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Rheumatoid Arthritis Patients
Benefit From Meditation Therapy
edited by Joint-Pain-Forum.com
revered contemplative practice for centuries, meditation has recently
inspired research into its therapeutic value for everything from
anxiety disorders to heart attack prevention. A painful, progressive
autoimmune disease, rheumatoid arthritis (RA) is associated with a high
risk of depression -- double the risk of the healthy population, by
conservative estimates -- and various forms of psychological distress.
Increasingly, RA patients are turning to alternative therapies like
meditation to ease the toll of their disease.
Stress Reduction (MBSR) is a meditation training program developed by
Dr. Kabat-Zinn and colleagues at the University of Massachusetts
Medical School. MBSR teaches participants to relate differently to
thoughts and emotions, and continually focus the mind on the present
moment to increase clarity and calmness. The program has been shown to
improve psychological symptoms in patients with fibromyalgia, cancer,
and multiple sclerosis, among other conditions. Researchers with the
University of Maryland School of Medicine set out to assess the effect
of this meditation therapy on depressive symptoms, psychological
distress, general well-being, and disease activity among RA patients.
Featured in the October 2007 issue of Arthritis Care & Research ,
their study supports the potential benefits of prescribing a course in
MBSR along with the conventional course of physical and pharmacological
Recruited through community health fairs
and ads in Baltimore newspapers, 63 adult RA patients were selected to
participate in this novel pilot study. Averaging 54 years in age,
participants were mostly female, white, married, college educated, and
comfortably middle-class. None had a history of psychiatric illness,
alcohol or drug addiction, or other chronic pain disorders. All
patients remained under their rheumatologist's care and continued to
take their routine medications throughout the study.
random assignment, 31 of the participants received intensive MBSR
therapy, starting with an 8-week training course followed by a 4-month
maintenance program. The remaining 32 participants were designated to a
waitlist, agreeing to attend assessment sessions in exchange for free
MBSR training after the study's end. At baseline, and again at 2 months
and 6 months into the study, both groups of participants underwent
psychological and rheumatological examinations. To evaluate depressive
symptoms and psychological distress, researchers used the Symptom
Checklist-90-Revised, a self-report questionnaire widely recognized for
its reliability and validity. Overall well-being was measured by the
Psychological Well-Being Scales, comprised of questions designed to
gauge positive outlook and approach to coping with difficulties. RA
disease status was assessed by the Disease Activity Score in 28 joints
Researchers compared scores of
psychological and physical disease symptoms among MBSR participants
with those among controls. Overwhelming, MBSR students embraced the
program and kept up their mindfulness practice throughout the followup
period. After 2 months, both groups showed improvements in depressive,
psychological, and emotional symptoms, with no significant benefits
attributed to MBSR. By 6 months, however, gains in the control group
had largely disappeared, while MBSR participants maintained or improved
further in psychological outcomes. By the culmination of the study, the
MBSR group achieved a significant 35 percent reduction in psychological
distress. Despite this dramatic improvement, the therapy had no impact
on RA disease activity, measured by the DAS-28, which takes into
account number of tender or swollen joints, a blood measure of
inflammation, and the patient's own report of disease status.
the researchers acknowledge, the study had limitations, primarily its
small sample size and its likely floor effect. On the strength of their
backgrounds, participants might have been less vulnerable to
psychological distress and depression than RA patients with fewer
socioeconomic advantages, not to mention those with a history of mental
illness or substance abuse. Yet, these limitations should not
overshadow the positive findings and applications. "The study
demonstrated that for patients with RA under routine medical
supervision, an 8-week MBSR class plus a 4-month maintenance program
had beneficial effects, and that it was safe and appealing to
participants," notes investigator Elizabeth Pradhan, PhD. "For doctors
wishing to offer patients a complement to medical management,
mindfulness meditation may offer hope for improving psychological
distress and strengthening well-being in patients with RA."
www.Joint-Pain-Forum.com from original press release.
Article: "Effect of Mindfulness-Based
Stress Reduction in Rheumatoid Arthritis Patients," Elizabeth K.
Pradhan, Mona Baumgarten, Patricia Langenberg, Barry Handwerger, Adele
Kaplan Gilpin, Trish Magyari, Marc C. Hochberg, and Brian M. Berman, Arthritis
Care & Research, October 2007; (10.1002/art.23010).
John Wiley & Sons, Inc.
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