Mindfulness Meditation to Improve Anxiety, Depression and Pain

Madhav Goyal MD, MPH  Assistant Professor General Internal Medicine Johns Hopkins School of MedicineMedicalResearch.com Interview with:
Madhav Goyal MD, MPH 
Assistant Professor
General Internal Medicine
Johns Hopkins School of Medicine

MedicalResearch.com: What are the main findings of the study?

Dr. Goyal:

  • The evidence is moderately strong that there is a small but consistent benefit for mindfulness meditation programs to improve 3 symptoms: anxiety, depression, and pain.  We found low level evidence that mindfulness meditation helps with symptoms of stress and distress, as well as with the mental health dimension of quality of life.
  • For the symptoms of anxiety and depression for which we find moderate evidence of benefit, we need to keep in mind that most of the trials didn’t study people with a clinical diagnosis of anxiety or depression (although a few did).  Most were studying diverse patient populations who may have had a low level of these symptoms, such as those with  breast cancer, fibromyalgia, organ transplant recipients, and caregivers of people with dementia.
  • We found about a 5-10% improvement in anxiety symptoms compared to placebo groups.  For depression, we found a roughly 10-20% improvement in depressive symptoms compared to the placebo groups. This is similar to the effects that other studies have found for the use of antidepressants in similar populations.
  • While we found that the evidence was moderately strong that mindfulness meditation programs may improve pain, there weren’t as many trials evaluating chronic pain, and so we don’t understand what kinds of pain this type of meditation may be most useful for.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Goyal:  This is a vast literature, and we weren’t sure what we were going to find. The mindfulness courses taught here are derived from Eastern practices such as Vipassana and related Buddhist practices.  The amount of training provided in the mindfulness courses was comparatively small (2.5 hrs/week over 8 weeks) to the more traditional courses, and it was surprising to see that with so little training we were still seeing consistent effects, and that those effects were being seen across a variety of clinical populations.  This begs the question of whether more training would yield larger effects.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Goyal:  Clinicians and patients should be aware that the average person going through a mindfulness-based meditation program can expect small to moderate reductions of multiple negative dimensions of psychological stress, as well as of chronic pain.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Goyal:  There are many unanswered questions related to the nature and amount of meditation training and the types of mental health and physical health conditions that may be responsive to it. While we found a small effect of meditation on the symptom of pain, we need studies evaluating different types of pain.  Since many of the studies we evaluated had deficiencies such as small samples or other methodological challenges, better studies that include larger, well defined samples with independent assessment of study outcomes would be helpful in fully determining the effects of meditation.

Citation:

Goyal M, Singh S, Sibinga ES, et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med. 2014;():. doi:10.1001/jamainternmed.2013.13018

 

 

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