukin-1 beta (IL-1β), interleukin 6 (IL-6), tumour necrosis factor-alpha (TNF-α) and interferon-gamma (INF-γ). The evidence for other less studied markers, telomerase activity, β-endorphins, Immunoglobulin A (IgA) and brain-derived neurotrophic factor (BDNF) is also growing. This mini-review centres around the interplay between yoga and these markers in stress management and depression, vascular and immune function in the older population, cardiovascular and metabolic diseases, auto-immune diseases, breast cancer and pregnancy.

Overall, the literature examined reveals the novelty of this field of research and sheds light on methodological challenges; however, it uncovers the potential for yoga to be used as adjuvant therapy in conditions with an inflammatory component.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842003/

 

Spirituality May Alter the Brain to Protect Against Major Depression

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Spirituality May Alter the Brain to Protect Against Major Depression

 

By John M. de Castro, Ph.D.

 

“spirituality or religion may protect against major depression by thickening the brain cortex and counteracting the cortical thinning that would normally occur with major depression.” – Lisa Miller

 

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.

 

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 associated with better mental health.

 

In today’s Research News article “Altruism and “love of neighbor” offer neuroanatomical protection against depression. Psychiatry research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672211/ ) Miller and colleagues reanalyzed longitudinal data obtained from individuals at risk for major depression and matched normal participants. At 30 and 35 years of age the participants brains were scanned with Magnetic Resonance Imaging (MRI) and the participants completed measures of major depressive disorder, level of depression and spirituality including measures of altruism, love thy neighbor as self, interconnectedness, contemplative practice, and commitment to religion/spirituality.

 

They found that the low risk of depression group had significantly greater cortical thickness in the Ventral Frontotemporal Network (VFTN), in comparison to the high-risk group. The VFTN had been previously shown to be associated with spiritual experience. They also found that in the at-risk for major depression group the greater the cortical thickness in the VFTN the lower levels of depression and the lower the risk of developing major depressive disorder. Across all participants, the higher the spirituality measures of altruism and love thy neighbor as self the greater the cortical thickness in the VFTN. In addition, in the high-risk group, the higher the levels of the spirituality measure of love thy neighbor as self the lower the levels of depression and the lower the risk of developing major depressive disorder.

 

The results demonstrate that the thickness of the Ventral Frontotemporal Network (VFTN) is associated with lower levels of depression and risk of major depressive disorder. In addition, thee results suggest that for people with a high risk of developing major depressive disorder spirituality particularly in the of altruism and love thy neighbor as self categories is associated with protection of the cortical areas from deterioration and this in turn is associated with lower depression and risk of major depressive disorder.

 

These results suggest that spirituality is associated protection from depression by protecting the brain particularly in people at high risk of developing major depressive disorder. These are correlative results, so it is not possible to determine causation. Future research needs to determine if promotion of spirituality, perhaps by training in contemplative practices, might produce neuroplastic changes in the brain and protect against the development of major depressive disorder.

 

So, spirituality may alter the brain to protect against major depression.

 

“there is neurobiological basis of spirituality and depression risk. It is unlikely to be harmful, and may very well help to steer the religious depressed patient to more spiritual contemplation, and the non-religious one to more meditation and reflection.” – Emily Deans

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Miller, L., Wickramaratne, P., Hao, X., McClintock, C. H., Pan, L., Svob, C., & Weissman, M. M. (2021). Altruism and “love of neighbor” offer neuroanatomical protection against depression. Psychiatry research. Neuroimaging, 315, 111326. https://doi.org/10.1016/j.pscychresns.2021.111326

 

Abstract

We prospectively investigate protective benefits against depression of cortical thickness across nine regions of a Ventral Frontotemporal Network (VFTN), previously associated with spiritual experience. Seventy-two participants at high and low risk for depression (Mean age 41 years; 22–63 years; 40 high risk, 32 low risk) were drawn from a three-generation, thirty-eight year study. FreeSurfer estimated cortical thickness over anatomical MRIs of the brain (Year 30) for each of the nine ROIs. Depression (MDD with SAD-L; symptoms with PHQ; Years 30 and 38) and spirituality (self-report on five phenotypes; Year 35), respectively, were associated with the weighted average of nine regions of interest. VFTN thickness was: 1) positively associated (p<0.01) with two of five spiritual phenotypes, altruism and love of neighbor, interconnectedness at a trend level, but neither commitment nor practice, 2) inversely associated with a diagnosis of MDD (SADS-L Year 30, for any MDD in the past ten years), and 3) prospectively neuroanatomically protective against depressive symptoms (PHQ-9 Year 38) for those at high familial risk.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8672211/

 

Improve Food Related Cognitive Processing in Patients with Eating Disorders with Mindfulness

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Improve Food Related Cognitive Processing in Patients with Eating Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Practicing mindfulness techniques has proven to be extremely helpful in aiding individuals to understand the driving forces behind their eating disorder.” – Greta Gleissner

 

Around 30 million people in the United States of all ages and genders suffer from an eating disorder: either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Two example of eating disorders are binge eating disorder (BED) and bulimia nervosa (BN). BED involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating. BN involves binge-eating and purging (e.g., self-induced vomiting, compensatory exercise).

 

Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. It is not known however, what processes are affected by mindfulness training to improve eating disorders.

 

In today’s Research News article “Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668447/ ) Sala and colleagues recruited adult participants who were diagnosed with either bulimia nervosa or binge eating disorder. They were on a wait-list for 8 weeks and then received weekly 2-hour sessions over 8 weeks of 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. They were measured before and after therapy for mindfulness, eating behaviors, anxiety, and depression. In addition, the participants were presented cards printed in various colors with either neutral words or food related words and asked to name the color of the word as quickly as possible.

 

After Mindfulness-Based Cognitive Therapy (MBCT) there were significant improvements in mindfulness, anxiety, depression and eating behaviors, including nonreactivity, cognitive restraint, disinhibition, and hunger. In addition, the reaction times to food-related words was significantly shorter after MBCT. Path analysis revealed that MBCT affected eating behavior indirectly by altering the responses to the food-related words.

 

These results are interesting, but the study lacked a comparison (control) condition limiting the strength of the conclusions. But previous controlled research has demonstrated that mindfulness training improves eating disorders. So, the present results are likely due to the effects of Mindfulness-Based Cognitive Therapy (MBCT) and not to potential confounding variables.

 

The present study, though, has an interesting new finding. Mindfulness-Based Cognitive Therapy (MBCT) appears to affect the cognitive processing involved with eating. This includes nonreactivity, cognitive restraint, disinhibition, and hunger. These changes predict more healthful eating behavior and a reduction in disordered eating. In addition, MBCT affected these cognitive processes only indirectly by altering responses to food-related cues (words). This suggests that MBCT improves eating disorders by changing the thought processes in response to food cues. In other words, mindfulness improves eating disorders by altering how the individual processes information related to food. This interesting finding needs further research.

 

So, improve food related cognitive processing in patients with eating disorders with mindfulness.

 

“increasing mindful awareness of internal experiences and automatic patterns could be effective for the improvement of self-acceptance and emotional regulation, thereby reducing the problematic eating behaviors.” – Jinyue Yu

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Sala, L., Gorwood, P., Vindreau, C., & Duriez, P. (2021). Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food. European psychiatry : the journal of the Association of European Psychiatrists, 64(1), e67. https://doi.org/10.1192/j.eurpsy.2021.2242

 

Abstract

Background

This study aimed to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) as a complementary approach in patients with bulimia nervosa (BN) or binge eating disorder (BED), and to assess how the reduction of the cognitive load of words related to eating disorders (ED) could constitute an intermediate factor explaining its global efficacy.

Methods

Eighty-eight women and men participated in clinical assessments upon inscription, prior to and following 8-week group MBCT. Mindfulness skills were assessed using the five facet mindfulness questionnaire; eating behaviors were assessed using the Three Factor Eating Questionnaire (TFEQ); comorbid pathologies were assessed using the beck depression index and the state-trait anxiety inventory. The cognitive load of words associated with ED was assessed through a modified version of the Stroop color naming task.

Results

Mindfulness skills improved significantly (p < .05) after group MBCT. The improvement of TFEQ scores was accompanied by reduced levels of depressive mood and trait anxiety. The positive impact of MBCT on TFEQ score was directly related to an improvement of the performance in the Stroop task.

Conclusions

MBCT represents an interesting complementary therapy for patients with either BN or BED, at least when cognitive and behavioral domains are concerned. Such efficacy seems to be mediated by the reduction of the cognitive load associated with ED stimuli, which offers a possible explanation of how MBCT could reduce binge-eating behaviors. Other studies are needed, in independent centers, to focus more directly on core symptoms and long-term outcome.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668447/

 

Improve the Psychological Well-Being of Opioid Users Undergoing Medicinal Therapy with Mindfulness

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Improve the Psychological Well-Being of Opioid Users Undergoing Medicinal Therapy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As individuals with [Substance Use Disorders] engage in mindfulness practices within [Mindfulness-Based Interventions], they learn to cultivate trait mindfulness, providing a bulwark against substance use and relapse.” – Sarah E Priddy

 

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 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. Medicinal therapies with drugs such as buprenorphine/naloxone have also been effective. But there is a need to study the effectiveness of mindfulness training in combination with medicinal therapy on relapse prevention.

 

In today’s Research News article “Testing Mindfulness-Based Relapse Prevention with Medications for Opioid Use Disorder Among Adults in Outpatient Therapy: a Quasi-experimental Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504564/ ) Zullig and colleagues recruited patients who were addicted to opioids and after treatment had been opioid free for at least 90 days. They continued on receiving treatment with daily injections of buprenorphine/naloxone and attending Narcotics Anonymous meetings. Patients who volunteered underwent additional 24 weeks of twice weekly 60-minute sessions of Mindfulness-Based Relapse Prevention (MBRP) treatment. The participants were measured before, at midpoint, and after treatment and 12 weeks later for relapse, craving symptoms, anxiety, depression, and mindfulness.

 

They found that 73% of the participants were retained through the entire 36 weeks with no differences between groups. Relapse occurred in 45% of the participants but there were no differences between groups. Cravings declined throughout the 36 weeks but again there were no differences between groups. On the other hand, the decline in anxiety and depression and increase in mindfulness was significantly greater for the group that received Mindfulness-Based Relapse Prevention (MBRP).

 

The findings suggest that adding Mindfulness-Based Relapse Prevention (MBRP) to medicinal therapy for opioid relapse prevention produced significantly lower levels of anxiety and depression in the patients. But it did not appear to improve relapses or cravings. More research is needed to ascertain whether the additional cost and staff support involved in implementing MBRP is justified by the additional improvements in psychological well-being.

 

So, improve the psychological well-being of opioid users undergoing medicinal therapy with mindfulness.

 

“Mindfulness-Based Relapse Prevention (MBRP) has been shown to help with physical and psychological well-being, reduce craving, and help with anxiety and depression.” – Keith Zullig

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zullig, K. J., Lander, L. R., Tuscano, M., Garland, M., Hobbs, G. R., & Faulkenberry, L. (2021). Testing Mindfulness-Based Relapse Prevention with Medications for Opioid Use Disorder Among Adults in Outpatient Therapy: a Quasi-experimental Study. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-021-01763-w

 

Abstract

Objectives

This study aimed to explore the effectiveness of mindfulness-based relapse prevention (MBRP) with individuals receiving medication for opioid use disorder (MOUD) in a naturalistic, open-ended outpatient group treatment setting.

Methods

Eighty participants (mean age 36.3) who had at least 90 consecutive days substance free self-selected into treatment (MBRP, n = 35) or comparison groups (treatment as usual, TAU, n = 45). Outcomes tracked included treatment retention and relapse, and self-reported craving, anxiety, depression, and mindfulness at baseline, 12 weeks, 24 weeks, and 36 weeks post-recruitment. MBRP group participants attended biweekly 60-min sessions for 24 weeks. A linear mixed model analysis of variance determined the significance of the MBRP intervention on changes in craving, anxiety, depression, and mindfulness.

Results

No significant differences in sex, education level, insurance status, relationship status, or employment status were detected at baseline between groups. The 36-week retention (74%, MBRP/MOUD; 71%, TAU/MOUD) and relapse rates (43%, MBRP/MOUD; 47%, TAU/MOUD) were similar for the groups. There were only four relapses on opioids. Significant reductions (p < .05) were observed in the MBRP/MOUD group for craving, anxiety, and depression in addition to significant increases in mindfulness compared to those in TAU/MOUD.

Conclusions

Although state and federal resources are available to expand MOUD, no standard of behavioral therapy has been established as most complimentary to MOUD. The current study results suggest MBRP can be implemented as an outpatient therapy for individuals in MOUD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504564/

 

Improved Psychological Well-Being and Cognition is Reported by Adult who Engage in Microdosing of Psychedelic Substances

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Improved Psychological Well-Being and Cognition is Reported by Adult who Engage in Microdosing of Psychedelic Substances

 

By John M. de Castro, Ph.D.

 

“After a 40-year moratorium, the psychedelic renaissance has begun: rigorous scientific methods can now be used to investigate psychedelics as potential medicines and for “the betterment of well people”. – Thomas Anderson

 

Psychedelic substances such as peyote, mescaline, LSD, Bufotoxin, ayahuasca and psilocybin 

have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. More recently hallucinogenic drugs such as MDMA (Ecstasy) and Ketamine have been similarly used. People find the experiences produced by these substances extremely pleasant. eye opening, and even transformative. They often report that the experiences changed them forever. Psychedelics and hallucinogens have also been found to be clinically useful as they markedly improve mood, increase energy and enthusiasm and greatly improve clinical depression.

 

Recently doses of psychedelic substances that are small enough that they do not produce psychedelic effects (microdoses) have been employed repeatedly in real world settings. They have been reported to produce reductions in the symptoms of depression and anxiety, improve cognitive function, and promote social interaction. But there is little systematic research on the effects of repeated psychedelic microdosing.

 

In today’s Research News article “Psychedelic Microdosing: Prevalence and Subjective Effects.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282936/ ) Cameron and colleagues recruited adult volunteers to complete an anonymous online survey of “Recreational Drug and Alcohol Use”. The survey requested information regarding familiarity with psychedelic microdosing. personal practices, drugs used, and any changes observed in depression, anxiety, memory, sociability, focus/attention, and physical health.

 

They found that of the 2347 respondents the majority (59%) were familiar with psychedelic microdosing but only 13 % ever practiced it and only 4% were currently practicing. LSD and Psilocybin were the most common drugs used in microdosing. Males, veterans, and less educated participants were significantly more likely to practice psychedelic microdosing.

 

In comparison to participants who did not microdose, those that did reported significantly greater reductions in depression anxiety and greater improvements in memory, attention, and sociability. Males again reported the greatest improvements. The majority of the participants who stopped microdosing attributed it to difficulty in obtaining the drugs and their legal riskiness.

 

These results were produced by an anonymous survey and there was no way to ascertain the veracity of the responses. In addition, there were no comparison to other spontaneously used drugs to determine demand characteristics or placebo effects. Hence, the results are from a self-selected sample, have strong expectancy effect, and with no objective verification of the responses. So, these results must be viewed as preliminary. Nevertheless, the findings suggest that psychedelic microdosing is viewed by those engaging in it as beneficial for their psychological well-being and cognitive ability. These are interesting results that suggest that further investigation in warranted to determine if this practicemay be useful in improving well-being.

 

So, improved psychological well-being and cognition is reported by adult who engage in microdosing of psychedelic substances.

 

“We have an epidemic of mental health problems, with existing treatments that don’t work for everyone. We need to follow the lead of patients who are taking these initiatives to improve their wellbeing and reduce suffering.” – Zach Walsh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Cameron, L. P., Nazarian, A., & Olson, D. E. (2020). Psychedelic Microdosing: Prevalence and Subjective Effects. Journal of psychoactive drugs, 52(2), 113–122. https://doi.org/10.1080/02791072.2020.1718250

 

Abstract

Anecdotal reports suggest that the administration of sub-hallucinogenic doses of psychedelic compounds on a chronic, intermittent schedule—a practice known as psychedelic microdosing—is becoming increasingly popular among young adults due to its purported ability to reduce symptoms of depression and anxiety while improving cognitive function and promoting social interaction. Using an anonymous online survey, we collected data from 2347 people to 1) assess the prevalence of psychedelic microdosing and characterize the demographics of microdosers, 2) determine whether microdosers associate the practice with changes in mood, cognitive function, social interaction, or physiology, and 3) investigate frequent motives for discontinuing the practice. Fifty-nine percent of respondents (NT = 2183) reported familiarity with the concept of psychedelic microdosing, with 17% (383 respondents, NT=2200) having engaged in this practice. Microdosers attributed psychedelic microdosing with improving their mood, decreasing their anxiety, and enhancing their memory, attention, and sociability. The most frequently cited reasons for quitting microdosing (NT = 243) were the risks associated with taking an illegal substance (24.28%) and the difficulty of obtaining psychedelic compounds (22.63%). Overall, our findings suggest that psychedelic microdosing is relatively common and is subjectively associated with a broad spectrum of socio-affective, cognitive, and physical outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282936/

Improve the Psychological Well-Being of Patients with Breast Cancer with Mindfulness

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Improve the Psychological Well-Being of Patients with Breast Cancer with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness based interventions hold a great deal of promise for helping people with cancer cope across a broad range of symptoms and issues, both during and after the completion of active treatment.” – Jessica Pieczynski

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and 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 an effective treatment for women with breast cancer.

 

In today’s Research News article “Efficacy of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer: a pre- and post-test clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317551/ ) Ghorbani and colleagues recruited married women with breast cancer who exhibited moderate levels of anxiety and depression and randomly assigned them to receive 8 weekly 90 minute sessions of Acceptance and Commitment Therapy (ACT) or to a wait list control condition. They were measured before and after ACT and 2 months later for perceived stress, anxiety, depression, chronic pain, and acceptance and action.

 

They found that in comparison to baseline and the wait-list control group after Acceptance and Commitment Therapy (ACT) there were significant reductions in depression and significant increases in pain acceptance and flexibility. These improvements were maintained at the 2-month follow-up.

 

The study did not have an active control condition, rather employing a wait-list control. This leaves open the possibility of participant expectancy (placebo) effects or attentional (Hawthorne) effects explaining the results. In addition, Acceptance and Commitment Therapy (ACT) is a complex therapy with several therapeutic components. It is unclear what components or combination of components are critical for the benefits. Nevertheless, the results demonstrate that Acceptance and Commitment Therapy (ACT) is effective in improving the psychological well-being of breast cancer patients. This could well translate into better recovery and health in these women.

 

So, improve the psychological well-being of patients with breast cancer with mindfulness.

 

“mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” –  BCRF

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Ghorbani, V., Zanjani, Z., Omidi, A., & Sarvizadeh, M. (2021). Efficacy of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer: a pre- and post-test clinical trial. Trends in psychiatry and psychotherapy, 43(2), 126–133. https://doi.org/10.47626/2237-6089-2020-0022

 

Abstract

Objective:

Breast cancer is the most common cancer in women worldwide. Many of these patients suffer from multiple psychological symptoms. The present study aimed to investigate the impact of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer.

Methods:

The present study was a pre- and post-test clinical trial with intervention and control groups. The research population consisted of women with breast cancer referred to the Ayatollah Yasrebi and Shahid Beheshti Hospitals in Kashan in 2018. Through a purposive sampling method, 40 women were selected and randomly divided into two groups, namely, intervention (n = 20) and control (n = 20). The applied tools included the Depression, Anxiety and Stress Scale (DASS-21), Chronic Pain Acceptance Questionnaire 8 (CPAQ-8), and Acceptance and Action Questionnaire – II (AAQ-II). Data were analyzed by SPSS 16 using descriptive statistics and analysis of variance (ANOVA).

Results:

The results showed that ACT treatment significantly reduced the mean scores of depression compared to the control group (F = 107.72, p < 0.001). The mean scores of pain acceptance (F = 9.58, p < 0.05) and psychological flexibility (F = 10.61, p < 0 .05) significantly increased in comparison with the control group.

Conclusion:

ACT can be considered as an effective therapeutic approach to reduce depression and increase pain acceptance and psychological flexibility in women with breast cancer. These changes appear to be due to improved acceptance of thoughts and feelings associated with cancer and increased psychological flexibility, which is the primary goal of ACT treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317551/

 

Improve Education Students Psychological Well-Being with Mindfulness

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Improve Education Students Psychological Well-Being with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness practices help anchor the mind, creating space to become aware of our thoughts and feelings, and keeps us in the present moment, all of which helps reduce stress and anxiety and boosts levels of attention and concentration.” – Rebecca Enderby 

 

In the modern world education is a key for success. There is a lot of pressure on university 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. But 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, 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 

 

In today’s Research News article “The Effects of a Mindfulness Program on Mental Health in Students at an Undergraduate Program for Teacher Education: A Randomized Controlled Trial in Real-Life.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.722771/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1790561_a0P58000000G0YfEAK_Psycho_20211214_arts_A ) Juul and colleagues recruited teacher education college students and randomly assigned them to a wait-list control condition or to receive 8 weekly 2.5 hour sessions of the Mindfulness-Based Stress Reduction (MBSR) program. The program consists of training in meditation, body scan, and yoga, group discussion, and daily home practice. They were measured before and after training and 3 months later for perceived stress, anxiety, depression, well-being, resilience, mindfulness, and resting state cognitive activity.

 

They found that in comparison to baseline and the wait-list control group, the group that received Mindfulness-Based Stress Reduction (MBSR) had significantly higher well-being and significantly lower levels of perceived stress, anxiety, depression, and resting state cognitive activity of distracting thoughts, thoughts of self and comfort. In addition, they found that the effect of MBSR on perceived stress was in part mediated by resting state cognitive activity of distracting thoughts and comfort and by thoughts of self on anxiety and depression. These effects were still present at the 3-month follow-up measurement.

 

The study demonstrates that mindfulness training improves the mental health of stresses teacher education college students. It has been routinely shown in previous research with a variety of groups that mindfulness training produces reduced levels of perceived stress, anxiety, and depression and increased levels of well-being. The new finding is that these improvements in mental health produced by the mindfulness training appear to be in part mediated by changes in the students’ resting state cognitive activity. In other words, the training appears to alter the mental contents of the students which in turn improves their mental health. The mindfulness trained students appear to have fewer distracting thoughts, thoughts of self and comfort and these reductions appear to improve their psychological well-being.

 

So, improve education students psychological well-being with mindfulness.

 

“It’s no secret that college can quickly become a major stressor for many students. Balancing multiple classes on top of work, a social life, and a million other things is a lot to take on at once. Don’t let yourself become too overwhelmed with everything. Instead, try . . . mindfulness.” – Savannah Byers

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Juul L, Brorsen E, Gøtzsche K, Nielsen BL and Fjorback LO (2021) The Effects of a Mindfulness Program on Mental Health in Students at an Undergraduate Program for Teacher Education: A Randomized Controlled Trial in Real-Life. Front. Psychol. 12:722771. doi: 10.3389/fpsyg.2021.722771

 

Background: In this study, we aimed to investigate the effects of a mindfulness program including Mindfulness-Based Stress Reduction (MBSR) on the mental health of student teachers when offered at their educational institution in a real-life context.

Methods: A parallel randomized controlled trial (RCT) was conducted among self-selected student teachers at a Danish undergraduate program for teacher education in the autumns of 2019 and 2020. Participation was not recommended in case of (1) clinical depression or a diagnosis of psychosis or schizophrenia, (2) abuse of alcohol, drugs, and/or medicine. Randomization was performed by a Statistician who was blinded to the identity of the students. Data was collected using self-reported questionnaires. The primary outcome was a change in perceived stress 3 months from baseline. Secondary outcome measures were symptoms of anxiety and depression, well-being, resilience, mindfulness, and thoughts and feelings during rest. The effects were analyzed according to the intention-to-treat principle using mixed-effect linear regression models. Mediating effects of mindfulness skills on the mental health outcomes were explored using structural equation modeling.

Results: The study group included 67 student teachers with 34 allocated to the intervention group (median age: 25 years; women: n = 24, 71%); and 33 students (median age: 25 years; women: n = 25, 76%) allocated to a waiting list control group. At baseline, mean Perceived Stress Scale (PSS) scores were 18.88 (SD: 5.75) in the intervention group and 17.91 (SD: 6.36) in the waiting list control group. A total of 56 students completed the questionnaire at a 3-month follow-up (28 in both the intervention- and the control group). Statistically significant effects of the intervention were found on perceived stress, symptoms of anxiety and depression, well-being, and on three of seven resting-state dimensions. No effects were found on resilience or mindfulness. Statistically significant mediated effects via resting-state dimensions were found.

Conclusion The findings suggested that offering a mindfulness program at an undergraduate program for teacher education could significantly improve the mental health among self-selected students within 3 months. Results of mediation analysis supported the hypothesis that some of the effects might be explained by reduced distracting thoughts.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.722771/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1790561_a0P58000000G0YfEAK_Psycho_20211214_arts_A

 

Reduce Depression with Mindfulness Training in Primary Care

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Reduce Depression with Mindfulness Training in Primary Care

 

By John M. de Castro, Ph.D.

 

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

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients 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 commonly 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. The research, however, has been performed in controlled settings. So, there is a need to determine if it’s effective in real world applications such as in primary care.

 

In today’s Research News article “The Effectiveness of Mindfulness-Based Cognitive Therapy in Primary Care and the Role of Depression Severity and Treatment Attendance.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628140/ ) Elices and colleagues recruited patients through primary care physicians who had participated in Mindfulness-Based Cognitive Therapy (MBCT) for mental health issues. MBCT involved 8 weekly 2.5-hour sessions and included daily home practice. The patients were measured for personality, and depression.

 

They found that after Mindfulness-Based Cognitive Therapy (MBCT) patients who were in the normal range for depression prior to therapy had small but significant reductions in depression while those who were classified as either mildly, moderately, or severely depressed prior to therapy had large and significant reductions in depression. Hence, in real world applications, .MBCT significantly reduced depression regardless of the initial state of depression.

 

Mindfulness training has been repeatedly shown to reduce depression in a wide range of ill and healthy participants. But most of the research involved systematic controlled research. The present study shows that even in the messy and uncontrolled situation of real world primary care applications, Mindfulness-Based Cognitive Therapy (MBCT) is very effective treatment for depression.

 

So, reduce depression with mindfulness training in primary care.

 

“Mindfulness-based cognitive therapy is a group program that is generally used to delay or prevent recurrence of major depression, but can also ameliorate acute depressive syndromes and symptoms.” – Zindel Segal,

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Elices, M., Pérez-Sola, V., Pérez-Aranda, A., Colom, F., Polo, M., Martín-López, L. M., & Gárriz, M. (2021). The Effectiveness of Mindfulness-Based Cognitive Therapy in Primary Care and the Role of Depression Severity and Treatment Attendance. Mindfulness, 1–11. Advance online publication. https://doi.org/10.1007/s12671-021-01794-3

 

Abstract

Objectives

Evidence suggests the efficacy of mindfulness-based cognitive therapy (MBCT) to prevent depression relapse and decrease depressive symptoms during the acute phase. However, the effectiveness of MBCT in real-world heterogeneous samples treated in clinical health settings, including primary care, has received little attention. This study had two aims: (1) to evaluate the effectiveness of MBCT delivered in primary care considering pre-treatment depression scores and (2) to explore the role of participants’ characteristics on symptom improvement.

Methods

Data were obtained from 433 individuals who received MBCT. Participants completed the Personality Inventory for ICD-11 (PiCD) pretreatment and the Beck Depression Inventory (BDI-II) pre- and post-treatment.

Results

Sixty percent presented moderate-to-severe depression according to scores on the BDI-II, 18.1% presented mild depression, and 21.7% were in the non-depressed range. The severity of pre-treatment depressive symptoms was associated with outcomes. Most individuals who lacked depressive symptoms at baseline remained in the non-clinical range after the treatment. Those in the severe group benefited the most from the intervention, since 35.6% were considered recovered. Rates of deterioration ranged from 2.1 to 2.7%, depending on the depression-baseline scores. Depression severity at the entrance, attendance, and age, but not personality traits, appear to be related to symptom improvement.

Conclusions

According to our results, MBCT can be effectively and safely delivered in primary care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628140/