|
1
|
Zhang L, Zhu W, Liu S. Psychological interventions for reducing depressive symptoms in rheumatoid arthritis patients: a systematic review and network meta-analysis. PSYCHOL HEALTH MED 2025:1-19. [PMID: 40153848 DOI: 10.1080/13548506.2025.2482949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/17/2025] [Indexed: 04/01/2025]
Abstract
Depression has long been recognized as the most common mental disorders of rheumatoid arthritis (RA) patients. This study aimed to compare and rank the efficacy of different psychological interventions for reducing depressive symptoms among RA patients. The PubMed, Embase, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang databases, and grey literature were searched between inception and 1 June 2023. Pairs of reviewers screened studies, abstracted aggregate-level data, and appraised risk of bias with the Cochrane risk of bias tool. The study was conducted using the STATA software version 14.0. A total of 23 randomized controlled trials, involving 1885 participants and 16 interventions were included in our analyses. In this network meta-analysis, two interventions were associated with a greater reduction in symptoms of depression compared with treatment as usual care group: mindfulness-based cognitive therapy (MBCT) and combined psychological interventions (CP). Although most psychological interventions showed non-significant effects, the surface under the cumulative ranking curve (SUCRA) values revealed that the best psychological intervention for depression was MBCT (99.9%), followed by CP (85.6%). MBCT may be the most recommended intervention against the depression among RA patients according to our network meta-analysis results. Considering the methodological limitations of the included studies, more high-quality and large-sample RCTs are needed to confirm this result in the future.
Collapse
Affiliation(s)
- Lijuan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiyi Zhu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shiguang Liu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
|
2
|
Pham P, Lee YC. Non-Pharmacological Pain Management of Rheumatoid Arthritis. Curr Rheumatol Rep 2025; 27:21. [PMID: 40100461 DOI: 10.1007/s11926-025-01184-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2025] [Indexed: 03/20/2025]
Abstract
PURPOSE OF REVIEW Many individuals with rheumatoid arthritis (RA) continue to suffer from pain despite treatment with disease-modifying antirheumatic drugs. In this review, we aim to summarize the evidence for non-pharmacological approaches for managing pain in RA. RECENT FINDINGS Few studies have examined the effect of non-pharmacological therapies on pain in patients with RA. Of these studies, many were not designed to specifically target pain and examined pain as a secondary outcome. While most studies reported within group improvements in pain, the magnitude of improvement varied, and differences between intervention and control groups often were not statistically significant. We recommend non-pharmacologic approaches for management of RA, based primarily on data for improving pain-related outcomes (e.g., physical function, overall health), as opposed to pain itself. The evidence base for non-pharmacologic interventions for pain remains poor, and there is a critical need for large RCTs designed to specifically target pain.
Collapse
Affiliation(s)
- Peter Pham
- Chicago Medical School, Rosalind Franklin University, 3333 N Green Bay Rd, North Chicago, IL, 60064, USA
| | - Yvonne C Lee
- Northwestern University Feinberg School of Medicine, 633 North St. Clair Street, 18-093, Chicago Illinois, 60611, USA.
| |
Collapse
|
|
3
|
Allameen NA, Lai YW, Lian G, Lee TZY, Selvakumaran S, Tan RYT, Xu C. Physiotherapy and occupational therapy in rheumatoid arthritis: Bridging functional and comorbidity gaps. Best Pract Res Clin Rheumatol 2025; 39:102032. [PMID: 39743473 DOI: 10.1016/j.berh.2024.102032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2024] [Revised: 12/20/2024] [Accepted: 12/20/2024] [Indexed: 01/04/2025]
Abstract
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease affecting a significant portion of the global population. Despite advancements in pharmacological treatments, the management of RA remains complex, particularly in regard to comorbidities such as cardiovascular disease and osteoporosis. Physiotherapy (PT) and occupational therapy (OT) are non-pharmacological approaches that play a critical role in the management of RA. This review explores the impact of PT and OT in improving joint function, reducing pain and fatigue, and enhancing the overall quality of life in RA patients. It also addresses the role of these therapies in managing RA-related comorbidities, with an emphasis on exercise therapy, manual techniques, patient education and emerging digital interventions. Evidence supports the inclusion of tailored exercise regimens, such as cardiorespiratory training, resistance exercises and neuromotor activities, as vital components of RA management. By incorporating PT and OT, healthcare providers can better address the multifaceted needs of RA patients, complementing pharmacological treatments and improving long-term outcomes.
Collapse
Affiliation(s)
| | - Yi Wye Lai
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore.
| | - Guojie Lian
- Department of Physiotherapy, Woodlands Health, Singapore.
| | | | | | | | - Chuanhui Xu
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
| |
Collapse
|
|
4
|
Sharpe L, Menzies RE, Boyse J, Bisby MA, Richmond B, Todd J, Sesel AL, Dear BF. Mediators and Moderators of two online interventions for managing pain, fear of progression and functional ability in rheumatoid arthritis. Behav Res Ther 2025; 185:104676. [PMID: 39742659 DOI: 10.1016/j.brat.2024.104676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 10/29/2024] [Accepted: 12/18/2024] [Indexed: 01/04/2025]
Abstract
This is a secondary analysis of a trial comparing online mindfulness-based stress reduction with cognitive-behaviour therapy for people with rheumatoid arthritis. Both interventions were administered over eight weeks with five lessons and accompanied by weekly therapist contact. For the purposes of this study, we investigated the pain severity, fear of progression and functional ability as the outcome variables because the treatments had differential effects on these three outcomes but had equivalent effects on other variables. We examined mediators and moderators of relative treatment efficacy of mindfulness based stress reduction (n = 91) versus cognitive-behaviour therapy (n = 103) for these outcomes. For pain severity, no significant mediators or moderators were identified. However, amongst those with low pain severity, mindfulness-based stress reduction was more efficacious than cognitive-behaviour therapy for fears of progression. Furthermore, mindfulness-based stress reduction was more efficacious than cognitive-behaviour therapy for functional ability for those with high trait mindfulness at baseline. Changes in fear of progression during treatment fully mediated the effect of treatment group on functional ability over follow-up. While both online mindfulness-based stress reduction and cognitive-behaviour therapy were efficacious for people with rheumatoid arthritis, mindfulness-based stress reduction was more effective in reducing fears of progression and improving functional ability for those with low levels of pain severity and high levels of mindfulness at baseline, respectively. These results highlight the importance of treating fear of progression for people with rheumatoid arthritis as reductions in fears of progression over treatment led to improvements in functional ability six months later.
Collapse
Affiliation(s)
- Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia, 2006.
| | - Rachel E Menzies
- School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia, 2006
| | - Jack Boyse
- School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia, 2006
| | - Madelyne A Bisby
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Bethany Richmond
- School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia, 2006
| | - Jemma Todd
- School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia, 2006
| | - Amy-Lee Sesel
- School of Psychology, Faculty of Science, The University of Sydney, NSW, Australia, 2006
| | - Blake F Dear
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| |
Collapse
|
|
5
|
Krishna AA, Abhirami BL, Kumaran A. Pain in rheumatoid arthritis: Emerging role of high mobility group box 1 protein-HMGB1. Life Sci 2025; 362:123361. [PMID: 39761742 DOI: 10.1016/j.lfs.2024.123361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 12/20/2024] [Accepted: 12/31/2024] [Indexed: 01/11/2025]
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease where pain, driven by both inflammatory and non-inflammatory processes, is a major concern for patients. This pain can persist even after joint inflammation subsides. High mobility group box-1 (HMGB1) is a non-histone-DNA binding protein located in the nucleus that plays a key role in processes such as DNA transcription, recombination, and replication. HMGB1 can be released into the extracellular space through both passive and active mechanisms. Extracellular HMGB1 contributes to synovial inflammation, bone degradation, and the production of cytokines in RA by binding to toll-like receptors (TLRs) and receptors for advanced glycation end products (RAGE). It also forms complexes with molecules like lipopolysaccharide (LPS) and IL-1β, amplifying inflammatory responses. Due to its central role in these processes, HMGB1 is considered a promising therapeutic target in RA. It also acts as a nociceptive molecule in mediating pain in diseases such as diabetes and bone cancer. In this review, we explore how HMGB1 contributes to chronic pain in RA, supported by both in vitro and in vivo models. We begin by providing an overview of the mechanisms of pain in RA, the structure of HMGB1, its release mechanisms, and the therapeutic potential of targeting HMGB1 in RA. Following this, we highlight its role in peripheral and central pain sensitization through direct activation of the TLR4/MAPK/NF-κB pathway, as well as indirectly through downstream mediators, underscoring its potential as a target for managing RA pain.
Collapse
Affiliation(s)
- Anithakumari Aswathy Krishna
- Agroprocessing and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology, Thiruvananthapuram 695019, Kerala, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Beena Levakumar Abhirami
- Agroprocessing and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology, Thiruvananthapuram 695019, Kerala, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Alaganandam Kumaran
- Agroprocessing and Technology Division, CSIR-National Institute for Interdisciplinary Science and Technology, Thiruvananthapuram 695019, Kerala, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
| |
Collapse
|
|
6
|
Sharpe L, Bisby MA, Menzies RE, Boyse JB, Richmond B, Todd J, Sesel AL, Dear BF. A Tale of Two Treatments: A Randomised Controlled Trial of Mindfulness or Cognitive Behaviour Therapy Delivered Online for People with Rheumatoid Arthritis. PSYCHOTHERAPY AND PSYCHOSOMATICS 2025; 94:89-100. [PMID: 39827846 DOI: 10.1159/000542489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 11/05/2024] [Indexed: 01/22/2025]
Abstract
INTRODUCTION This study aimed to determine the relative efficacy of mindfulness-based stress reduction (MBSR) or cognitive behaviour therapy (CBT) in comparison to a waitlist control (WLC) for people with rheumatoid arthritis (RA). Participants completed assessments before and after treatment and at 6-month follow-up. METHODS Two hundred and sixty-nine participants with RA were recruited and randomised in a 2:2:1 ratio to MBSR:CBT:WLC. Participants completed a semi-structured clinical interview for depression and were stratified for history of recurrent depression. We measured the primary outcome of pain interference, as well as pain severity, depression, anxiety, functional ability, and fear of progression. We predicted that MBSR and CBT would result in improvements compared to WLC. We also predicted that those with a history of recurrent depression would benefit more from MBSR than CBT for depression. RESULTS MBSR and CBT were equally efficacious in reducing pain interference compared to WLC. Similar results were found for depression. MBSR demonstrated superior outcomes to CBT for fear of progression at post-treatment and functional ability at 6-month follow-up. CBT only was better than WLC for pain severity at 6-month follow-up. Depressive status did not moderate the efficacy of treatment. CONCLUSIONS MBSR and CBT resulted in statistically and clinically significant changes in pain interference compared to WLC. MBSR was more efficacious than CBT for functional ability and fear of progression, while CBT showed superiority for pain severity. The effect sizes were comparable to those achieved with face-to-face interventions, confirming both online treatments are effective for people with RA.
Collapse
Affiliation(s)
- Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Madelyne A Bisby
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Rachel E Menzies
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Jack Benjamin Boyse
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Bethany Richmond
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Jemma Todd
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Amy-Lee Sesel
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Blake F Dear
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
|
7
|
Miller-Matero LR, Hecht LM, Gavrilova L, Haage B, Autio K, Tobin ET, Ahmedani BK. Utilizing primary care to engage underserved patients in a psychological intervention for chronic pain. Prim Health Care Res Dev 2024; 25:e54. [PMID: 39450755 PMCID: PMC11569855 DOI: 10.1017/s1463423624000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/12/2024] [Accepted: 07/12/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND Although psychological interventions can be used to improve chronic pain management, underserved individuals (i.e., racially minoritized and socioeconomically disadvantaged) may be less likely to engage in such services. The purpose of this study was to examine whether offering a psychological intervention for chronic pain in a primary care clinic could be a method in which to successfully engage underserved patients. METHODS There were 220 patients with chronic pain in a primary care clinic located in a socioeconomically and racially diverse city who were approached to discuss enrolment in a pilot randomized controlled trial of a five-session psychological intervention for chronic pain. Patients were introduced to the study by their primary care provider using the warm handoff model. We compared whether there were sociodemographic differences between those who enrolled in the study and those who declined to enrol. RESULTS There were no differences between those who enrolled and those who declined enrolment with regard to race, age, insurance type, and household income. However, females were more likely to enrol in the study compared to males. CONCLUSIONS Recruiting patients to participate in a trial of a psychological intervention for chronic pain in a primary care clinic appeared to be effective for engaging Black patients, patients with lower income, and those with government insurance. Thus, offering a psychological intervention for chronic pain in a primary care clinic may encourage engagement among racially minoritized individuals and those with lower socioeconomic status.
Collapse
Affiliation(s)
- Lisa R. Miller-Matero
- Henry Ford Health, Behavioral Health, Detroit, MI, USA
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, MI, USA
- Michigan State University, East Lansing, MI, USA
| | - Leah M. Hecht
- Henry Ford Health, Behavioral Health, Detroit, MI, USA
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, MI, USA
- Michigan State University, East Lansing, MI, USA
| | - Lyubov Gavrilova
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, MI, USA
| | | | - Kirsti Autio
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, MI, USA
- Henry Ford Health, Public Health Sciences, Detroit, MI, USA
| | - Erin T. Tobin
- Henry Ford Health, Behavioral Health, Detroit, MI, USA
- Henry Ford Health, Internal Medicine, Detroit, MI, USA
| | - Brian K. Ahmedani
- Henry Ford Health, Behavioral Health, Detroit, MI, USA
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, MI, USA
- Michigan State University, East Lansing, MI, USA
| |
Collapse
|
|
8
|
Lopes A, Sampaio R, Tavares I. Pain, mindfulness, and placebo: a systematic review. Front Integr Neurosci 2024; 18:1432270. [PMID: 39267814 PMCID: PMC11390565 DOI: 10.3389/fnint.2024.1432270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 07/11/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction Pain is a complex phenomenon influenced by psychosocial variables, including the placebo effect. The effectiveness of mindfulness-based interventions (MBIs) for pain has been demonstrated in experimental studies and systematic reviews, but the mechanisms of action are only starting to be established. Whether the expectations of individuals experiencing pain can be manipulated during MBIs remains to be systematically evaluated, and what role placebo effects might play remains to be explored. Methods To evaluate the literature analyzing placebo effects in MBIs for pain, we performed a systematic review based on searches conducted in PubMed, Web of Science, and SCOPUS databases. Our search revealed a total of 272 studies, of which only 19 studies were included (10 acute pain and nine chronic pain), considering the inclusion and exclusion criteria related to expectations and placebo effects. Results From the 19 included studies, six measured placebo effects only in relation to the pharmacological intervention used in the study and not to an MBI. Discussion The results of the few studies that focused on the placebo effects of the MBIs indicate that placebo and expectations play a role in the MBIs' effects on pain. Although expectations and placebo effects are frequently discussed in the context of mindfulness and pain research, these results show that these factors are still not routinely considered in experimental designs. However, the results of the few studies included in this systematic review highlight a clear role for placebo and expectancy effects in the overall effects of MBIs for both acute and chronic pain, suggesting that routine measurement and further consideration in future studies are warranted. Additional research in this fascinating and challenging field is necessary to fully understand the connection between MBIs, placebo/expectations, and their effects on pain relief.
Collapse
Affiliation(s)
- Alexandra Lopes
- Department of Biomedicine, Unit of Experimental Biology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Rute Sampaio
- Department of Biomedicine, Unit of Experimental Biology, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS-Centre for Health Technology and Services Research, Porto, Portugal
| | - Isaura Tavares
- Department of Biomedicine, Unit of Experimental Biology, Faculty of Medicine, University of Porto, Porto, Portugal
- IBMC-Institute of Molecular and Cell Biology, University of Porto, Porto, Portugal
- I3S-Institute of Investigation and Innovation in Health, University of Porto, Porto, Portugal
| |
Collapse
|
|
9
|
Wilk M, Zimba O, Haugeberg G, Korkosz M. Pain catastrophizing in rheumatic diseases: prevalence, origin, and implications. Rheumatol Int 2024; 44:985-1002. [PMID: 38609656 PMCID: PMC11108955 DOI: 10.1007/s00296-024-05583-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/12/2024] [Indexed: 04/14/2024]
Abstract
Pain is a crucial factor in rheumatic disorders, and reducing it is a primary goal of successful treatment. Adaptive pain-coping strategies can enhance this improvement, but maladaptive approaches such as pain catastrophizing may worsen overall patient well-being. This narrative review aims to provide a concise overview of the existing knowledge on pain catastrophizing in the most prevalent specific rheumatic disorders. The objective of this study was to improve understanding of this phenomenon and its implications, as well as to pinpoint potential directions for future research. We conducted searches in the MEDLINE/PubMed, SCOPUS, and DOAJ bibliography databases to identify articles related to pain catastrophizing in rheumatoid arthritis, psoriatic arthritis, axial spondylarthritis, systemic sclerosis, systemic lupus erythematosus, Sjögren's syndrome, juvenile idiopathic arthritis, and osteoarthritis (non-surgical treatment). Data extraction was performed on November 1, 2023. The investigators screened the identified articles to determine their relevance and whether they met the inclusion criteria. Following a bibliography search, which was further expanded by screening of citations and references, we included 156 records in the current review. The full-text analysis centred on pain catastrophizing, encompassing its prevalence, pathogenesis, and impact. The review established the role of catastrophizing in amplifying pain and diminishing various aspects of general well-being. Also, potential treatment approaches were discussed and summarised across the examined disorders. Pain catastrophizing is as a significant factor in rheumatic disorders. Its impact warrants further exploration through prospective controlled trials to enhance global patient outcomes.
Collapse
Affiliation(s)
- Mateusz Wilk
- Division of Rheumatology, Immunology and Internal Medicine, University Hospital in Krakow, Krakow, Poland
| | - Olena Zimba
- Division of Rheumatology, Immunology and Internal Medicine, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Glenn Haugeberg
- Division of Rheumatology, Department of Internal Medicine, Sørlandet Hospital, Kristiansand, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mariusz Korkosz
- Division of Rheumatology, Immunology and Internal Medicine, University Hospital in Krakow, Krakow, Poland.
- Department of Rheumatology and Immunology, Jagiellonian University Medical College, Świętej Anny 12 St., 31-008, Kraków, Poland.
| |
Collapse
|
|
10
|
Si XW, Yang ZK, Feng X. A meta-analysis of the intervention effect of mindfulness training on athletes' performance. Front Psychol 2024; 15:1375608. [PMID: 38939219 PMCID: PMC11210447 DOI: 10.3389/fpsyg.2024.1375608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/17/2024] [Indexed: 06/29/2024] Open
Abstract
Objective To explore the intervention effect of mindfulness training on athletes' performance using meta-analysis method. Methods A total of 11 articles and 23 effect sizes were included through retrieval of Chinese and English databases, with a total sample size of 582. Result Mindfulness training improves the level of mindfulness [SMD =1.08, 95%CI (0.30, 1.86), p < 0.01], fluency (The optimal competitive psychological state of the athlete, the athlete's attention is all focused on the task, and other things no longer attract their attention) [SMD =1.47, 95%CI (0.87, 2.08), p < 0.001] and performance [SMD =0.92, 95% CI (0.40, 1.43), p < 0.01], reduced psychological anxiety [SMD = -0.87, 95% CI (-1.54, -0.20), p < 0.05], and all reached the level of large effect size. Conclusion The effect of mindfulness training on athletes' sports performance is effective, and it can be used as an effective psychological skill intervention method to improve athletes' sports performance. In the future, we should further expand the sample size, strengthen the comparative study of different sports and intervention modes, and pay attention to the difference between the time effect and trait mindfulness level in fluency state.
Collapse
Affiliation(s)
- Xing Wei Si
- Henan Normal University, Xinxiang, Henan, China
| | | | | |
Collapse
|
|
11
|
Sibilia J, Berna F, Bloch JG, Scherlinger M. Mind-body practices in chronic inflammatory arthritis. Joint Bone Spine 2024; 91:105645. [PMID: 37769800 DOI: 10.1016/j.jbspin.2023.105645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 10/03/2023]
Abstract
Mind-body practices are complementary approaches recognized by the World Health Organization (WHO). While these practices are very diverse, they all focus on the interaction between mind and body. These include mindful meditation, yoga, Tai Chi, sophrology, hypnosis and various relaxation techniques. There is growing interest in incorporating these strategies in the management of chronic rheumatic diseases including rheumatoid arthritis. The aim of this review is to describe the main mind-body practices and analyze the existing evidence in chronic rheumatic diseases. In rheumatoid arthritis, the Mindfulness-Based Stress Reduction program, yoga, Tai Chi and relaxation may improve patient-reported outcomes, but the benefit on inflammation and structural progression is unclear. In spondyloarthritis, very few studies are available but similar evidence exist. Further evaluations of these practices in chronic rheumatic diseases are needed since their risk/benefit ratio appears excellent.
Collapse
Affiliation(s)
- Jean Sibilia
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; UMR INSERM 1109, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.
| | - Fabrice Berna
- Service de Psychiatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jean-Gérard Bloch
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Marc Scherlinger
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; UMR INSERM 1109, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| |
Collapse
|
|
12
|
Day MA, Ehde DM, Bindicsova I, Jensen MP. Understanding the Role of Therapist Quality in Accounting for Heterogeneity of Patient Outcomes in Psychosocial Chronic Pain Treatments. THE JOURNAL OF PAIN 2024; 25:843-856. [PMID: 37832902 DOI: 10.1016/j.jpain.2023.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/24/2023] [Accepted: 10/09/2023] [Indexed: 10/15/2023]
Abstract
A variety of evidence-based psychosocial treatments now exist for chronic pain. However, on average, effect sizes have tended to be modest and there is a high degree of heterogeneity in treatment response. In this focus article, we explore the potential role that therapist quality in delivering treatment may have in accounting for a degree of this variability in outcome. Therapist quality refers to the skillful delivery of treatment, harnessing both specific and common therapeutic factors during sessions. While recognized as important to assess and report in clinical trials by some reporting guidelines, few randomized controlled trials evaluating psychosocial treatments for chronic pain have reported on therapist factors. We reviewed the clinical trials included in three systematic reviews and meta-analyses of trials of cognitive-behavioral therapy (mainly), mindfulness-based interventions, and acceptance and commitment therapy. We found that of the 134 trials included, only nine assessed and reported therapist quality indicators, with a variety of procedures used. This is concerning as without knowledge of the quality in which treatments are delivered, the estimates of effect sizes reported may be misrepresented. We contextualize this finding by drawing on the broader psychotherapy literature which has shown that more skillful, effective therapists demonstrated ten times better patient response rates. Examination of the characteristics associated with these more effective therapists tends to indicate that skillful engagement of common factors in therapy sessions represents a distinguishing feature. We conclude by providing recommendations for assessing and reporting on therapist quality within clinical trials evaluating psychosocial treatments for chronic pain. PERSPECTIVE: Therapist quality in the delivery of psychosocial treatments for chronic pain has rarely been assessed in clinical trials. We propose that therapist quality indicators are an under-studied mechanism that potentially contributes to the heterogeneity of treatment outcomes. We provide recommendations for assessing and reporting on therapist quality in future trials.
Collapse
Affiliation(s)
- Melissa A Day
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia; Department of Rehabilitation Medicine, The University of Washington, Seattle, Washington
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, The University of Washington, Seattle, Washington
| | - Ingrid Bindicsova
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Mark P Jensen
- Department of Rehabilitation Medicine, The University of Washington, Seattle, Washington
| |
Collapse
|
|
13
|
Sharpe L, Richmond B, Menzies RE, Forrest D, Crombez G, Colagiuri B. A synthesis of meta-analyses of mindfulness-based interventions in pain. Pain 2024; 165:18-28. [PMID: 37578535 DOI: 10.1097/j.pain.0000000000002997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/13/2023] [Indexed: 08/15/2023]
Abstract
ABSTRACT Mindfulness interventions have become popular in recent decades, with many trials, systematic reviews, and meta-analyses of the impact of mindfulness-based interventions (MBIs) on pain. Although many meta-analyses provide support for MBIs, the results are more mixed than they at first appear. The aim of this umbrella review was to determine the strength of evidence for MBIs by synthesizing available meta-analyses in pain. We conducted a systematic search in 5 databases and extracted data from published meta-analyses as the unit of analysis. For each outcome, we reported the range of effect sizes observed across studies and identified the largest meta-analysis as the "representative" study. We separately analysed effect sizes for different pain conditions, different types of MBIs, different control groups, and different outcomes. We identified 21 meta-analyses that included 127 unique studies. According to Assessment of Multiple Systematic Review ratings, the meta-analyses ranged from very strong to weak. Overall, there was an impact of MBIs on pain severity, anxiety, and depression but not pain interference or disability. When conditions were considered in isolation, only fibromyalgia and headache benefited significantly from MBIs. Mindfulness-based interventions were more efficacious for pain severity than passive control conditions but not active control conditions. Only pain severity and anxiety were affected by MBIs at follow-up. Overall, our results suggest that individual meta-analyses of MBIs may have overestimated the efficacy of MBIs in a range of conditions. Mindfulness-based interventions likely have a role in pain management but should not be considered a panacea.
Collapse
Affiliation(s)
| | | | | | | | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | |
Collapse
|
|
14
|
Tourny C, Zouita A, El Kababi S, Feuillet L, Saeidi A, Laher I, Weiss K, Knechtle B, Zouhal H. Endometriosis and physical activity: A narrative review. Int J Gynaecol Obstet 2023; 163:747-756. [PMID: 37345574 DOI: 10.1002/ijgo.14898] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 06/23/2023]
Abstract
Endometriosis is a painful gynecological disorder that affects many women. Constant treatments and contraception changes affect women looking for solutions to treat and limit the problems caused by endometriosis. The current narrative review discusses the effects of physical activity on the management, pain, and quality of life in patients with endometriosis. Findings suggest that body awareness practices such as Hatha yoga, the Jacobson method, and progressive muscle relaxation reduce pain and stress and improve the quality of life associated with endometriosis. It also highlights the current knowledge gap on available evidence and future research. Moreover, care must be taken when considering patients' physical abilities and goals and avoiding intense physical activities. The forms of endometriosis and its symptoms vary from one woman to another, so it is important to perform studies with various nonmedicinal or surgical techniques. It is important to continue randomized controlled trials to obtain more data on the benefits of physical activity in women with endometriosis and also to identify what types of activities could be beneficial to combat pain symptoms and improve the daily lives of women with endometriosis.
Collapse
Affiliation(s)
- Claire Tourny
- Univ Rouen Normandie, CETAPS - UR 3832, Mont Saint Aignan, France
| | - Amira Zouita
- Higher Institute of Sport and Physical Education of Ksar-Said, Research Unit "Sports Performance, Health & Society" (UR17JS01), University of Manouba, Manouba, Tunisia
| | - Samira El Kababi
- High Institute of Nursing Professions and Health Techniques, Casablanca, Morocco
| | - Léa Feuillet
- Univ Rouen Normandie, CETAPS - UR 3832, Mont Saint Aignan, France
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, Kurdistan, Iran
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Katja Weiss
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé), Rennes, France
- Institut International des Sciences du Sport (2I2S), Irodouer, France
| |
Collapse
|
|
15
|
Seizer L, Huber E, Schirmer M, Hilbert S, Wiest EM, Schubert C. Personalized therapy in rheumatoid arthritis (PETRA): a protocol for a randomized controlled trial to test the effect of a psychological intervention in rheumatoid arthritis. Trials 2023; 24:743. [PMID: 37986029 PMCID: PMC10659068 DOI: 10.1186/s13063-023-07707-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/22/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects cartilage and bone. Psychological stress can both trigger disease exacerbation and result from disease activity. As standard pharmacological interventions alone have limited success in treating RA, a more comprehensive biopsychosocial approach to treatment has been recommended. In this prospective randomized controlled trial (RCT), a psychotherapeutically guided, group-based intervention program will be conducted with RA patients over a period of 9 months. This program combines a dynamic-interactional model with disorder-specific coping-oriented perspectives to improve patients' social, emotional, and problem-solving competencies as well as stress system functional status. The enrolment of 440 patients, randomly allocated to either an intervention (n = 220) or control group (n = 220), is planned. To evaluate the intervention effect, various indicators of RA disease activity, stress system activity, and psychological condition will be assessed through sets of standardized questionnaires and biochemical analyses of blood and saliva samples. Moreover, healthcare-related costs for each patient will be obtained using routine health insurance data. Outcome variables will be measured in all patients at regular intervals prior to intervention (baseline), during the 9-month intervention (five time points), and during a 9-month follow-up phase (three time points), allowing the comprehensive analysis of within- and between-subject effects, i.e. trajectories of the target variables in the intervention and control groups. In addition, to investigate the intervention effects on real-life stress system functioning in RA, 10 integrative single-case studies (n = 5 from the intervention group, n = 5 from the control group) will be conducted. In each study, once before and after the 9-month intervention, urine samples will be collected, and patients will fill out questionnaires for approximately 1 month at 12-h intervals. Moreover, weekly in-depth interviews will be conducted with patients to determine their previous week's emotionally positive and negative incidents. Using time series analysis, it is then possible to investigate whether and how stress system function in these RA patients has improved from the applied intervention. By using both an investigational macro- and microperspective, this project aims to evaluate a psychological intervention in the routine care of individuals with RA.Trial registration German Clinical Trials Register DRKS00028144. Registered on 1 March 2022.
Collapse
Affiliation(s)
- Lennart Seizer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Ellis Huber
- Professional Association of Preventologists, Berlin, Germany
| | - Miriam Schirmer
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
| | - Sven Hilbert
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
| | - Eva-Maria Wiest
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Schubert
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria.
| |
Collapse
|
|
16
|
Jensen MP, Ehde DM, Hakimian S, Pettet MW, Day MA, Ciol MA. Who Benefits the Most From Different Psychological Chronic Pain Treatments? An Exploratory Analysis of Treatment Moderators. THE JOURNAL OF PAIN 2023; 24:2024-2039. [PMID: 37353183 PMCID: PMC10615716 DOI: 10.1016/j.jpain.2023.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/25/2023]
Abstract
Different psychological chronic pain treatments benefit some individuals more than others. Understanding the factors that are associated with treatment response-especially when those factors differ between treatments-may inform more effective patient-treatment matching. This study aimed to identify variables that moderate treatment response to 4 psychological pain interventions in a sample of adults with low back pain or chronic pain associated with multiple sclerosis, spinal cord injury, acquired amputation, or muscular dystrophy (N = 173). The current study presents the results from secondary exploratory analyses using data from a randomized controlled clinical trial which compared the effects of 4 sessions of cognitive therapy (CT), hypnosis focused on pain reduction (HYP), hypnosis focused on changing pain-related cognitions and beliefs (HYP-CT), and a pain education control condition (ED). The analyses tested the effects of 7 potential treatment moderators. Measures of primary (pain intensity) and secondary (pain interference, depression severity) outcome domains were administered before and after the pain treatments, and potential moderators (catastrophizing, hypnotizability, and electroencephalogram (EEG)-assessed oscillation power across five bandwidths) were assessed at pre-treatment. Moderator effects were tested fitting regression analyses to pre- to post-treatment changes in the three outcome variables. The study findings, while preliminary, support the premise that pre-treatment measures of hypnotizability and EEG brain activity predict who is more (or less) likely to respond to different psychological pain treatments. If additional research replicates the findings, it may be possible to better match patients to their more individually suitable treatment, ultimately improving pain treatment outcomes. PERSPECTIVE: Pre-treatment measures of hypnotizability and EEG-assessed brain activity predicted who was more (or less) likely to respond to different psychological pain treatments. If these findings are replicated in future studies, they could inform the development of patient-treatment matching algorithms.
Collapse
Affiliation(s)
- Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Dawn M. Ehde
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Shahin Hakimian
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Mark W. Pettet
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Melissa A. Day
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Marcia A. Ciol
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| |
Collapse
|
|
17
|
Duarte C, Spilker RLF, Paiva C, Ferreira RJO, da Silva JAP, Pinto AM. MITIG.RA: study protocol of a tailored psychological intervention for managing fatigue in rheumatoid arthritis randomized controlled trial. Trials 2023; 24:651. [PMID: 37803467 PMCID: PMC10559483 DOI: 10.1186/s13063-023-07692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Despite remarkable medical advances in the treatment of rheumatoid arthritis (RA), a subset of patients fails to achieve complete clinical remission, as the Patient Global Assessment (PGA) of disease activity remains above 1, even after the inflammatory process is brought under control. This so-called state of 'PGA-near-remission' negatively impacts individuals' functioning and potentiates inadequate care. Fatigue is a distressing and disabling symptom frequently reported by patients in PGA-near-remission, and its management remains challenging. While classic cognitive-behavioural interventions show some benefits in managing fatigue, there is potential for improvement. Recently, contextual-cognitive behavioural therapies (CCBT), like mindfulness, acceptance, and compassion-based interventions, have shown promising results in fatigue-associated disorders and their determinants. This study primarily aims to examine the efficacy of the Compassion and Mindfulness Intervention for RA (MITIG.RA), a novel intervention combining different components of CCBT, compared to treatment-as-usual (TAU) in the management of RA-associated fatigue. Secondary aims involve exploring whether MITIG.RA produces changes in the perceived impact of disease, satisfaction with disease status, levels of depression, and emotion-regulation skills. METHODS This is a single center, two-arm parallel randomized controlled trial. Patients will be screened for eligibility and willingness to participate and will be assessed and randomized to the experimental (MITIG.RA + TAU) or control condition (TAU) using computer randomization. MITIG.RA will be delivered by a certified psychologist and comprises eight sessions of 2 h, followed by two booster sessions. Outcomes will be assessed through validated self-report measures, including fatigue (primary outcome), perceived impact of disease, depressive symptoms, mindfulness, self-compassion, safety, and satisfaction (secondary outcomes). Assessment will take place at baseline, post-intervention, before the first and second booster sessions (weeks 12 and 20, respectively), and at 32 and 44 weeks after the interventions' beginning. DISCUSSION We expect MITIG.RA to be effective in reducing levels of RA-associated fatigue. Secondarily, we hypothesize that the experimental group will show improvements in the overall perceived impact of disease, emotional distress, and emotion regulation skills. Our findings will contribute to determine the benefits of combining CCBT approaches for managing fatigue and associated distress in RA. TRIAL REGISTRATION ClinicalTrials.gov NCT05389189. Registered on May 25, 2022.
Collapse
Affiliation(s)
- Cátia Duarte
- Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal.
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.
| | | | - Cláudia Paiva
- Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
| | - Ricardo J O Ferreira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisbon, Portugal
| | - José A Pereira da Silva
- Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal
| | - Ana M Pinto
- Centre for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
|
18
|
Schuette SA, Andrade FC, Woodward JT, Smoski MJ. Identifying modifiable factors associated with psychological health in women experiencing infertility. J Health Psychol 2023; 28:1143-1156. [PMID: 37403402 DOI: 10.1177/13591053231185549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
This study assessed the relationship between modifiable psychological variables and depression, anxiety, and posttraumatic growth in women experiencing infertility. U.S. women (N = 457) who identified as experiencing infertility completed standardized self-report measures of mindfulness, self-compassion, positive affect, intolerance of uncertainty, relationship satisfaction, experiential avoidance, depression, anxiety, and posttraumatic growth. Clinical and demographic characteristics (age, duration trying to conceive, miscarriage, and childlessness) did not predict depression or anxiety. Lower positive affect and higher experiential avoidance were associated with depression and anxiety. Lower self-compassion was associated with depression; higher intolerance of uncertainty was associated with anxiety. There were indirect effects of mindfulness on anxiety and depression via these variables. Future research should explore whether intervening on these factors reduces depressive and anxiety symptoms. Promoting mindfulness may have beneficial effects on symptoms via its downstream effects on multiple coping variables. Counterintuitively, posttraumatic growth was associated with higher intolerance of uncertainty and experiential avoidance.
Collapse
Affiliation(s)
| | | | | | - Moria J Smoski
- Duke University, USA
- Duke University School of Medicine, USA
| |
Collapse
|
|
19
|
Irwin MR, Straub RH, Smith MT. Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis. Nat Rev Rheumatol 2023; 19:545-559. [PMID: 37488298 DOI: 10.1038/s41584-023-00997-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Abstract
Sleep has a homeostatic role in the regulation of the immune system and serves to constrain activation of inflammatory signalling and expression of cellular inflammation. In patients with rheumatoid arthritis (RA), a misaligned inflammatory profile induces a dysregulation of sleep-wake activity, which leads to excessive inflammation and the induction of increased sensitivity to pain. Given that multiple biological mechanisms contribute to sleep disturbances (such as insomnia), and that the central nervous system communicates with the innate immune system via neuroendocrine and neural effector pathways, potential exists to develop prevention opportunities to mitigate the risk of insomnia in RA. Furthermore, understanding these risk mechanisms might inform additional insomnia treatment strategies directed towards steering and reducing the magnitude of the inflammatory response, which together could influence outcomes of pain and disease activity in RA.
Collapse
Affiliation(s)
- Michael R Irwin
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
- Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience and Human Behaviour, Los Angeles, CA, USA.
| | - Rainer H Straub
- Laboratory of Experimental Rheumatology and Neuroendocrine Immunology, Department of Internal Medicine I, University Hospital, Regensburg, Germany
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| |
Collapse
|
|
20
|
Abomoelak B, Prather R, Pragya SU, Pragya SC, Mehta ND, Uddin P, Veeramachaneni P, Mehta N, Young A, Kapoor S, Mehta D. Cognitive Skills and DNA Methylation Are Correlating in Healthy and Novice College Students Practicing Preksha Dhyāna Meditation. Brain Sci 2023; 13:1214. [PMID: 37626570 PMCID: PMC10452635 DOI: 10.3390/brainsci13081214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/15/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
The impact of different meditation protocols on human health is explored at the cognitive and cellular levels. Preksha Dhyana meditation has been observed to seemingly affect the cognitive performance, transcriptome, and methylome of healthy and novice participant practitioners. In this study, we performed correlation analyses to investigate the presence of any relationships in the changes in cognitive performance and DNA methylation in a group of college students practicing Preksha Dhyāna (N = 34). Nine factors of cognitive performance were assessed at baseline and 8 weeks postintervention timepoints in the participants. Statistically significant improvements were observed in six of the nine assessments, which were predominantly relating to memory and affect. Using Illumina 850 K microarray technology, 470 differentially methylated sites (DMS) were identified between the two timepoints (baseline and 8 weeks), using a threshold of p-value < 0.05 and methylation levels beyond -3% to 3% at every site. Correlation analysis between the changes in performance on each of the nine assessments and every DMS unveiled statistically significant positive and negative relationships at several of these sites. The identified DMS were in proximity of essential genes involved in signaling and other important metabolic processes. Interestingly, we identified a set of sites that can be considered as biomarkers for Preksha meditation improvements at the genome level.
Collapse
Affiliation(s)
- Bassam Abomoelak
- Gastrointestinal Translational Laboratory, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA;
| | - Ray Prather
- Pediatric Cardiothoracic Surgery Department, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA;
| | - Samani U. Pragya
- Department of Religions and Philosophies, University of London, London WC1H 0XG, UK;
| | - Samani C. Pragya
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA;
| | - Neelam D. Mehta
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA;
| | - Parvin Uddin
- College of Arts, Sciences and Education, Florida International University, Miami, FL 33199, USA;
| | | | - Naina Mehta
- Neurodevelopmental Pediatrician, Behavioral and Developmental Center, Orlando Health, Orlando, FL 32805, USA;
| | - Amanda Young
- Institute for Simulation and Training, University of Central Florida, Orlando, FL 32765, USA;
| | - Saumya Kapoor
- Medical School, University of Central Florida, Orlando, FL 32827, USA;
| | - Devendra Mehta
- Gastrointestinal Translational Laboratory, Arnold Palmer Hospital for Children, Orlando, FL 32806, USA;
| |
Collapse
|
|
21
|
Bishop MER, Hamiduzzaman M, Veltre AS. Mindfulness meditation use in chronic pain treatment in rural Australia: Pitfalls and potential - A case report. J Neurosci Rural Pract 2023; 14:516-521. [PMID: 37692825 PMCID: PMC10483197 DOI: 10.25259/jnrp-2022-4-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/05/2022] [Indexed: 02/12/2023] Open
Abstract
Mindfulness is a state of awareness characterized by open and non-judgmental recognition of thoughts and sensations and an ability to resist the usual wandering of an individual's attention. Usually achieved by meditation, mindfulness is recognized as a treatment for chronic pain. Evidence, thus far, has been characterized by poor quality trials and mixed results, but a growing body of research is further investigating its effectiveness. Despite inconclusive evidence, the inherent difficulties of mindfulness research, and problems of accessibility in rural settings, mindfulness meditation is an emerging treatment strategy for many chronic pain patients. This report presents the case of a patient admitted to a rural hospital in New South Wales, whose quality of life was severely impacted by chronic pain.
Collapse
Affiliation(s)
| | | | - Arron Sam Veltre
- Department of Rural Health, The University of Newcastle, NSW, Australia
| |
Collapse
|
|
22
|
Ballesio A, Zagaria A, Vacca M, Pariante CM, Lombardo C. Comparative efficacy of psychological interventions on immune biomarkers: A systematic review and network meta-analysis (NMA). Brain Behav Immun 2023; 111:424-435. [PMID: 37187256 DOI: 10.1016/j.bbi.2023.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/25/2023] [Accepted: 05/12/2023] [Indexed: 05/17/2023] Open
Abstract
Psychological interventions are viable, cost-effective strategies for improving clinical and psychological impact of inflammation-related conditions. However, their efficacy on immune system function remains controversial. We performed a systematic review and frequentist random-effects network meta-analysis of randomised controlled trials (RCTs) assessing the effects of psychological interventions, against a control condition, on biomarkers of innate and adaptive immunity in adults. PubMed, Scopus, PsycInfo, and Web of Science were searched from inception up to Oct 17, 2022. Cohen's d at 95% confidence interval (CI) was calculated to assess the effect sizes of each class of intervention against active control conditions at post-treatment. The study was registered in PROSPERO (CRD42022325508). Of the 5024 articles retrieved, we included 104 RCTs reporting on 7820 participants. Analyses were based on 13 types of clinical interventions. Compared with the control conditions, cognitive therapy (d = - 0.95, 95% CI: -1.64 to - 0.27), lifestyle (d = - 0.51, 95% CI: -0.99 to - 0.02), and mindfulness-based (d = - 0.38, 95% CI: -0.66 to - 0.09) interventions were associated with post-treatment reduction of proinflammatory cytokines and markers. Mindfulness-based interventions were also significantly associated with post-treatment increase in anti-inflammatory cytokines (d = 0.69, 95% CI: 0.09 to 1.30), while cognitive therapy was associated also with post-treatment increase in white blood cell count (d = 1.89, 95% CI: 0.05 to 3.74). Results on natural killer cells activity were non-significant. Grade of evidence was moderate for mindfulness and low-to-moderate for cognitive therapy and lifestyle interventions; however, substantial overall heterogeneity was detected in most of the analyses.
Collapse
Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Andrea Zagaria
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Mariacarolina Vacca
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
|
23
|
The Efficacy of Acceptance and Commitment Therapy for Chronic Pain: A Systematic Review and Meta-analysis. Clin J Pain 2023; 39:147-157. [PMID: 36827194 DOI: 10.1097/ajp.0000000000001096] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/03/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES Previous meta-analyses of a small number of trials showed that acceptance and commitment therapy (ACT) might improve chronic pain. Many new trials have been published afterward, and the factors that may impact the efficacy of ACT are less understood. We, therefore, conducted an updated systematic review with meta-analysis to investigate the efficacy of ACT for people with chronic pain. METHODS Randomized controlled trials that investigated the efficacy of ACT in clinical or community setting for adult populations with chronic pain were included. The methodological quality of trials was assessed with the Cochrane Risk of Bias tool. Standardized mean differences between ACT and comparison groups in their effects on 6 outcomes (ie, pain acceptance, quality of life, pain-related functioning, pain intensity, anxiety, and depression) were pooled across studies. RESULTS Of the 3171 records identified, 21 trials with 1962 participants were included for analysis. The comparison groups included active treatment and waitlist control/usual care. The standardized mean difference was 0.67 (95% CI: 0.48, 0.87) for pain acceptance, 0.43 (95% CI: 0.29, 0.57) for quality of life, -0.88 (95% CI: -1.14, -0.63) for pain-related functioning, -0.45 (95% CI: -0.62, -0.27) for pain intensity, -0.35 (95% CI: -0.54, -0.15) for anxiety, and -0.74 (95% CI, -0.98, -0.50) for depression, all favoring ACT. Subgroup analyses showed that the effects were statistically significant across almost all subgroups and for some outcomes were greater in the trials conducted in people with a specific diagnosis (as compared with those conducted in people with general chronic pain), the trials with waitlist or usual care control, the trials with a greater number of sessions of ACT, and the trials with a longer ACT intervention. DISCUSSION ACT is effective and comparable to, if not better than, some other available active treatments for chronic pain.
Collapse
|
|
24
|
Slagter L, Demyttenaere K, Verschueren P, De Cock D. The Effect of Meditation, Mindfulness, and Yoga in Patients with Rheumatoid Arthritis. J Pers Med 2022; 12:1905. [PMID: 36422081 PMCID: PMC9696072 DOI: 10.3390/jpm12111905] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/02/2022] [Accepted: 11/10/2022] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVES Mind-body therapies (MBTs), including meditation, yoga, and mindfulness, create an interaction between the mind and body to enhance health. MBTs are perceived by both patients and healthcare professionals as valuable in the management of rheumatoid arthritis (RA), but the extent of this contribution is unclear, as are the patient subgroups who benefit most from MBTs. Therefore, this systematic literature review investigates the effects of meditation, mindfulness, and yoga in patients with RA. METHODS We searched four databases (PubMed, Embase, Web of Science (core collection, Chinese and Korean collection), and CINAHL). All studies were screened by two independent reviewers via the title/abstract/full text. The studies included any form of meditation/mindfulness/yoga as an intervention for RA. Animal studies, case reports, non-English articles, qualitative studies, conference abstracts, and articles without full-text access were excluded. Each study was assessed for its quality. RESULTS Out of 1527 potentially eligible records, 23 studies were included. All three MBTs showed various effects on patient-reported outcomes, such as vitality, functioning, and mental health, as well as on disease activity markers. Mindfulness-based interventions mainly reduced the subjective disease activity parameters (e.g., joint tenderness, morning stiffness, and pain), rather than the objective disease activity parameters (e.g., swollen joints and C-reactive protein (CRP)). RA patients with recurrent depression may benefit more from these non-pharmacological therapies than patients without recurrent depression. DISCUSSION This systematic literature review found that MBTs show added value in RA management, especially for patients with depressive symptoms. These non-pharmacological approaches, when used in addition to medication, might diminish polypharmacy in specific RA patient populations. Lay Summary: In recent decades, more attention has been given to the management of rheumatoid arthritis (RA) with options other than solely using medication. Such alternative options for patients to increase their quality of life are, for instance, meditation, yoga, and mindfulness. These examples of mind-body therapies (MBTs) are techniques that create an interaction between the mind and the bodily functions in order to obtain relaxation and enhance overall health. Although it is believed that these mind-body techniques are valuable in the management of RA, the extent of their contribution is still unclear, as is the question of if certain subgroups of patients benefit more from these complementary therapies. This systematic literature review investigated the effects of meditation, mindfulness, and yoga in patients with rheumatoid arthritis. A literature search was systematically performed within four different scientific databases by two independent reviewers. Out of 1527 potentially eligible articles, 23 studies were included. All three MBTs showed beneficial effects, which were mostly on the vitality, functioning, and mental health of patients with RA, but also on symptoms related to disease activity. RA patients with recurrent depression seemed to benefit more from these non-pharmacological therapies than patients without recurrent depression. Hence, we can conclude that MBTs show added value in the management of RA.
Collapse
Affiliation(s)
- Laura Slagter
- Skeletal Biology and Engineering Research Centre, KU Leuven, 3001 Leuven, Belgium
| | - Koen Demyttenaere
- Department of Neurosciences, Psychiatry Research Group and University Psychiatric Center KU Leuven, Belgium University Psychiatric Center, KU Leuven, 3001 Leuven, Belgium
| | - Patrick Verschueren
- Skeletal Biology and Engineering Research Centre, KU Leuven, 3001 Leuven, Belgium
- Department of Rheumatology, University Hospitals of Leuven, 3001 Leuven, Belgium
| | - Diederik De Cock
- Skeletal Biology and Engineering Research Centre, KU Leuven, 3001 Leuven, Belgium
- Biostatistics and Medical Informatics Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1005 Brussels, Belgium
| |
Collapse
|
|
25
|
Savitz J, Ford BN, Yeh HW, Akeman E, Cosgrove K, Clausen AN, Martell C, Kirlic N, Santiago J, Teague TK, Irwin MR, Paulus MP, Aupperle RL. Behavioral activation therapy for depression is associated with a reduction in the concentration of circulating quinolinic acid. Psychol Med 2022; 52:2500-2509. [PMID: 33234171 PMCID: PMC8144244 DOI: 10.1017/s0033291720004389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND An inflammation-induced imbalance in the kynurenine pathway (KP) has been reported in major depressive disorder but the utility of these metabolites as predictive or therapeutic biomarkers of behavioral activation (BA) therapy is unknown. METHODS Serum samples were provided by 56 depressed individuals before BA therapy and 29 of these individuals also provided samples after 10 weeks of therapy to measure cytokines and KP metabolites. The PROMIS Depression Scale (PROMIS-D) and the Sheehan Disability Scale were administered weekly and the Beck depression inventory was administered pre- and post-therapy. Data were analyzed with linear mixed-effect, general linear, and logistic regression models. The primary outcome for the biomarker analyses was the ratio of kynurenic acid to quinolinic acid (KynA/QA). RESULTS BA decreased depression and disability scores (p's < 0.001, Cohen's d's > 0.5). KynA/QA significantly increased at post-therapy relative to baseline (p < 0.001, d = 2.2), an effect driven by a decrease in QA post-therapy (p < 0.001, uncorrected, d = 3.39). A trend towards a decrease in the ratio of kynurenine to tryptophan (KYN/TRP) was also observed (p = 0.054, uncorrected, d = 0.78). Neither the change in KynA/QA, nor baseline KynA/QA were associated with response to BA therapy. CONCLUSION The current findings together with previous research show that electronconvulsive therapy, escitalopram, and ketamine decrease concentrations of the neurotoxin, QA, raise the possibility that a common therapeutic mechanism underlies diverse forms of anti-depressant treatment but future controlled studies are needed to test this hypothesis.
Collapse
Affiliation(s)
- Jonathan Savitz
- Laureate Institute for Brain Research, Tulsa, OK
- Oxley College of Health Sciences, The University of Tulsa, Tulsa OK
| | - Bart N. Ford
- Laureate Institute for Brain Research, Tulsa, OK
| | | | | | - Kelly Cosgrove
- Laureate Institute for Brain Research, Tulsa, OK
- Department of Psychology, The University of Tulsa, Tulsa OK
| | - Ashley N. Clausen
- Kansas City VA Healthcare System, Kansas City, MO
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City, MO
| | - Christopher Martell
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - Namik Kirlic
- Laureate Institute for Brain Research, Tulsa, OK
| | | | - T. Kent Teague
- Department of Surgery, University of Oklahoma School of Community Medicine, Tulsa, OK
- Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, OK
- Department of Pharmaceutical Sciences, University of Oklahoma College of Pharmacy, Tulsa, OK
| | - Michael R. Irwin
- Cousins Center for Psychoneuroimmunology at UCLA, Semel Institute for Neuroscience and UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, OK
- Oxley College of Health Sciences, The University of Tulsa, Tulsa OK
| | - Robin L. Aupperle
- Laureate Institute for Brain Research, Tulsa, OK
- Oxley College of Health Sciences, The University of Tulsa, Tulsa OK
| |
Collapse
|
|
26
|
Fonia D, Aisenberg D. The Effects of Mindfulness Interventions on Fibromyalgia in Adults aged 65 and Older: A Window to Effective Therapy. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09911-7. [PMID: 36163446 DOI: 10.1007/s10880-022-09911-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/25/2022]
Abstract
Pain usually receives insufficient attention by individuals due to the misconception that pain is a natural consequence of aging. For persons aged 65 and older, a disease requiring further research is fibromyalgia, characterized by chronic pain without clear pathology. Mind-body therapies like mindfulness are beneficial for this population as they affect psychological and biological aspects of pain. These therapies emphasize a nonjudgmental acceptance of thoughts and attention to the experience without attempting to resist or change them. Despite the potential benefits of mindfulness interventions for persons with fibromyalgia aged 65 and older, only few studies have examined the effects of these therapies, yielding conflicting findings. Importantly, no study has yet to be conducted exclusively on this population. This comprehensive review examined existing literature focusing on the effects of mindfulness-based interventions on the physical and mental well-being of persons with fibromyalgia aged 65 and older. It highlights the need for further research on the relationship between mindfulness, fibromyalgia, and gerontology, calling for a standard protocol of intervention.
Collapse
Affiliation(s)
- Dvir Fonia
- Clinical Psychology of Adulthood and Aging, Ruppin Academic Center, Emek Hefer, Israel.
| | - Daniela Aisenberg
- Clinical Psychology of Adulthood and Aging, Ruppin Academic Center, Emek Hefer, Israel
- The Dror (Imri) Aloni Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
|
27
|
Fisher HM, Taub CJ, Lechner SC, Heller AS, Lee DJ, Antoni MH. Does the Broaden-and-Build Theory Explain Reduction in Social Disruption After a Brief Relaxation Intervention for Women With Breast Cancer Undergoing Treatment? Behav Ther 2022; 53:995-1008. [PMID: 35987554 PMCID: PMC9404531 DOI: 10.1016/j.beth.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022]
Abstract
Women with breast cancer experience social disruption during and after treatment. Brief cognitive-behavioral (CBT) and relaxation (RT) interventions may improve social disruption by increasing positive affect. Using the Broaden-and-Build Theory as a framework, this study examined whether short-term CBT- and RT-related increases in positive affect mediate long-term reductions in social disruption in women with breast cancer undergoing treatment (N = 183). This secondary analysis used latent change score and growth models to test 6- and 12-month intervention effects on positive affect and social disruption, respectively; a parallel-process model assessed mediation. RT demonstrated larger reductions in social disruption across 12 months compared to CBT and a health education control. Six-month latent change in positive affect was significant but not driven by condition. There was a significant direct effect linking the latent slopes of positive affect and social disruption but meditation was not observed. These preliminary findings hint at the value of promoting positive affect and inform the development of brief behavioral interventions that aim to augment social functioning among women surviving breast cancer.
Collapse
Affiliation(s)
| | | | | | - Aaron S. Heller
- University of Miami,Sylvester Cancer Center, University of Miami Miller School of Medicine
| | | | - Michael H. Antoni
- University of Miami,Sylvester Cancer Center, University of Miami Miller School of Medicine
| |
Collapse
|
|
28
|
Majnik J, Császár-Nagy N, Böcskei G, Bender T, Nagy G. Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis. Front Med (Lausanne) 2022; 9:991677. [PMID: 36106320 PMCID: PMC9465607 DOI: 10.3389/fmed.2022.991677] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022] Open
Abstract
Although the management of rheumatoid arthritis (RA) has improved remarkably with new pharmacological therapies, there is still a significant part of patients not reaching treatment goals. Difficult-to-treat RA (D2TRA) is a complex entity involving several factors apart from persistent inflammation, thereafter requiring a holistic management approach. As pharmacological treatment options are often limited in D2TRA, the need for non-pharmacological treatments (NPT) is even more pronounced. The mechanism of action of non-pharmacological treatments is not well investigated, NPTs seem to have a complex, holistic effect including the immune, neural and endocrine system, which can have a significant additive benefit together with targeted pharmacotherapies in the treatment of D2TRA. In this review we summarize the current knowledge on different NPT in rheumatoid arthritis, and we propose a NPT plan to follow when managing D2TRA patients.
Collapse
Affiliation(s)
- Judit Majnik
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
- Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
- *Correspondence: Judit Majnik,
| | - Noémi Császár-Nagy
- Department of Public Management and Information Technology, Faculty of Science of Public Governance and Administration, National University of Public Service, Budapest, Hungary
| | - Georgina Böcskei
- Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
| | - Tamás Bender
- Hospital of the Hospitaller Order of Saint John of God, Budapest, Hungary
| | - György Nagy
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
|
29
|
Irwin MR. Sleep disruption induces activation of inflammation and heightens risk for infectious disease: Role of impairments in thermoregulation and elevated ambient temperature. Temperature (Austin) 2022; 10:198-234. [PMID: 37332305 PMCID: PMC10274531 DOI: 10.1080/23328940.2022.2109932] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 10/15/2022] Open
Abstract
Thermoregulation and sleep are tightly coordinated, with evidence that impairments in thermoregulation as well as increases in ambient temperature increase the risk of sleep disturbance. As a period of rest and low demand for metabolic resources, sleep functions to support host responses to prior immunological challenges. In addition by priming the innate immune response, sleep prepares the body for injury or infection which might occur the following day. However when sleep is disrupted, this phasic organization between nocturnal sleep and the immune system becomes misaligned, cellular and genomic markers of inflammation are activated, and increases of proinflammatory cytokines shift from the nighttime to the day. Moreover, when sleep disturbance is perpetuated due to thermal factors such as elevated ambient temperature, the beneficial crosstalk between sleep and immune system becomes further imbalanced. Elevations in proinflammatory cytokines have reciprocal effects and induce sleep fragmentation with decreases in sleep efficiency, decreases in deep sleep, and increases in rapid eye movement sleep, further fomenting inflammation and inflammatory disease risk. Under these conditions, sleep disturbance has additional potent effects to decrease adaptive immune response, impair vaccine responses, and increase vulnerability to infectious disease. Behavioral interventions effectively treat insomnia and reverse systemic and cellular inflammation. Further, insomnia treatment redirects the misaligned inflammatory- and adaptive immune transcriptional profiles with the potential to mitigate risk of inflammation-related cardiovascular, neurodegenerative, and mental health diseases, as well as susceptibility to infectious disease.
Collapse
Affiliation(s)
- Michael R. Irwin
- University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, USA
| |
Collapse
|
|
30
|
Lindsay EK, Creswell JD, Stern HJ, Greco CM, Walko TD, Dutcher JM, Wright AGC, Brown KW, Marsland AL. Mindfulness-based stress reduction increases stimulated IL-6 production among lonely older adults: A randomized controlled trial. Brain Behav Immun 2022; 104:6-15. [PMID: 35550854 PMCID: PMC9646928 DOI: 10.1016/j.bbi.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/15/2022] [Accepted: 05/06/2022] [Indexed: 12/13/2022] Open
Abstract
Loneliness is a potent psychosocial stressor that predicts poor health and mortality among older adults, possibly in part by accelerating age-related declines in immunocompetence. Mindfulness interventions have shown promise for reducing loneliness and improving markers of physical health. In a sample of lonely older adults, this two-arm parallel trial tested whether mindfulness training enhances stimulated interleukin-6 (IL-6) production, a measure of innate immune responsivity. Lonely older adults (65-85 years; N = 190) were randomized to an 8-week Mindfulness-Based Stress Reduction (MBSR) or control Health Enhancement Program (HEP) intervention. Lipopolysaccharide (LPS)-stimulated production of IL-6 was measured in vitro by blinded outcome assessors at pre-intervention, post-intervention, and 3-month follow-up. Mixed-effects linear models tested time (pre, post, follow-up) by condition (MBSR vs. HEP) effects. As predicted, a significant time × condition effect on stimulated IL-6 production was observed across pre, post, and follow-up timepoints. Significant MBSR vs. HEP differences emerged from pre- to post-intervention (p =.009, d = 0.38) and from pre-intervention to 3-month follow-up (p =.017, d = 0.35), with larger increases in IL-6 production following MBSR compared to HEP. No study-related adverse events were reported. Results show that mindfulness training may be effective for boosting innate immunocompetence among lonely older adults. Given that immunocompetence tends to decline with age, mindfulness training may help to counteract the effects of aging and psychosocial stress on infection risk and recovery from injury.
Collapse
|
|
31
|
Bunjak A, Černe M, Schölly EL. Exploring the past, present, and future of the mindfulness field: A multitechnique bibliometric review. Front Psychol 2022; 13:792599. [PMID: 35959046 PMCID: PMC9361873 DOI: 10.3389/fpsyg.2022.792599] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 07/06/2022] [Indexed: 12/28/2022] Open
Abstract
This paper provides an overview of the mindfulness literature up until the end of 2020 by (a) uncovering its underlying intellectual structure, (b) identifying the most influential and popular themes, and (c) presenting new directions for future research on mindfulness. To this end, a systematic quantitative review based on bibliometric methods was conducted, which is perhaps less prone to researcher bias and can complement existing meta-analyses and qualitative (narrative) structured reviews as an objective approach. Three bibliometric techniques—document co-citation analysis, co-word (co-occurrence and content) analysis, and bibliographic coupling—were applied to explore the past, present, and future of mindfulness research. The co-citation analysis showed that measurement, mechanisms, mindfulness-based interventions, and examinations of the efficacy of mindfulness interventions are among the key theoretical knowledge bases from which the field of mindfulness is derived. The content analysis demonstrated the beneficial effects of mindfulness meditation for physical and mental health conditions. The bibliographic coupling revealed novel directions in cognitive behavioral therapy, emotion regulation, the application of mindfulness practice to children and adolescents, mindfulness at work, and the role of mindfulness in positive psychology. The large sample of articles that was analyzed allowed us to provide a broader and more objective overview than possible with other forms of literature reviews. The combination of the three bibliometric techniques granted deeper insights into the complex multidisciplinary field of mindfulness, along with specific suggestions for future research.
Collapse
Affiliation(s)
- Aldijana Bunjak
- Institute for Leadership and Human Resource Management, University of St. Gallen, St. Gallen, Switzerland
- *Correspondence: Aldijana Bunjak
| | - Matej Černe
- School of Economics and Business, University of Ljubljana, Ljubljana, Slovenia
| | - Emilie Lara Schölly
- Institute for Leadership and Human Resource Management, University of St. Gallen, St. Gallen, Switzerland
| |
Collapse
|
|
32
|
Sebastian BB, Slaten CD. “I'm prepared for this moment”: The role of mindfulness in the psychosocial health of women of color. JOURNAL OF MULTICULTURAL COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1002/jmcd.12259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Bini B. Sebastian
- Department of Educational School & Counseling Psychology University of Missouri‐Columbia Columbia Missouri USA
| | - Christopher D. Slaten
- Department of Educational School & Counseling Psychology University of Missouri‐Columbia Columbia Missouri USA
| |
Collapse
|
|
33
|
Blessin M, Lehmann S, Kunzler AM, van Dick R, Lieb K. Resilience Interventions Conducted in Western and Eastern Countries-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6913. [PMID: 35682495 PMCID: PMC9180776 DOI: 10.3390/ijerph19116913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/26/2022]
Abstract
Previous research has demonstrated the efficacy of psychological interventions to foster resilience. However, little is known about whether the cultural context in which resilience interventions are implemented affects their efficacy on mental health. Studies performed in Western (k = 175) and Eastern countries (k = 46) regarding different aspects of interventions (setting, mode of delivery, target population, underlying theoretical approach, duration, control group design) and their efficacy on resilience, anxiety, depressive symptoms, quality of life, perceived stress, and social support were compared. Interventions in Eastern countries were longer in duration and tended to be more often conducted in group settings with a focus on family caregivers. We found evidence for larger effect sizes of resilience interventions in Eastern countries for improving resilience (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] 0.28 to 0.67; p < 0.0001; 43 studies; 6248 participants; I2 = 97.4%). Intercultural differences should receive more attention in resilience intervention research. Future studies could directly compare interventions in different cultural contexts to explain possible underlying causes for differences in their efficacy on mental health outcomes.
Collapse
Affiliation(s)
- Manpreet Blessin
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Sophie Lehmann
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Angela M. Kunzler
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
| | - Rolf van Dick
- Department of Social Psychology, Goethe University, 60323 Frankfurt, Germany;
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany; (M.B.); (S.L.); (A.M.K.)
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, 55131 Mainz, Germany
| |
Collapse
|
|
34
|
Menzies RE, Sharpe L, Richmond B, Dudeney J, Todd J, Szabo M, Sesel AL, Dear B. Randomised controlled trial of cognitive behaviour therapy versus mindfulness for people with rheumatoid arthritis with and without a history of recurrent depression: study protocol and design. BMJ Open 2022; 12:e056504. [PMID: 35589354 PMCID: PMC9121498 DOI: 10.1136/bmjopen-2021-056504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Psychosocial treatments have been shown to benefit people with rheumatoid arthritis (RA) on various outcomes. Two evidence-based interventions are cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR). However, these interventions have been compared only once. Results showed that CBT outperformed MBSR on some outcomes, but MBSR was more effective for people with RA with a history of recurrent depression, with efficacy being moderated by history of depressive episodes. However, this was a post-hoc finding based on a small subsample. We aim to examine whether a history of recurrent depression will moderate the relative efficacy of these treatments when delivered online. METHODS AND ANALYSIS This study is a randomised controlled trial comparing CBT and MBSR delivered online with a waitlist control condition. History of recurrent depressive episodes will be assessed at baseline. The primary outcome will be pain interference. Secondary outcomes will include pain intensity, RA symptoms, depressive symptoms and anxiety symptoms. Outcome measures will be administered at baseline, post-treatment and at 6 months follow-up. We aim to recruit 300 participants, and an intention-to-treat analysis will be used. Linear mixed models will be used, with baseline levels of treatment outcomes as the covariate, and group and depressive status as fixed factors. The results will demonstrate whether online CBT and MBSR effectively improve outcomes among people with RA. Importantly, this trial will determine whether one intervention is more efficacious, and whether prior history of depression moderates this effect. ETHICS AND DISSEMINATION The trial has been approved by the Human Research Ethics Committee of the University of Sydney (2021/516). The findings will be subject to publication irrespective of the final results of the study, and based on the outcomes presented in this protocol. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12621000997853p).
Collapse
Affiliation(s)
- Rachel E Menzies
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Bethany Richmond
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Joanne Dudeney
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | - Jemma Todd
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Marianna Szabo
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Amy-Lee Sesel
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Blake Dear
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
|
35
|
Zanca JM, Gilchrist C, Ortiz CE, Dyson-Hudson TA. Pilot clinical trial of a clinical meditation and imagery intervention for chronic pain after spinal cord injury. J Spinal Cord Med 2022; 45:339-353. [PMID: 34612802 PMCID: PMC9135436 DOI: 10.1080/10790268.2021.1970894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To assess the feasibility and potential benefits of clinical meditation and imagery (CMI) for people with chronic spinal cord injury (SCI) and chronic pain. DESIGN Pilot randomized, controlled trial. SETTING Outpatients with SCI in the United States. PARTICIPANTS 24 adults with chronic SCI (>1 year) and a >3 month history of pain rated ≥4/10 on average over the last week. INTERVENTIONS 4-week program of once-weekly 2-hour group classes, offered in-person and online. CMI group participants were taught mindfulness, mantra meditation, and guided imagery practices. Control group participants received education on topics related to health and function after SCI. OUTCOME MEASURES Pain interference (primary outcome), pain cognitions, pain intensity/unpleasantness, depressive symptomology, perceived stress. RESULTS Pain interference decreased to a greater extent in the control group at both Day 42 and Day 70, with a large effect size (d > 1.0). Several secondary outcome measures showed changes consistent with more favorable outcomes in the CMI group at both Day 42 and Day 70, with a large effect size d > 0.80, including worst pain intensity over the last week, depressive symptomology, belief in pain as a sign of harm and perceived control over pain. Perceived stress improved to a greater extent in the control group (d = 1.16 at Day 42, d = .20 at Day 70). CONCLUSION CMI is feasible and acceptable to implement with people with SCI and chronic pain. Further study is warranted to assess potential benefits for pain-related outcomes.
Collapse
Affiliation(s)
- Jeanne M. Zanca
- Center for Spinal Cord Injury Research, Kessler Foundation, West Orange, New Jersey, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Christine Gilchrist
- Department of Integrative Medicine, Mount Sinai Beth Israel, New York, New York, USA
| | - Caroline E. Ortiz
- Department of Integrative Medicine, Mount Sinai Beth Israel, New York, New York, USA
| | - Trevor A. Dyson-Hudson
- Center for Spinal Cord Injury Research, Kessler Foundation, West Orange, New Jersey, USA
| |
Collapse
|
|
36
|
López-Roig S, Ecija C, Peñacoba C, Ivorra S, Nardi-Rodríguez A, Lecuona O, Pastor-Mira MA. Assessing Walking Programs in Fibromyalgia: A Concordance Study between Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2995. [PMID: 35270687 PMCID: PMC8910142 DOI: 10.3390/ijerph19052995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023]
Abstract
This study analyzes the degree of agreement between three self-report measures (Walking Behavior, WALK questionnaire and logbooks) assessing adherence to walking programs through reporting their components (minutes, rests, times a week, consecutive weeks) and their concordance with a standard self-report of physical activity (IPAQ-S questionnaire) and an objective, namely number of steps (pedometer), in 275 women with fibromyalgia. Regularized partial correlation networks were selected as the analytic framework. Three network models based on two different times of assessment, namely T1 and T2, including 6 weeks between both, were used. WALK and the logbook were connected with Walking Behavior and also with the IPAQ-S. The logbook was associated with the pedometers (Z-score > 1 in absolute value). When the behavior was assessed specifically and in a detailed manner, participants’ results for the different self-report measures were in agreement. Specific self-report methods provide detailed information that is consistent with validated self-report measures (IPAQ-S) and objective measures (pedometers). The self-report measures that assess the behavioral components of physical activity are useful when studying the implementation of walking as physical exercise.
Collapse
Affiliation(s)
- Sofía López-Roig
- Department of Behavioral Sciences and Health, University Miguel Hernández, 03540 San Juan de Alicante, Spain; (S.L.-R.); (A.N.-R.); (M.A.P.-M.)
| | - Carmen Ecija
- Department of Psychology, Rey Juan Carlos University, 28922 Madrid, Spain; (C.P.); (O.L.)
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, 28922 Madrid, Spain; (C.P.); (O.L.)
| | - Sofía Ivorra
- Official College of Nursing, 03007 Alicante, Spain;
| | - Ainara Nardi-Rodríguez
- Department of Behavioral Sciences and Health, University Miguel Hernández, 03540 San Juan de Alicante, Spain; (S.L.-R.); (A.N.-R.); (M.A.P.-M.)
| | - Oscar Lecuona
- Department of Psychology, Rey Juan Carlos University, 28922 Madrid, Spain; (C.P.); (O.L.)
| | - María Angeles Pastor-Mira
- Department of Behavioral Sciences and Health, University Miguel Hernández, 03540 San Juan de Alicante, Spain; (S.L.-R.); (A.N.-R.); (M.A.P.-M.)
| |
Collapse
|
|
37
|
Buric I, Farias M, Driessen JMA, Brazil IA. Individual differences in meditation interventions: A meta-analytic study. Br J Health Psychol 2022; 27:1043-1076. [PMID: 35224829 PMCID: PMC9543193 DOI: 10.1111/bjhp.12589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/09/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
Abstract
Objectives Meditation interventions typically show small to moderate effects on health and well‐being, but we know little about how these effects vary across individuals. This meta‐analytic study investigates the relationship between baseline participant characteristics and the outcomes of meditation. Methods A systematic search yielded 51 eligible studies with 7782 participants. A combination of subgroup analyses and meta‐regression based on the random‐effects model were used. Results We found that a higher baseline level of psychopathology or depression was associated with deterioration in mental health after a meditation intervention. On the other hand, participants with higher scores on interpersonal variables, motivation, medical conditions, and mindfulness showed higher levels of positive meditation outcomes. Higher well‐being and stress were simultaneously associated with moderate increases in negative and positive meditation outcomes. Participant demographics, psychological traits, self‐concept, and length of meditation practice did not significantly influence the response to meditation. Conclusions Overall, we found that meditation interventions affect participants differently, and identified some of the individual characteristics that should be considered when using meditation interventions.
Collapse
Affiliation(s)
- Ivana Buric
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, The Netherlands.,Department of Psychology, University of Amsterdam, The Netherlands.,Brain, Belief, & Behaviour Lab, Centre for Trust, Peace and Social Relations, Coventry University, UK
| | - Miguel Farias
- Brain, Belief, & Behaviour Lab, Centre for Trust, Peace and Social Relations, Coventry University, UK
| | - Josi M A Driessen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, The Netherlands.,Department of Psychology, Utrecht University, The Netherlands
| | - Inti A Brazil
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, The Netherlands.,Forensic Psychiatric Centre Pompestichting, The Netherlands
| |
Collapse
|
|
38
|
Sesel AL, Sharpe L, Beadnall HN, Barnett MH, Szabo M, Naismith SL. A randomized controlled trial of a web-based mindfulness programme for people with MS with and without a history of recurrent depression. Mult Scler 2022; 28:1392-1401. [PMID: 35130768 DOI: 10.1177/13524585211068002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Evidence shows small positive effects associated with psychological treatments for people with multiple sclerosis (PwMS). In a recent meta-analysis, the treatment with the largest effect size was a mindfulness-based intervention (MBI). OBJECTIVES We aimed to determine whether an Internet-delivered MBI was beneficial for PwMS. Furthermore, we aimed to investigate history of recurrent depression as a moderator of treatment outcome. METHODS Participants (N = 132) were assessed based on whether they had a history of recurrent depression, then stratified and randomized to MBI or waitlist. Outcomes were assessed at baseline, post-intervention, and 3 and 6 months. RESULTS The MBI group reported significantly improved depressive symptoms (primary outcome) compared with the waitlist (p = 0.046, Cohen's d = 0.39). Those with a history of recurrent depression benefitted significantly more than those without (p = 0.034, d = 0.66). There were benefits for health-related quality of life (HRQoL) in the MBI, irrespective of depression history (p = 0.009, d = 0.5). Pain interference was less overall in the MBI group (p < 0.001, d = 0.2), but change over time did not differ from waitlist. There were no treatment effects for anxiety, pain severity or fatigue. CONCLUSION The Internet-delivered MBI significantly improved depressive symptoms and HRQoL in PwMS. For depression, the benefits were greater for those with a history of recurrent depression. TRIAL REGISTRATION ACTRN12618001260213, available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375598.
Collapse
Affiliation(s)
- Amy-Lee Sesel
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Heidi N Beadnall
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia/Neurology Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Michael H Barnett
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia/Neurology Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Marianna Szabo
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Sharon L Naismith
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
|
39
|
Kim DY, Hong SH, Jang SH, Park SH, Noh JH, Seok JM, Jo HJ, Son CG, Lee EJ. Systematic Review for the Medical Applications of Meditation in Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1244. [PMID: 35162267 PMCID: PMC8834867 DOI: 10.3390/ijerph19031244] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 11/23/2022]
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.
Collapse
Affiliation(s)
- Do-Young Kim
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Soo-Hwa Hong
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Seung-Hyeon Jang
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - So-Hyeon Park
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Jung-Hee Noh
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Jung-Mi Seok
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Hyun-Jeong Jo
- Korean Medical College, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Korea; (D.-Y.K.); (S.-H.H.); (S.-H.J.); (S.-H.P.); (J.-H.N.); (J.-M.S.); (H.-J.J.)
| | - Chang-Gue Son
- Department of Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, Daejeon Oriental Hospital of Daejeon University, 75, Daedeok-daero 176, Seo-gu, Daejeon 35235, Korea
| |
Collapse
|
|
40
|
Lancaster K, Thomson SJ, Chiaravalloti ND, Genova HM. Improving mental health in Multiple Sclerosis with an interpersonal emotion regulation intervention: a prospective, randomized controlled trial. Mult Scler Relat Disord 2022; 60:103643. [DOI: 10.1016/j.msard.2022.103643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/27/2021] [Accepted: 01/29/2022] [Indexed: 01/10/2023]
|
|
41
|
Ma H, Xu J, Li R, McIntyre RS, Teopiz KM, Cao B, Yang F. The Impact of Cognitive Behavioral Therapy on Peripheral Interleukin-6 Levels in Depression: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:844176. [PMID: 35633813 PMCID: PMC9136073 DOI: 10.3389/fpsyt.2022.844176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/28/2022] [Indexed: 11/28/2022] Open
Abstract
UNLABELLED There is interest in the role of peripheral interleukin-6 (IL-6) in depression and the effect of treatment (e. g., pharmacologic, psychosocial, neurostimulation). However, the relationship between cognitive behavioral therapy (CBT), IL-6 and depression has not yet been established. We conducted a meta-analysis to explore the association between CBT and change of peripheral IL-6 levels in depressive symptoms or major depressive disorder (MDD). A systematic search of online databases (i.e., PubMed, Web of Science, Google Scholar, PsycINFO, and Cochrane Library) was completed from inception to May 2021. In total, 10 eligible papers with 940 participants reporting peripheral IL-6 levels before and after CBT were included in the analysis. The main result indicates that peripheral levels of IL-6 were significantly lower after CBT intervention in individuals with depression, with a small effect (SMD = 0.38, 95% CI: 0.07, 0.69, p = 0.02). The results of subgroup analyses demonstrate that (1) there was a significant decrease in IL-6 for studies that were equal to or <8 weeks in duration vs. more than 8 weeks in duration, and (2) IL-6 was significantly reduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis (i.e., DSM-IV, DSM-IV-TR, or DSM-V) of MDD, but not for the subgroup without DSM diagnosis. Publication year was identified as a potential contributor to heterogeneity of the results from our analysis. Taken together, our findings support the notion that CBT influences peripheral IL-6 in individuals with depression and represents a point of commonality with other antidepressant treatment modalities (e.g., antidepressants). SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/osf.io/tr9yh, identifier: 10.17605/osf.io/tr9yh.
Collapse
Affiliation(s)
- Haijing Ma
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Jiatong Xu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Ruonan Li
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Fahui Yang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| |
Collapse
|
|
42
|
Ford JD, Tennen H, Grasso DJ, Chan G. An in-Vivo Daily Self-Report Approach to the Assessment of Outcomes of Two Psychotherapies for Women With Posttraumatic Stress Disorder. Behav Ther 2022; 53:11-22. [PMID: 35027153 DOI: 10.1016/j.beth.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/23/2021] [Accepted: 05/07/2021] [Indexed: 11/02/2022]
Abstract
Emotion regulation and interpersonal psychotherapies that do not require trauma memory processing have been shown to be effective in treating posttraumatic stress disorder (PTSD). This study used a novel method to assess in vivo outcomes in a randomized clinical trial with women (N = 147; ages 18-54; 61% of color; 94% low income) with full (79%) or partial (21%) PTSD. Participants were assigned to affect regulation or interpersonal therapy, or wait-list, and completed daily self-reports for 2 to 4 weeks at baseline and up to 30 days at posttest. Mixed model regression analyses tested pre-post change on five factor analytically derived aggregated daily self-report scores. Emotion regulation-focused therapy was associated with reduced PTSD symptoms, dysregulation, and negative affect, and improvement in adaptive self-regulation and positive affect. Interpersonal-focused therapy was associated with reduced PTSD symptoms and dysregulation. Although both therapies were associated with reduced PTSD symptoms, whether this was due to nonspecific factors rather than the treatments per se could not be determined. Daily self-report data warrant further investigation in psychotherapy research with disorders such as PTSD, in order to assess affective and interpersonal dysregulation and adaptive regulation as they occur in daily life.
Collapse
Affiliation(s)
| | | | | | - Grace Chan
- University of Connecticut, School of Medicine
| |
Collapse
|
|
43
|
Tripathy A, Swain N, Gupta B. Understanding the Role and Uses of Alternative Therapies for Management of Rheumatoid Arthritis. Curr Rheumatol Rev 2021; 18:89-100. [PMID: 34784872 DOI: 10.2174/1573397117666211116102454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/30/2021] [Accepted: 08/30/2021] [Indexed: 11/22/2022]
Abstract
With growing popularity of complementary and alternative medicine (CAM) among the individuals with chronic pain and muscular problems, a number of patients with rheumatoid arthritis (RA) show their interest in CAM interventions for disease improvement. Various reports published on CAM are based on animal model of RA however there is often lack of high quality clinical investigations for explaining the success stories of CAM therapies in patients with RA. CAMs having potential to be used for therapy in patients with RA have been identified, however lack of awareness and scepticism of their efficacy has made the patients reluctant to choose these drug less therapies. In this review, we have summarized the existing evidences which suggest promising efficacy of different alternative therapies in managing RA and providing both physical and mental well being to RA patients.
Collapse
Affiliation(s)
- Archana Tripathy
- Disease Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) deemed to be University, Bhubaneswar-751024, Odisha. India
| | - Nitish Swain
- Disease Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) deemed to be University, Bhubaneswar-751024, Odisha. India
| | - Bhawna Gupta
- Disease Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) deemed to be University, Bhubaneswar-751024, Odisha. India
| |
Collapse
|
|
44
|
Lindsay EK. Mindfulness interventions for offsetting health risk following early life stress: Promising directions. Brain Behav Immun Health 2021; 17:100338. [PMID: 34589821 PMCID: PMC8474678 DOI: 10.1016/j.bbih.2021.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/19/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022] Open
Abstract
Early life stress (ELS), common to childhood maltreatment, socioeconomic disadvantage, and racial discrimination, is thought to create a proinflammatory phenotype that increases risk for poor health in adulthood. Systemic change is needed to address the root causes of ELS, but a substantial number of adults are already at increased health risk by virtue of ELS exposure. Interventions that target stress pathways have the potential to interrupt the trajectory from ELS to inflammatory disease risk in adulthood. Mindfulness-based interventions (MBIs), which train acceptance toward present-moment experience, have shown promise for reducing stress and improving a variety of stress-sensitive health outcomes. Although MBIs have primarily been conducted in more advantaged populations, evidence suggests that they may be uniquely effective for improving mental health and health-related quality of life among those with a history of ELS. Whether these effects extend to physical health remains unknown. To shed light on this question, I review evidence that MBIs influence inflammatory markers in at-risk samples, explore the promise of MBIs for improving stress-related health outcomes in diverse at-risk populations, and describe adaptations to MBIs that may increase their acceptability and efficacy in populations exposed to ELS. This prior work sets the stage for well-controlled RCTs to evaluate whether MBIs influence stress and inflammatory pathways among those exposed to ELS and for pragmatic and implementation trials focused on disseminating MBIs to reach these at-risk populations. Overall, the evidence assembled here shows the potential of MBIs for offsetting physical health risk related to ELS.
Collapse
Affiliation(s)
- Emily K Lindsay
- University of Pittsburgh, Department of Psychology 600 Old Engineering Hall, 3943 O'Hara Street, Pittsburgh, PA, 15213, USA
| |
Collapse
|
|
45
|
Zgierska AE, Burzinski CA, Garland EL, Lennon RP, Jamison R, Nakamura Y, Barrett B, Sehgal N, Mirgain SA, Singles JM, Cowan P, Woods D, Edwards RR. Mindfulness-based therapy compared to cognitive behavioral therapy for opioid-treated chronic low back pain: Protocol for a pragmatic randomized controlled trial. Contemp Clin Trials 2021; 110:106548. [PMID: 34478870 DOI: 10.1016/j.cct.2021.106548] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/12/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Chronic low back pain (CLBP) is disabling and costly. Existing therapies have proven suboptimal, with many patients resorting to long-term opioid therapy, which can cause harms. Cognitive behavioral (CBT) and mindfulness-based (MBT) therapies can be effective and offer unique skills for safe pain coping. This article describes the protocol for a study evaluating comparative effectiveness of CBT and MBT in adults with opioid-treated CLBP. DESIGN Pragmatic, multi-center randomized controlled trial (RCT). SETTINGS Community and outpatient care. PARTICIPANTS Planned enrollment of 766 adults (383/group) with CLBP treated with long-term opioids (≥3 months; ≥15 mg/day morphine-equivalent dose). INTERVENTIONS CBT or MBT consisting of eight weekly therapist-led, two-hour group sessions, and home practice (≥30 min/day, 6 days/week) during the 12-month study. MAIN OUTCOME MEASURES Main outcome measures, collected by self-report at baseline, then three, six, nine and 12 months post-entry, include co-primary measures: pain intensity (Numeric Rating Scale) and function (Oswestry Disability Index), and secondary measures: quality of life (Medical Outcomes Study) and average daily opioid dose (Timeline Followback). Baseline scores of depression, anxiety, and opioid misuse questionnaires will be assessed as potential contributors to the heterogeneity of treatment response. Intention-to-treat, linear mixed-effects analysis will examine treatment effectiveness. Qualitative data will augment the quantitative measures. CONCLUSIONS This will be the largest RCT comparing CBT and MBT in opioid-treated CLBP. It will provide evidence on the impact of these interventions, informing clinical decisions about optimal therapy for safe, effective care, improving quality of life and decreasing opioid-related harm among adults with refractory CLBP.
Collapse
Affiliation(s)
- Aleksandra E Zgierska
- Pennsylvania State University College of Medicine, Departments of Family and Community Medicine, Public Health Sciences and Anesthesiology and Perioperative Medicine, 700 HMC Crescent Road, Hershey, PA 17033, United States of America.
| | - Cindy A Burzinski
- University of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health, 1100 Delaplaine Court, Madison, WI 53715, United States of America.
| | - Eric L Garland
- University of Utah, College of Social Work, 395 1500 E, Salt Lake City, UT 84112, United States of America
| | - Robert P Lennon
- Pennsylvania State University College of Medicine, Department of Family and Community Medicine and Law School, 700 HMC Crescent Road, Hershey, PA 17033, United States of America.
| | - Robert Jamison
- Harvard Medical School, Brigham and Women's Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry, 850 Boylston Street, Chestnut Hill, MA 02467, United States of America.
| | - Yoshio Nakamura
- University of Utah School of Medicine, Department of Anesthesiology, Division of Pain Medicine, Pain Research Center, 615 Arapeen Drive, Suite 200, Salt Lake City, UT 84108, United States of America.
| | - Bruce Barrett
- University of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health, 1100 Delaplaine Court, Madison, WI 53715, United States of America.
| | - Nalini Sehgal
- University of Wisconsin School of Medicine and Pulic Health, Department of Orthopedics & Rehabilitation, Pain Medicine, 1685 Highland Avenue, Madison, WI 53705-2281, United States of America.
| | - Shilagh A Mirgain
- University of Wisconsin School of Medicine and Pulic Health, Department of Orthopedics & Rehabilitation, Pain Medicine, 1685 Highland Avenue, Madison, WI 53705-2281, United States of America.
| | - Janice M Singles
- University of Wisconsin School of Medicine and Pulic Health, Department of Orthopedics & Rehabilitation, Pain Medicine, 1685 Highland Avenue, Madison, WI 53705-2281, United States of America.
| | - Penney Cowan
- American Chronic Pain Association, Inc, PO Box 850, Rocklin, CA 95677, United States of America.
| | - David Woods
- University of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health, 1100 Delaplaine Court, Madison, WI 53715, United States of America.
| | - Robert R Edwards
- Harvard Medical School, Brigham and Women's Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry, 850 Boylston Street, Chestnut Hill, MA 02467, United States of America.
| |
Collapse
|
|
46
|
Grekhov RA, Suleimanova GP, Trofimenko AS, Shilova LN. Psychosomatic Features, Compliance and Complementary Therapies in Rheumatoid Arthritis. Curr Rheumatol Rev 2021; 16:215-223. [PMID: 31830886 DOI: 10.2174/1573397115666191212114758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/05/2019] [Accepted: 11/08/2019] [Indexed: 11/22/2022]
Abstract
This review highlights the issue of psychosomatic conditions in rheumatoid arthritis, paying special attention to new researches and trends in this field. Emerging concepts in all the major parts of the problem are covered consecutively, from the impact of chronic musculoskeletal pain on the emotional state to disease influence over quality of life, socio-psychological, and interpersonal relationships. Chronic pain is closely related to emotional responses and coping ability, with a pronounced positive effect of psychotherapeutic interventions, family and social support on it. Psychosexual disorders, anxiety, depression also commonly coexist with rheumatoid arthritis, leading to further decrease in quality of life, low compliance, and high suicide risk. Influence of psychosomatic conditions on the overall treatment effect is usually underestimated by rheumatologists and general practitioners. Psychosomatic considerations are of great importance for up-to-date management of rheumatoid arthritis, as they strongly influence the quality of life, compliance, and thereby disease outcomes. Two major approaches of psychological rehabilitation exist, both coping with pain through the regulation of emotion and psychotherapeutic intervention, which not only helps patients in coping with the disease, but also aimed at improving the overall adaptation of the patient. It includes techniques of relaxation, cognitive-behavioral therapy, and biofeedback therapy. Current data about the efficacy of the additional correcting therapies for patients with rheumatoid arthritis, both emerging and common ones, are discussed in the review.
Collapse
Affiliation(s)
- Rostislav A Grekhov
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Galina P Suleimanova
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Andrei S Trofimenko
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | | |
Collapse
|
|
47
|
Miller-Matero LR, Hecht LM, Miller MK, Autio K, Pester BD, Tobin ET, Patel S, Braciszewski JM, Maye M, Ahmedani BK. A Brief Psychological Intervention for Chronic Pain in Primary Care: A Pilot Randomized Controlled Trial. PAIN MEDICINE 2021; 22:1603-1611. [PMID: 33616190 DOI: 10.1093/pm/pnaa444] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Although evidence-based psychological interventions improve chronic pain, many patients do not engage in behavioral health services. Offering a brief intervention in a medical setting may provide benefits to patients with chronic pain. The purpose of this study was to examine preliminary outcomes of a brief psychological intervention for chronic pain delivered in primary care. DESIGN Pilot randomized controlled trial. SETTING Primary care clinic. SUBJECTS Sixty participants with chronic pain were randomized to a 5-session psychological intervention or treatment-as-usual control group. METHODS Participants completed pre- and post-intervention measures assessing pain severity, pain interference, pain catastrophizing, depression, and anxiety. RESULTS Most participants (76.7%) randomized to the intervention completed all sessions. Compared to the control group, those in the intervention had decreases in pain severity (P = .048), pain catastrophizing (P = .04), and depression (P = .01) from pre- to post-intervention. Within the intervention group, there was a significant improvement in pain interference scores (P = 0.02). Within the intervention group, effect sizes were medium to large for changes in pain severity, pain interference, pain catastrophizing, and depression scores. There were no significant changes in anxiety scores. CONCLUSION Results suggest that delivery of a brief psychological intervention for chronic pain in primary care appears to offer improvements in pain severity, pain interference, pain catastrophizing, and depression. Findings suggest that shorter-term psychological interventions may offer similar benefits as longer-term ones. Furthermore, offering a brief intervention in primary care may increase access and engagement in behavioral pain management services. Future research should examine this through a fully-powered trial with longer-term outcomes.
Collapse
Affiliation(s)
- Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Leah M Hecht
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Mary Kate Miller
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Kirsti Autio
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Bethany D Pester
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Erin T Tobin
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
| | - Shivali Patel
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA
| | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Melissa Maye
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| | - Brian K Ahmedani
- Behavioral Health, Henry Ford Health System, Detroit, Michigan, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA
| |
Collapse
|
|
48
|
Cognitive therapy, mindfulness-based stress reduction, and behavior therapy for the treatment of chronic pain: randomized controlled trial. Pain 2021; 163:376-389. [PMID: 34074945 DOI: 10.1097/j.pain.0000000000002357] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/23/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Trials of cognitive therapy (CT), mindfulness-based stress reduction (MBSR), and behavior therapy (BT) suggest that all 3 treatments produce reductions in pain and improvements in physical function, mood, and sleep disturbance in people with chronic pain conditions. Fewer studies have compared the relative efficacies of these treatments. In this randomized controlled study, we compared CT, MBSR, BT, and treatment as usual (TAU) in a sample of people with chronic low back pain (N = 521). Eight individual sessions were administered with weekly assessments of outcomes. Consistent with the prior work, we found that CT, MBSR, and BT produced similar pretreatment to posttreatment effects on all outcomes and revealed similar levels of maintenance of treatment gains at 6-month follow-up. All 3 active treatments produced greater improvements than TAU. Weekly assessments allowed us to assess rates of change; ie, how quickly a given treatment produced significant differences, compared with TAU, on a given outcome. The 3 treatments differed significantly from TAU on average by session 6, and this rate of treatment effect was consistent across all treatments. Results suggest the possibility that the specific techniques included in CT, MBSR, and BT may be less important for producing benefits than people participating in any techniques rooted in these evidence-based psychosocial treatments for chronic pain.
Collapse
|
|
49
|
Allen ES, Evans S, Wyka K. Making the Most of Mindfulness-Based Stress Reduction: Participant Feedback Reveals Strengths and Challenges. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
|
50
|
A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 170] [Impact Index Per Article: 42.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
Collapse
|