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Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review.

ABSTRACT: Background:Emotion (dys)regulation as well as the interventions for improving these difficulties are receiving a growing attention in the literature. The aim of the present paper was to conduct a systematic review about the efficacy of mindfulness-based interventions (MBIs) in both substance and behavioral addictions (BAs). Method:A literature search was conducted using Cochrane, PubMed, and Web of Science. Fifty-four randomized controlled trials published in English since 2009 to April 2017 were included into a narrative synthesis. Results:Mindfulness-based interventions were applied in a wide range of addictions, including substance use disorders (from smoking to alcohol, among others) and BAs (namely, gambling disorder). These treatments were successful for reducing dependence, craving, and other addiction-related symptoms by also improving mood state and emotion dysregulation. The most commonly used MBI approaches were as follows: Mindfulness-Based Relapse Prevention, Mindfulness Training for Smokers, or Mindfulness-Oriented Recovery Enhancement, and the most frequent control group in the included studies was Treatment as Usual (TAU). The most effective approach was the combination of MBIs with TAU or other active treatments. However, there is a lack of studies showing the maintenance of the effect over time. Therefore, studies with longer follow-ups are needed. Conclusion:The revised literature shows support for the effectiveness of the MBIs. Future research should focus on longer follow-up assessments as well as on adolescence and young population, as they are a vulnerable population for developing problems associated with alcohol, drugs, or other addictions.

SUBMITTER: Sancho M

PROVIDER: S-EPMC5884944 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundMultiple sclerosis (MS) is a stressful condition; depression, anxiety, pain and fatigue are all common problems. Mindfulness based interventions (MBIs) mitigate stress and prevent relapse in depression and are increasingly being used in healthcare. However, there are currently no systematic reviews of MBIs in people with MS. This review aims to evaluate the effectiveness of MBIs in people with MS.MethodsSystematic searches were carried out in seven major databases, using both subject headings and key words. Papers were screened, data extracted, quality appraised, and analysed by two reviewers independently, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Perceived stress was the primary outcome. Secondary outcomes include mental health, physical health, quality of life, and health service utilisation. Statistical meta-analysis was not possible. Disagreements were adjudicated by a third party reviewer.ResultsThree studies (n = 183 participants) were included in the final analysis. The studies were undertaken in Wales (n = 16, randomised controlled trial - (RCT)), Switzerland (n = 150, RCT), and the United States (n = 17, controlled trial). 146 (80%) participants were female; mean age (SD) was 48.6 (9.4) years. Relapsing remitting MS was the main diagnostic category (n = 123, 67%); 43 (26%) had secondary progressive disease; and the remainder were unspecified. MBIs lasted 6-8 weeks; attrition rates were variable (5-43%); all employed pre- post- measures; two had longer follow up; one at 3, and one at 6 months. Socio-economic status of participants was not made explicit; health service utilisation and costs were not reported. No study reported on perceived stress. All studies reported quality of life (QOL), mental health (anxiety and depression), physical (fatigue, standing balance, pain), and psychosocial measures. Statistically significant beneficial effects relating to QOL, mental health, and selected physical health measures were sustained at 3- and 6- month follow up.ConclusionFrom the limited data available, MBIs may benefit some MS patients in terms of QOL, mental health, and some physical health measures. Further studies are needed to clarify how MBIs might best serve the MS population.

Project description:Mindfulness-based interventions (MBIs) are becoming increasingly popular as treatments for physical and psychological problems. Recently, several studies have suggested that MBIs may also be effective in reducing symptoms of attention-deficit hyperactivity disorder (ADHD). Most studies have examined the effectiveness in children, but there are now a sufficient number of individual treatment trials to consider a systematic review in adults. Majority of existing systematic reviews and meta-analyses only consider ADHD symptoms as an outcome, and most of them do not fully report potential biases of included studies, thus limiting considerably their conclusions. This is an important facet because some studies could be found ineligible to be included in future analysis due to their low quality. In this systematic review, we followed the PRISMA/PICO criteria and we thoroughly assessed the risks of bias for each of the selected studies according to Cochrane guidelines. We searched the available literature concerning MBIs in adult participants with ADHD using PsycINFO, PubMed, Scopus, and ERIC databases. In total, 13 studies conducted with 753 adults (mean age of 35.1 years) were identified as eligible. Potential moderators such as participants' age, ADHD subtypes, medication status, comorbidity, intervention length, mindfulness techniques, homework amount, and training of therapists were carefully described. Aside from measuring the symptoms of ADHD, outcome measures were categorized into executive/cognitive functioning, emotional disturbances, quality of life, mindfulness, and grade point average at school. According to presented descriptive results, all the studies (100%) showed improvement of ADHD symptoms. In addition, mindfulness meditation training improves some aspects of executive function and emotion dysregulation. Although these are promising findings to support treatment efficacy of MBIs for ADHD, various biases such as absence of randomization and lack of a control group may affect the actual clinical value and implications of the studies. Moreover, the relatively low quality of selection and performance criteria in several studies, as well as relatively high attrition bias across studies, call for caution before considering conducting further analysis.

Project description:Objectives: With this systematic review we aim to provide an overview of the evidence of the effect of Mindfulness Based Interventions (MBIs) on (1) tinnitus distress and (2) anxiety and/or depression in tinnitus patients. Methods: We conducted a systematic search in PubMed Medline, EMBASE and PsycInfo combining the terms and synonyms of "Tinnitus" and "Mindfulness." The most recent search was performed on December 4th 2018. We wrote this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent authors identified studies, assessed the risk of bias and extracted data. Studies were considered eligible if they included adults with tinnitus, performed a protocolled MBI and measured tinnitus distress with validated questionnaires. Studies were appraised with either the Cochrane Risk of Bias tool or the MINORS criteria, depending on their design. Results: The systematic search yielded seven articles (425 patients). Three randomized controlled trials (RCTs), three cohort studies and one comparative controlled trial. Different types of MBIs, including MBCT and MBSR, were assessed with various questionnaires. Two of three RCTs showed a statistically significant decrease in tinnitus distress scores directly after treatment in the mindfulness group compared to the control group. Six of seven studies showed statistically significant decrease in tinnitus distress scores directly after mindfulness therapy. One of three RCTs showed a statistically significant improvement of depression questionnaire scores after MBI compared to the control group directly post treatment. Conclusions: A decrease of tinnitus distress scores in MBIs can be observed directly post-therapy based on moderate to high quality studies. This was found regardless of the heterogeneity of patients, study design, type of MBI and outcome assessment. Two out of three RCTs found clinically relevant decreases in tinnitus distress scores. No effect of MBIs was observed for depression and anxiety in tinnitus patients. Long term effects remain uncertain. Mindfulness may have a place in tinnitus therapy, although the long term effects need to be studied.

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Mindfulness-Based Interventions for the Treatment of Substance and Behavioral Addictions: A Systematic Review.

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