Friday, November 13, 2015
MINDFULNESS AND INFLAMMATORY BOWEL DISEASE
A recent study published in the journal Inflammatory Bowel Diseases suggests that training in meditation and other mindfulness-based techniques can bring lasting improvements in mental health and quality of life for patients with inflammatory bowel disease (IBD). IBD, of which Crohn's disease and ulcerative colitis are the principal types, is a complex disease involving chronic inflammation of some or all of the digestive tract.
‘Our study provides support for the feasibility, acceptability, and effectiveness of a tailored mindfulness-based group intervention for patients with IBD,’ concludes the research report by Clinical Professor Dr David Castle [pictured left], Chair of Psychiatry at St Vincent's Hospital, Melbourne, Australia, and colleagues. However, more research is needed to demonstrate the clinical benefits of mindfulness techniques, including whether they can help to reduce IBD symptoms and relapses.
The researchers evaluated a mindfulness-based stress reduction (MBSR) program tailored for patients with IBD. The study included 60 adults with IBD: Crohn's disease or ulcerative colitis. The patients' average age was 36 years, and average duration of IBD 11 years. Twenty-four patients had active disease at the time of the study.
The MBSR intervention consisted of the usual 8 weekly group sessions plus a daylong intensive session, led by an experienced instructor. The program included guided meditations, exercises designed to enhance mindfulness in daily life, and group discussions of challenges and experiences. Participants were also encouraged to perform daily ‘mindfulness meditation’ at home.
Thirty-three patients agreed to participate in the MBSR intervention, 27 of whom completed the program. Ratings of mental health, quality of life, and mindfulness were compared to those of the 27 patients who chose not to participate (mainly because of travel time).
Anxiety, depression, and decreased quality of life are common in patients with IBD. Psychological distress may lead to increased IBD symptoms and play a role in triggering disease flare-ups. The study revealed that the MBSR participants had greater reductions in anxiety and depression scores, as well as improvement in physical and psychological quality of life. They also had higher scores on a questionnaire measuring various aspects of mindfulness--for example, awareness of inner and outer experiences. Six months later, MBSR participants still had significant reduction in depression and improvement in quality of life, with a trend toward reduced anxiety. The patients were highly satisfied with the mindfulness intervention.
Dr Castle and colleagues conclude, ‘A larger adequately powered, randomised study with an active control arm is warranted to evaluate the effectiveness of a mindfulness group program for patients with IBD in a definitive manner.’
Study: Neilson K, Ftanou M, Monshat K, Salzberg M, Bell S, Kamm MA, Connell W, Knowles SR, Sevar K, Mancuso SG, and Castle D. ‘A Controlled Study of a Group Mindfulness Intervention for Individuals Living With Inflammatory Bowel Disease’ (doi: 10.1097/MIB.0000000000000629).