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International Journal of Mental Health... Jun 2021Mental health issues and disorders are major public health challenges, particularly in low- and middle-income countries in Southeast Asia, where chronic shortages in... (Review)
Review
BACKGROUND
Mental health issues and disorders are major public health challenges, particularly in low- and middle-income countries in Southeast Asia, where chronic shortages in mental health services and human resources exist. The development of effective and accessible mental health systems in Southeast Asia will require evidence based psychological and social interventions. This systematic review provides a narrative synthesis of the evidence on the effectiveness of such interventions for mental health issues and disorders in Southeast Asia.
METHODS
A comprehensive literature search of 7 electronic databases (PsycINFO, Medline (Ovid), Cochrane library, EMBASE, SCOPUS, APA PsycArticles, and Social Care Online) was undertaken.
RESULTS
Thirty two studies employing RCT designs to evaluate the effectiveness of a range of psychological and social mental health interventions on a number of different mental health outcomes were included in this review. The disparate intervention programmes reviewed were categorised as: lay delivered, yoga, aerobic and/or meditation based, cognitive behavioural therapy oriented, eye movement desensitization and reprocessing based (EMDR), health worker delivered, and hybrid programmes. The majority of the studies included in this review were of low to moderate quality due to the variability in the quality of the study design. The highest quality, and most promising evidence came from the evaluations of lay delivered interventions. This evidence demonstrates the feasibility and potential sustainability of implementing such interventions in resource constrained contexts.
CONCLUSIONS
The review findings indicate that a disparate array of mental health interventions can be implemented effectively in a range of Southeast Asian mental health and health settings. There is a clear need for significantly more research however, through higher quality and larger scale RCTs before it will be known more definitively, if these interventions are effective, and for whom they are most effective in different Southeast Asian contexts.
PubMed: 34090491
DOI: 10.1186/s13033-021-00482-y -
JMIR Mental Health Sep 2022Although there are thousands of mental health apps, 2 apps, Headspace and Calm, claim a large percentage of the marketplace. These two mindfulness and meditation apps... (Review)
Review
BACKGROUND
Although there are thousands of mental health apps, 2 apps, Headspace and Calm, claim a large percentage of the marketplace. These two mindfulness and meditation apps have reached tens of millions of active users. To guide consumers, clinicians, and researchers, we performed a systematic review of randomized controlled trials (RCTs) of Headspace and Calm.
OBJECTIVE
Our study aimed to evaluate intervention efficacy, risk of bias, and conflicts of interest (COIs) in the evidence base for Headspace and Calm, the two most popular mental health apps at the time of our search.
METHODS
To identify studies, we searched academic databases (Google Scholar, MEDLINE, and PsycINFO) and the websites of Headspace and Calm in May 2021 for RCTs of Headspace and Calm testing efficacy via original data collection, published in English in peer-reviewed journals. For each study, we coded (1) study characteristics (eg, participants, sample size, and outcome measures), (2) intervention characteristics (eg, free vs paid version of the app and intended frequency of app usage), (3) all study outcomes, (4) Cochrane risk of bias variables, and (5) COI variables (eg, presence or absence of a preregistration and the presence or absence of a COI statement involving the company).
RESULTS
We identified 14 RCTs of Headspace and 1 RCT of Calm. Overall, 93% (13/14) of RCTs of Headspace and 100% (1/1) of RCTs of Calm recruited participants from a nonclinical population. Studies commonly measured mindfulness, well-being, stress, depressive symptoms, and anxiety symptoms. Headspace use improved depression in 75% of studies that evaluated it as an outcome. Findings were mixed for mindfulness, well-being, stress, and anxiety, but at least 40% of studies showed improvement for each of these outcomes. Studies were generally underpowered to detect "small" or "medium" effect sizes. Furthermore, 50% (7/14) of RCTs of Headspace and 0% (0/1) of RCTs of Calm reported a COI that involved Headspace or Calm (the companies). The most common COI was the app company providing premium app access for free for participants, and notably, 14% (2/14) of RCTs of Headspace reported Headspace employee involvement in study design, execution, and data analysis. Only 36% (5/14) of RCTs of Headspace were preregistered, and the 1 RCT of Calm was not preregistered.
CONCLUSIONS
The empirical research on Headspace appears promising, whereas there is an absence of randomized trials on Calm. Limitations of this study include an inability to compare Headspace and Calm owing to the dearth of RCTs studying Calm and the reliance on author reports to evaluate COIs. When determining whether or not mental health apps are of high quality, identification of high-quality apps and evaluation of their effectiveness and investigators' COIs should be ensured.
PubMed: 36125880
DOI: 10.2196/40924 -
International Journal of Environmental... Mar 2023Mindfulness-, compassion-, and acceptance-based (i.e., "third wave") psychotherapies are effective for treating chronic pain conditions. Many of these programs require... (Review)
Review
Mindfulness-, compassion-, and acceptance-based (i.e., "third wave") psychotherapies are effective for treating chronic pain conditions. Many of these programs require that patients engage in the systematic home practice of meditation experiences so they can develop meditation skills. This systematic review aimed at evaluating the frequency, duration, and effects of home practice in patients with chronic pain undergoing a "third wave" psychotherapy. A comprehensive database search for quantitative studies was conducted in PubMed, Embase, and Web of Sciences Core Collection; 31 studies fulfilled the inclusion criteria. The reviewed studies tended to indicate a pattern of moderately frequent practice (around four days/week), with very high variability in terms of time invested; most studies observed significant associations between the amount of practice and positive health outcomes. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy were the most common interventions and presented low levels of adherence to home practice (39.6% of the recommended time). Some studies were conducted on samples of adolescents, who practiced very few minutes, and a few tested eHealth interventions with heterogeneous adherence levels. In conclusion, some adaptations may be required so that patients with chronic pain can engage more easily and, thus, effectively in home meditation practices.
Topics: Adolescent; Humans; Meditation; Chronic Pain; Cognitive Behavioral Therapy; Mindfulness; Chronic Disease
PubMed: 36901448
DOI: 10.3390/ijerph20054438 -
Systematic Reviews Sep 2023Qualitative research on women's experiences participating in yoga after a cancer diagnosis is growing; systematic synthesis and integration of results are necessary to...
BACKGROUND
Qualitative research on women's experiences participating in yoga after a cancer diagnosis is growing; systematic synthesis and integration of results are necessary to facilitate the transfer and implementation of knowledge among researchers and end-users. Thus, the purpose of this meta-synthesis was to: (1) integrate findings from qualitative studies, (2) compare and contrast findings to elucidate patterns or contradictions in conclusions, and (3) develop an overarching interpretation of women's experiences participating in yoga after a cancer diagnosis.
METHODS
Using meta-study methodology, six electronic databases were searched using a sensitive search strategy in November 2020, a supplemental scan of reference lists was conducted in August 2021, and the database search was replicated in October 2021. Two reviewers independently screened titles/abstracts and full-texts to determine eligibility.
RESULTS
The searches yielded 6804 citations after de-duplication. Data from 24 articles meeting the eligibility criteria were extracted, and the results, methods, and theoretical approach(es) were analyzed. The analysis revealed that there was a predominant focus on two focal points in the primary articles: (1) women's well-being and quality of life (QoL; part I) and (2) intervention preferences (part II). Five overarching categories emerged related to well-being and QoL: (1) yoga can support improvements in multiple dimensions of QoL in women diagnosed with cancer, (2) women diagnosed with cancer experience an interaction between QoL dimensions, (3) elements of yoga that support improvements in QoL dimensions, (4) breathwork and meditation are integral elements of yoga, and (5) yoga practice may support lifestyle behavior change. The articles reviewed had notable limitations related to: (1) reporting about instructor(s), content of the intervention, and environmental characteristics of the setting, (2) identifying and incorporating optimal features in the intervention design, (3) incorporating theory and real-world considerations into the study procedures, and (4) including positive and negative conceptualizations of QoL as an interconnected and multidimensional concept.
CONCLUSION
Moving forward, it remains critical to identify the ideal structure and content of yoga programs for promoting well-being and QoL among women diagnosed with cancer, as well as to explore barriers and facilitators to sustainable program implementation.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42021229253.
Topics: Female; Humans; Life Style; Meditation; Neoplasms; Quality of Life; Yoga
PubMed: 37752520
DOI: 10.1186/s13643-023-02350-x -
Annals of the New York Academy of... Jan 2014With a rapidly aging society it becomes increasingly important to counter normal age-related decline in cognitive functioning. Growing evidence suggests that cognitive... (Review)
Review
With a rapidly aging society it becomes increasingly important to counter normal age-related decline in cognitive functioning. Growing evidence suggests that cognitive training programs may have the potential to counteract this decline. On the basis of a growing body of research that shows that meditation has positive effects on cognition in younger and middle-aged adults, meditation may be able to offset normal age-related cognitive decline or even enhance cognitive function in older adults. In this paper, we review studies investigating the effects of meditation on age-related cognitive decline. We searched the Web of Science (1900 to present), PsycINFO (1597 to present), MEDLINE (1950 to present), and CABI (1910 to present) to identify original studies investigating the effects of meditation on cognition and cognitive decline in the context of aging. Twelve studies were included in the review, six of which were randomized controlled trials. Studies involved a wide variety of meditation techniques and reported preliminary positive effects on attention, memory, executive function, processing speed, and general cognition. However, most studies had a high risk of bias and small sample sizes. Reported dropout rates were low and compliance rates high. We conclude that meditation interventions for older adults are feasible, and preliminary evidence suggests that meditation can offset age-related cognitive decline.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Aging; Attention; Clinical Trials as Topic; Cognition; Cognition Disorders; Executive Function; Female; Humans; Male; Meditation; Memory; Middle Aged; Mindfulness
PubMed: 24571182
DOI: 10.1111/nyas.12348 -
Psychosomatics 2015Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, owing to a lower... (Review)
Review
BACKGROUND
Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, owing to a lower side-effect burden, potential reduction of polypharmacy, and theoretical considerations that such interventions may target some of the cognitive roots of depression.
OBJECTIVE
We aimed to determine the state of the evidence supporting this application.
METHODS
Randomized controlled trials of techniques meeting the Agency for Healthcare Research and Quality definition of meditation, for participants having clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e., how they were applied) components, and trial outcomes were reviewed.
RESULTS
18 studies meeting the inclusion criteria were identified, encompassing 7 distinct techniques and 1173 patients. Mindfulness-Based Cognitive Therapy comprised the largest proportion of studies. Studies including patients having acute major depressive episodes (n = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (n = 8), demonstrated moderate to large reductions in depression symptoms within the group, and relative to control groups. There was significant heterogeneity of techniques and trial designs.
CONCLUSIONS
A substantial body of evidence indicates that meditation therapies may have salutary effects on patients having clinical depressive disorders during the acute and subacute phases of treatment. Owing to methodologic deficiencies and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium.
Topics: Cognitive Behavioral Therapy; Depressive Disorder; Depressive Disorder, Major; Humans; Meditation; Mindfulness; Treatment Outcome
PubMed: 25591492
DOI: 10.1016/j.psym.2014.10.007 -
Complementary Therapies in Medicine Aug 2023To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer.
DESIGN
Systematic review and meta-analysis of randomized controlled trials (RCTs).
METHODS
Seven English electronic databases were searched from the date of inception to September 2022. All RCTs that included adults (≥18 years) who were treated with mindfulness, yoga, qigong, relaxation, and hypnosis were screened. The outcome was subjective and/or objective sleep disturbance.The revised Cochrane tool (RoB 2.0) was applied to evaluate the risk of bias. The RevMan software was applied to assessed each outcome according different control groups and assessment time points. Subgroup analyses were performed according to different categories of MBTs.
RESULTS
Sixty-eight RCTs (6339 participants) were identified. After requesting for missing data from corresponding authors of included RCTs, 56 studies (5051 participants) were included in the meta-analysis. The meta-analysis showed a significant immediate effect of mindfulness, yoga, relaxation, and hypnosis on subjective sleep disturbance, compared with usual care or wait list control, and the effect of mindfulness lasted at least 6 months. For objective sleep outcomes, we observed significant immediate effects of yoga on wake after sleep onset and of mindfulness on sleep onset latency and total sleep time. Compared with active control interventions, MBTs had no significant effect on sleep disturbance.
CONCLUSIONS
Mindfulness, yoga, relaxation, and hypnosis were effective in sleep disturbance severity reduction among patients with cancer at post-intervention, and the effect of mindfulness lasted at least 6 months. Future MBTs studies should apply both objective and subjective sleep measurement tools.
Topics: Adult; Humans; Mind-Body Therapies; Yoga; Meditation; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Neoplasms
PubMed: 37244384
DOI: 10.1016/j.ctim.2023.102954 -
Pediatrics Sep 2009Although the efficacy of meditation interventions has been examined among adult samples, meditation treatment effects among youth are relatively unknown. We... (Review)
Review
OBJECTIVE
Although the efficacy of meditation interventions has been examined among adult samples, meditation treatment effects among youth are relatively unknown. We systematically reviewed empirical studies for the health-related effects of sitting-meditative practices implemented among youth aged 6 to 18 years in school, clinic, and community settings.
METHODS
A systematic review of electronic databases (PubMed, Ovid, Web of Science, Cochrane Reviews Database, Google Scholar) was conducted from 1982 to 2008, obtaining a sample of 16 empirical studies related to sitting-meditation interventions among youth.
RESULTS
Meditation modalities included mindfulness meditation, transcendental meditation, mindfulness-based stress reduction, and mindfulness-based cognitive therapy. Study samples primarily consisted of youth with preexisting conditions such as high-normal blood pressure, attention-deficit/hyperactivity disorder, and learning disabilities. Studies that examined physiologic outcomes were composed almost entirely of African American/black participants. Median effect sizes were slightly smaller than those obtained from adult samples and ranged from 0.16 to 0.29 for physiologic outcomes and 0.27 to 0.70 for psychosocial/behavioral outcomes.
CONCLUSIONS
Sitting meditation seems to be an effective intervention in the treatment of physiologic, psychosocial, and behavioral conditions among youth. Because of current limitations, carefully constructed research is needed to advance our understanding of sitting meditation and its future use as an effective treatment modality among younger populations.
Topics: Adolescent; Child; Humans; Meditation; Treatment Outcome
PubMed: 19706568
DOI: 10.1542/peds.2008-3434 -
Evidence-based Mental Health Aug 2018The efficacy of meditation-based therapies for attention deficit/hyperactivity disorder (ADHD) across the lifespan remains uncertain. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The efficacy of meditation-based therapies for attention deficit/hyperactivity disorder (ADHD) across the lifespan remains uncertain.
OBJECTIVE
To conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy of meditation-based therapies for ADHD core symptoms and associated neuropsychological dysfunctions in children/adolescents or adults with ADHD.
METHODS
We searched Pubmed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge with no language, date or type of document restriction, up to 5 May 2018. Random-effects model was used. Heterogeneity was assessed with Cochran's Q and I statistics. Publication (small studies) bias was assessed with funnel plots and the Egger's test. Studies were evaluated with the Cochrane risk of bias (RoB) tool. Analyses were conducted using Comprehensive Meta-Analysis.
FINDINGS
13 RCTs (seven in children/adolescents, n=270 and six in adults, n=339) were retained. Only one RCT was double-blind.Meditation-based therapies were significantly more efficacious than the control conditions in decreasing the severity of ADHD core symptoms (inattention+hyperactivity/impulsivity: children/adolescents: Hedge's g=-0.44, 95% CI -0.69 to -0.19, I0%; adults: Hedge's g=-0.66, 95% CI -1.21 to -0.11, I81.81%). No significant effects were found on neuropsychological measures of inattention and inhibition in children/adolescents. In adults, significant effects were detected on working memory and inhibition, although these results were based on a small number of studies (n=3). 57% and 43% of the studies in children/adolescents were rated at overall unclear and high risk of bias, respectively. In adults, 33% and 67% of the studies were deemed at overall unclear and high risk of bias, respectively. No evidence of publication bias was found.
CONCLUSIONS
Despite statistically significant effects on ADHD combined core symptoms, due to paucity of RCTs, heterogeneity across studies and lack of studies at low risk of bias, there is insufficient methodologically sound evidence to support meditation-based therapies for ADHD.
TRIAL REGISTRATION NUMBER
PROSPERO 2018 [CRD42018096156].
Topics: Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Child; Humans; Meditation; Outcome Assessment, Health Care
PubMed: 29991532
DOI: 10.1136/ebmental-2018-300015 -
Integrative Cancer Therapies 2023We examined the effects of Mindfulness-based interventions (MBIs) on depressive symptoms in women with breast cancer and examined the moderating effects of participant... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We examined the effects of Mindfulness-based interventions (MBIs) on depressive symptoms in women with breast cancer and examined the moderating effects of participant characteristics, research methodologies, and features of interventions.
METHODS
We systematically searched 12 databases through November 2022 without date restrictions using the following search terms: (mindful* or meditation) AND (cancer OR neoplasm) AND (depress*). Studies included were primary studies evaluating MBIs in women with breast cancer who also had depression. Studies were included if they used a control group and were written in English. We used a random-effects model to compute effect sizes (ESs) using Hedges' g, forest plot, and Q and statistics as measure of heterogeneity. We also requested moderator analyses.
RESULTS
We found 19 studies with 2139 participants (49.4 ± 8.3 years old) that met inclusion criteria for this meta-analysis and systematic review. Overall, women in MBI groups demonstrated significantly lower levels of depression ( = 0.48, 95% CI:0.159, 0.792, < .001) compared to women in control groups. Regarding moderators, providing MBIs with a home assignment component showed a significantly greater effect on decreasing depressive symptoms ( = 1.75) compared to MBIs without a home assignment component ( = 0.20). When researchers used concealed allocation technique, the interventions demonstrated lower effects on depression than when concealed allocation ( = 0.11vs = 1.33, ≤ .001) was not reported. Additionally, when researchers reported high rates of sample attrition, they found a lower effect size on depression (β = -.019, = 3.97, = .046) indicating that attrition moderates the effect.
CONCLUSION
MBIs are moderately effective interventions to reduce depressive symptoms among women with breast cancer. Clinicians might consider encouraging MBIs as adjunct/alternative treatments for women with breast cancer to manage symptoms of depression. Interventions that incorporat home assignments for practicing mindfulness are likely to have a greater effect on reducing depressive symptoms. Additionally, methods including concealed allocation and attrition rate were moderators of the effects of MBIs on depression in women with breast cancer.
Topics: Adult; Female; Humans; Middle Aged; Breast Neoplasms; Depression; Meditation; Mindfulness; Southern African People
PubMed: 38140816
DOI: 10.1177/15347354231220617