Meditation can’t hurt, might help
By Andrew M. Seaman
NEW YORK Mon Jan 6, 2014 4:18pm EST
NEW YORK (Reuters Health) – Mindfulness meditation may be useful in battles against anxiety, depression and pain, according to a fresh look at past research.
Using data from 47 earlier studies, researchers found moderate evidence to support the use of mindfulness meditation to treat those conditions. Meditation didn’t seem to affect mood, sleep or substance use.
“Many people have the idea that meditation means just sitting quietly and doing nothing,” wrote Dr. Madhav Goyal in an email to Reuters Health. “That is not true. It is an active training of the mind to increase awareness, and different meditation programs approach this in different ways.”
Goyal led the study at The Johns Hopkins University in Baltimore.
He and his colleagues write in JAMA Internal Medicine that meditation techniques emphasize mindfulness and concentration.
So-called mindfulness meditation is aimed at allowing the mind to pay attention to whatever thoughts enter it, such as sounds in the environment, without becoming too focused. Mantra meditation, on the other hand, involves focusing concentration on a particular word or sound.
Approximately 9 percent of people in the U.S. reported meditating in 2007, according to the National Institutes of Health. About 1 percent said they use meditation as some sort of treatment or medicine.
For the new report, the researchers searched several electronic databases that catalog medical research for trials that randomly assigned people with a certain condition – such as anxiety, pain or depression – to do meditation or another activity. These randomized controlled trials are considered the gold standard of medical research.
The researchers found 47 studies with over 3,500 participants that met their criteria.
After combining the data, Goyal said his team found between a 5 and 10 percent improvement in anxiety symptoms among people who took part in mindfulness meditation, compared to those who did another activity.
There was also about a 10 to 20 percent improvement in symptoms of depression among those who practiced mindfulness meditation, compared to the other group.
“This is similar to the effects that other studies have found for the use of antidepressants in similar populations,” Goyal said.
Mindfulness meditation was also tied to reduced pain. But Goyal said it’s hard to know what kind of pain may be most affected by meditation.
The benefits of meditation didn’t surpass what is typically associated with other treatments, such as drugs and exercise, for those conditions.
“As with many therapies, we try to get a moderate level of confidence that the therapy works before we prescribe it,” Goyal said. “If we have a high level of confidence, it is much better.”
But he noted that the researchers didn’t find anything more than moderate evidence of benefit from meditation for anxiety, depression and pain.
There was some suggestion that meditation may help improve stress and overall mental health, but the evidence supporting those findings was of low quality.
There was no clear evidence that meditation could influence positive mood, attention, substance use, eating habits, sleep or weight.
“Clinicians should be prepared to talk with their patients about the role that meditation programs could have in addressing psychological stress, particularly when symptoms are mild,” Goyal said.
Dr. Allan Goroll, who wrote an editorial accompanying the new study, told Reuters Health the analysis is an example of an area of much-needed scientific study, because many people make treatment decisions based on beliefs – not data.
“That is particularly the case with alternative and complimentary approaches to treating medical problems,” he said. “It ranges from taking vitamins to undergoing particular procedures for which the scientific evidence is very slim but people’s beliefs are very great.”
Goroll is professor at Harvard Medical School and Massachusetts General Hospital in Boston.
Goyal said people should remember that meditation was not conceived to treat any particular health problem.
“Rather, it is a path we travel on to increase our awareness and gain insight into our lives,” he wrote. “The best reason to meditate is to gain this insight. Improvements in health conditions are really a side benefit, and it’s best to think of them that way.”
SOURCE: bit.ly/WiwDtv JAMA Internal Medicine, online January 6, 2014.
Everything in proper amounts
A review of medical literature finds meditation can’t hurt, might help. Getty Images
By Lindsay Gellman
Certain types of meditation may provide some modest relief from anxiety, depression and pain, a new study found.
But the study found little evidence for other reported benefits of meditation, including help in curbing substance abuse, poor eating habits, sleep disorders and weight problems.
The report, published Monday in the journal JAMA Internal Medicine, reviewed the findings from 47 previous studies, all randomized clinical trials, with 3,515 adult participants in total.
Many people use meditation to ease stress and promote general health. The purpose of the report was to examine the accumulated evidence to help doctors determine how best to counsel patients on the possible benefits and limitations of meditation, said Madhav Goyal, assistant professor of general internal medicine at Johns Hopkins University in Baltimore and the report’s lead researcher.
In each of the underlying studies, participants received professional instruction in one of two types of meditation: mantra meditation or mindfulness meditation. A popular form of mantra meditation is transcendental meditation, which involves repetition of a phrase “in such a way that it transcends one to an effortless state where focused attention is absent,” the study said. By contrast, mindfulness meditation emphasizes training in “present-focused awareness,” or mindfulness. The study noted that the distinctions between the meditation types aren’t always clear.
Researchers found that only mindfulness meditation produced some benefits. For example, the improvement in patients with mild symptoms of depression was similar in magnitude to what might be expected from the use of an antidepressant, the study said. It also noted that there were few mantra-meditation studies to include in the JAMA review, which could help account for the lack of evidence of benefits from this type of meditation.
The study didn’t find any evidence meditation was harmful.
Researchers culled through nearly 19,000 previous studies on meditation to select the most scientific. Dr. Goyal said his team used rigorous inclusion criteria. Each of the 47 included studies was a controlled trial in which at least one group received either a therapy with known psychological benefits, such as exercise, or a placebo instructional or educational session, he said. Studies that looked only at children or adolescents, or those without a control group, were excluded.
“Although uncontrolled studies have usually found a benefit of meditation, very few controlled studies have found a similar benefit for the effects of meditation programs on health-related behaviors affected by stress,” the JAMA report said.
The report’s findings show that meditation is perhaps less effective in alleviating stress-related symptoms than is widely believed, said Allan H. Goroll, professor of medicine at Harvard Medical School-Massachusetts General Hospital, in invited commentary also published Monday in JAMA Internal Medicine. “The studies overall failed to show much benefit from meditation with regard to relief of suffering or improvement in overall health, with the important exception that mindfulness meditation provided a small but possibly meaningful degree of relief from psychological distress,” he wrote.
Still, Dr. Goroll noted that participants only received 30 to 40 hours of training in meditation, which could indicate that “meditation is a skill that takes time to master.” He also said more evidence is needed to draw more robust conclusions about any benefits to meditation.
“People come to a meditation class because they’re suffering in some way,” said Jon Aaron, an instructor at New York Insight Meditation Center, which promotes mindfulness meditation. Through meditation, they learn to relate to their stress in a way that is more productive, he said.
Write to Lindsay Gellman at Lindsay.Gellman@wsj.com
Photo: Amy Winehouse
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