mind over medicine pdf free download

Junko Walch December 02, 2021

Review

. 2014 Mar;174(3):357-68.

doi: 10.1001/jamainternmed.2013.13018.

Meditation programs for psychological stress and well-being: a systematic review and meta-analysis

Sonal Singh 1 , Erica M S Sibinga 2 , Neda F Gould 3 , Anastasia Rowland-Seymour 1 , Ritu Sharma 4 , Zackary Berger 1 , Dana Sleicher 3 , David D Maron 4 , Hasan M Shihab 4 , Padmini D Ranasinghe 1 , Shauna Linn 4 , Shonali Saha 2 , Eric B Bass 5 , Jennifer A Haythornthwaite 3

Affiliations

  • PMID: 24395196
  • PMCID: PMC4142584
  • DOI: 10.1001/jamainternmed.2013.13018

Free PMC article

Review

Meditation programs for psychological stress and well-being: a systematic review and meta-analysis

Madhav Goyal  et al. JAMA Intern Med. 2014 Mar .

Free PMC article

Abstract

Importance: Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation.

Objective: To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations.

Evidence review: We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals.

Findings: After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies).

Conclusions and relevance: Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.

Figures

Figure 1
Figure 1

Figure 1A: Summary across measurement domains of comparisons of meditation programs with non-specific active controls Figure 1B. Summary across measurement domains of comparisons of meditation programs with specific active controls

  1. CSM = Clinically Standardized Meditation, a mantra meditation program; TM=Transcendental Meditation, a mantra meditation program

  2. CHF = Congestive Heart Failure; CAD = Coronary Artery Disease

  3. PO = Number of trials in which this was a primary outcome for the trial; PA = Primary Analysis; MA = Meta-analysis; N = sample size

  4. Direction based on relative difference in change analysis:

    ↑ indicates that the meditation group improved relative to the control group (with a relative difference generally greater than or equal to 5 percent across trials).

    ↓ indicates the meditation group worsened relative to the control group (with a relative difference generally greater than or equal to 5 percent across trials).

    Ø indicates a null effect (with a relative difference generally less than 5 percent across trials).

    ↑↓ indicates inconsistent findings (some trials reported improvement with meditation [relative to control] while others showed no improvement or improvement in the control group [relative to meditation]).

  5. Magnitude based on relative difference in the change score: This is a relative percent difference, using the baseline mean in the meditation group as the denominator. For example, if the meditation group improves from a 10 to 19 on a mental health scale and the control group improves from 11 to 16 on the same scale, the relative difference between groups in the change score is: (((19-10)-(16-11))/10)x100=40%. The interpretation is that there is a 40% relative improvement on the mental health scale in the meditation group compared with the control group. Improvement in all scales is indicated in the positive direction. A positive relative percent difference means that the score improved more in the intervention group than in the control group

Meta-analysis figure on far right shows Cohen's d with the 95% CI * Summary effect size not shown due to concern for publication bias for this outcome **Negative affect combines the outcomes of anxiety, depression, stress/distress, and is thus duplicative of those outcomes *** We did not perform meta-analysis on this outcome since it would duplicate the anxiety meta-analysis for mantra. Anxiety and depression are indirect measures of negative affect, and therefore resulted in a lower strength of evidence than for the outcome of mantra on anxiety.

Figure 1
Figure 1

Figure 1A: Summary across measurement domains of comparisons of meditation programs with non-specific active controls Figure 1B. Summary across measurement domains of comparisons of meditation programs with specific active controls

  1. CSM = Clinically Standardized Meditation, a mantra meditation program; TM=Transcendental Meditation, a mantra meditation program

  2. CHF = Congestive Heart Failure; CAD = Coronary Artery Disease

  3. PO = Number of trials in which this was a primary outcome for the trial; PA = Primary Analysis; MA = Meta-analysis; N = sample size

  4. Direction based on relative difference in change analysis:

    ↑ indicates that the meditation group improved relative to the control group (with a relative difference generally greater than or equal to 5 percent across trials).

    ↓ indicates the meditation group worsened relative to the control group (with a relative difference generally greater than or equal to 5 percent across trials).

    Ø indicates a null effect (with a relative difference generally less than 5 percent across trials).

    ↑↓ indicates inconsistent findings (some trials reported improvement with meditation [relative to control] while others showed no improvement or improvement in the control group [relative to meditation]).

  5. Magnitude based on relative difference in the change score: This is a relative percent difference, using the baseline mean in the meditation group as the denominator. For example, if the meditation group improves from a 10 to 19 on a mental health scale and the control group improves from 11 to 16 on the same scale, the relative difference between groups in the change score is: (((19-10)-(16-11))/10)x100=40%. The interpretation is that there is a 40% relative improvement on the mental health scale in the meditation group compared with the control group. Improvement in all scales is indicated in the positive direction. A positive relative percent difference means that the score improved more in the intervention group than in the control group

Meta-analysis figure on far right shows Cohen's d with the 95% CI * Summary effect size not shown due to concern for publication bias for this outcome **Negative affect combines the outcomes of anxiety, depression, stress/distress, and is thus duplicative of those outcomes *** We did not perform meta-analysis on this outcome since it would duplicate the anxiety meta-analysis for mantra. Anxiety and depression are indirect measures of negative affect, and therefore resulted in a lower strength of evidence than for the outcome of mantra on anxiety.

Figure 2
Figure 2. Summary of the literature search

* Total exceeds the number in the exclusion box because reviewers were allowed to mark more than 1 reason for exclusion

Comment in

  • Moving toward evidence-based complementary care.

    Goroll AH. Goroll AH. JAMA Intern Med. 2014 Mar;174(3):368-9. doi: 10.1001/jamainternmed.2013.12995. JAMA Intern Med. 2014. PMID: 24395188 No abstract available.

  • Meditation intervention reviews.

    Rutledge T, Mills P, Schneider R. Rutledge T, et al. JAMA Intern Med. 2014 Jul;174(7):1193. doi: 10.1001/jamainternmed.2014.1419. JAMA Intern Med. 2014. PMID: 25003876 No abstract available.

  • Meditation intervention reviews.

    Walach H, Schmidt S, Esch T. Walach H, et al. JAMA Intern Med. 2014 Jul;174(7):1193-4. doi: 10.1001/jamainternmed.2014.1422. JAMA Intern Med. 2014. PMID: 25003877 No abstract available.

  • Meditation intervention reviews.

    Loucks EB. Loucks EB. JAMA Intern Med. 2014 Jul;174(7):1194-5. doi: 10.1001/jamainternmed.2014.1924. JAMA Intern Med. 2014. PMID: 25003878 Free PMC article. No abstract available.

  • Meditation intervention reviews--reply.

    Goyal M, Bass EB, Haythornthwaite JA. Goyal M, et al. JAMA Intern Med. 2014 Jul;174(7):1195. doi: 10.1001/jamainternmed.2014.1393. JAMA Intern Med. 2014. PMID: 25003880 No abstract available.

Similar articles

  • Meditation Programs for Psychological Stress and Well-Being [Internet].

    Goyal M, Singh S, Sibinga EMS, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA. Goyal M, et al. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Jan. Report No.: 13(14)-EHC116-EF. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Jan. Report No.: 13(14)-EHC116-EF. PMID: 24501780 Free Books & Documents. Review.

  • Music interventions for improving psychological and physical outcomes in cancer patients.

    Bradt J, Dileo C, Magill L, Teague A. Bradt J, et al. Cochrane Database Syst Rev. 2016 Aug 15;(8):CD006911. doi: 10.1002/14651858.CD006911.pub3. Cochrane Database Syst Rev. 2016. PMID: 27524661 Updated. Review.

  • Suicidal Ideation.

    Harmer B, Lee S, Duong TVH, Saadabadi A. Harmer B, et al. 2021 Aug 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. 2021 Aug 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 33351435 Free Books & Documents. Review.

  • Psychological, social and welfare interventions for psychological health and well-being of torture survivors.

    Patel N, Kellezi B, Williams AC. Patel N, et al. Cochrane Database Syst Rev. 2014 Nov 11;(11):CD009317. doi: 10.1002/14651858.CD009317.pub2. Cochrane Database Syst Rev. 2014. PMID: 25386846 Review.

  • Smoking cessation for improving mental health.

    Taylor GM, Lindson N, Farley A, Leinberger-Jabari A, Sawyer K, Te Water Naudé R, Theodoulou A, King N, Burke C, Aveyard P. Taylor GM, et al. Cochrane Database Syst Rev. 2021 Mar 9;3(3):CD013522. doi: 10.1002/14651858.CD013522.pub2. Cochrane Database Syst Rev. 2021. PMID: 33687070

Cited by 424 articles

  • Randomized, wait-list-controlled pilot study of app-delivered mindfulness for patients reporting chronic pain.

    Mascaro JS, Singh V, Wehrmeyer K, Scott B, Juan J, McKenzie-Brown AM, Lane OP, Haack C. Mascaro JS, et al. Pain Rep. 2021 Apr 2;6(1):e924. doi: 10.1097/PR9.0000000000000924. eCollection 2021. Pain Rep. 2021. PMID: 34778688 Free PMC article.

  • Impact of Virtual Heartfulness Meditation Program on Stress, Quality of Sleep, and Psychological Wellbeing during the COVID-19 Pandemic: A Mixed-Method Study.

    Desai K, Gupta P, Parikh P, Desai A. Desai K, et al. Int J Environ Res Public Health. 2021 Oct 22;18(21):11114. doi: 10.3390/ijerph182111114. Int J Environ Res Public Health. 2021. PMID: 34769634 Free PMC article.

  • Depression and Anxiety Disorders in Patients With Inflammatory Bowel Disease.

    Hu S, Chen Y, Chen Y, Wang C. Hu S, et al. Front Psychiatry. 2021 Oct 8;12:714057. doi: 10.3389/fpsyt.2021.714057. eCollection 2021. Front Psychiatry. 2021. PMID: 34690829 Free PMC article. Review.

  • The importance of formal versus informal mindfulness practice for enhancing psychological wellbeing and study engagement in a medical student cohort with a 5-week mindfulness-based lifestyle program.

    Kakoschke N, Hassed C, Chambers R, Lee K. Kakoschke N, et al. PLoS One. 2021 Oct 21;16(10):e0258999. doi: 10.1371/journal.pone.0258999. eCollection 2021. PLoS One. 2021. PMID: 34673830 Free PMC article.

  • Impact of App-Delivered Mindfulness Meditation on Functional Connectivity, Mental Health, and Sleep Disturbances Among Physician Assistant Students: Randomized, Wait-list Controlled Pilot Study.

    Smith JL, Allen JW, Haack CI, Wehrmeyer KL, Alden KG, Lund MB, Mascaro JS. Smith JL, et al. JMIR Form Res. 2021 Oct 19;5(10):e24208. doi: 10.2196/24208. JMIR Form Res. 2021. PMID: 34665153 Free PMC article.

Publication types

MeSH terms

LinkOut - more resources

  • Full Text Sources

    • Europe PubMed Central
    • Ovid Technologies, Inc.
    • PubMed Central
    • Silverchair Information Systems

  • Other Literature Sources

    • scite Smart Citations

  • Medical

    • ClinicalTrials.gov
    • MedlinePlus Health Information

Source: https://pubmed.ncbi.nlm.nih.gov/24395196/

Posted by: rhiannonamreine0194075.blogspot.com

Post a Comment

0 Comments