Search

Objective: Understanding the relevance of religion or spirituality (R/S) in the treatment of mental disorders is central to clinical and academic psychiatry. In this secondary analysis, associations of R/S with depression were investigated with respect to a new second-generation mindfulness-based intervention, the Meditation-Based Lifestyle Modification (MBLM) program. Methods: Different aspects of spirituality, spiritual coping, and spiritual engagement were assessed in 81 patients with a diagnosis of mild-to-moderate depression. Treatment effects on R/S postscores and predictor and moderation effects of depression severity and stress change-scores were evaluated at 8 weeks (MBLM vs. CONTROL [drug continuation therapy] vs. TAU [inpatient treatment as usual]) and 6 months (TAU+MBLM vs. TAU). Results: At both time points, significant differences between MBLM versus TAU and CONTROL were found in a range of spiritual outcomes, most of them with a medium-to-large effect size and in favor of MBLM. Baseline interest in spirituality ( p  = 0.001) and baseline spiritual mind-body practice ( p  = 0.017) were identified as independent predictors of change in depression severity at 6 months. Moreover, moderation analyses found that patients reporting often/regular spiritual mind-body practice at 6 months did not benefit differently from TAU+MBLM versus TAU ( p  = 0.437) regarding their change in depression severity and stress, while those reporting no/seldom spiritual mind-body practice at 6 months benefited significantly worse from TAU than from TAU+MBLM ( p  = 0.002). Conclusions: Participation in the MBLM program resulted in significantly greater increases in spirituality in depressed patients than standard therapy. Interest in spirituality and engagement in spiritual mind-body practices at baseline were positive predictors of clinical outcome in both groups. Patients of any group who regularly performed spiritual mind-body practices benefited equally in terms of antidepressant outcomes, underlining the benefit of these practices within a general therapeutic framework. ClinicalTrials.gov Identifier: NCT03652220.

Mental disorders are a core health challenge in the 21st century. Integrative mental health care takes an individual, lifestyle-modifying, salutogenic approach, combining somatic, psychosocial, and spiritual perspectives from evidence-based conventional and complementary medicine. In particular, meditation and mindfulness have received growing research interest in the last decade. In this article, we present Meditation-Based Lifestyle Modification (MBLM), a new, complex mind-body intervention for mental health care. It is the first program to intensify meditation practice using classical yoga. The program (a) covers all areas of classical yoga, (b) considers ethical and spiritual aspects of daily life, (c) orients participants toward sustained lifestyle modification, and (d) is applicable in a clinical context. The scientific rationale of the program is outlined in this article, based on the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare. Further research is planned to show the clinical feasibility of MBLM and evaluate its efficacy, processes of change, and cost-effectiveness., (© 2020 The Author(s) Published by S. Karger AG, Basel.)

Background: Integrative mental health care can be applied to treat depression with a person-centered, lifestyle-modifying, and more salutogenic approach to mental health and human flourishing. In this article, we report on the feasibility and acceptability of a new mind-body program, Meditation Based Lifestyle Modification (MBLM), in outpatients with mild or moderate depression., Methods: This is a single-arm mixed-methods feasibility study of n = 25 outpatients in psychiatric care. Depressive symptoms, scores for mindfulness, aspects of spirituality, and eudaemonic well-being based on yoga philosophy were assessed at baseline and at the end of the intervention. Adherence was monitored and face-to-face interviews were held after the program to explore the acceptability and feasibility of MBLM., Results: Twenty patients (75 %) completed at least six sessions of the course. Adherence was 87.5 % of allocated sessions. In qualitative analysis, more than half of the participants experienced novelty and inspiration through practicing the ethical aspects of yoga (e.g., nonviolence, truthfulness, etc.). Almost all participants experienced a decrease in emotional distress. Virtually all participants reported more self-confidence and self-acceptance. In quantitative analysis, participants reported a clinically important decrease in depressive symptoms of 39.23 % (p = .002), eudaemonic well-being increased significantly in a range of related scales and scores for mindfulness increased (p < .001)., Conclusion: MBLM is a highly acceptable and feasible program for outpatients with mild to moderate depression. This comprehensive, lifestyle-modifying approach is highly relevant to preventing and treating mental illness, and treating psychic comorbidities in patients with chronic somatic illness., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Dietary supplements are very widely used in the general population and there is a growing market for them, which is against the recommendations of the German Society for Nutrition. There is some evidence that dietary supplements are useful additions in the treatment of psychiatric disorders. This review is an overview of available practical knowledge regarding the use of supplements in psychiatric treatment. In particular, the review focused on the diagnosis of depression and anxiety in terms of supplement treatment., Methods: This is a narrative review of the evidence regarding supplements for treating anxiety and depression. We searched PubMed to 2018. Two reviewers screened the citations and abstracted the data. Phytopharmaceutical attends and animal-based data were excluded., Results: There are strong indications regarding the impact of supplements on the selected psychiatric disorders, but at this time, there only a few randomized clinical studies available, so evidence for these findings is quite low. However, it must be noted that there are strong hints for a relationship between vitamin D level and depression. Furthermore, various supplements have got potentially an influence on the characteristics of depression., Discussion: This review summarizes the current knowledge about supplements when used for some psychiatric conditions, but the data does not provide compelling evidence in any direction. There are only indications that there is an influence of supplements on psychiatric diseases. In support of this, there is further need for high-quality studies in this field. Reviews on other diagnoses, such as schizophrenia and dementia, will be part of further work., Competing Interests: The authors all declare no conflicts of interest., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objectives: We aimed to evaluate the effectiveness of an 8-week meditation program (focused meditation) in patients with chronic low-back pain., Design: A randomized clinical trial was conducted on 68 patients (55 years;75% female) with chronic low-back pain who scored >40mm on a 100mm Visual-Analogue-Scale. Subjects were allocated to an 8-week meditation program (focused meditation) with weekly 75min classes or to a self-care exercise program with a wait-list offer for meditation. Both groups were instructed to practice at home. Outcomes were assessed baseline and after 4 and 8 weeks. The primary outcome measure was the change in mean back pain at rest after 8 weeks. Secondary outcomes included function, pain-related bothersomeness, perceived stress, quality-of-life (QOL), and psychological outcomes., Results: Twelve (meditation) and 4 (exercise) patients were lost to follow-up. The primary outcome, pain at rest after 8 weeks, was reduced from 59.3±13.9mm to 40.8±21.8mm with meditation vs. 52.9±11.8mm to 37.3±18.2mm with exercise (adjusted group difference: -1.4 (95%CI:11.6;8.8;p=n.s.) Perceived stress was significantly more reduced with meditation (p=0.011). No significant treatment effects were found for other secondary outcomes as pain-related bothersomeness, function, quality-of-life and psychological scores, although the meditation group consistently showed non-significant better improvements compared to the exercise group., Conclusions: Focused meditation and self-care exercise lead to comparable, symptomatic improvements in patients with chronic low back pain. Future studies should include longer-term follow-ups and develop guided meditation programs to support compliance., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Unlabelled: Chronic neck pain is a common medical complaint partly mediated by psychosocial distress and having a high socioeconomic impact. There is preliminary evidence that stress reduction by meditation might be beneficial in chronic pain syndromes. We aimed to evaluate the effectiveness of an 8-week meditation program (jyoti meditation) in patients with chronic neck pain by means of a randomized clinical trial. Eighty-nine patients (aged 49.7 ± 10.5 years, 73 female) with chronic neck pain who scored >40 mm on a 100-mm visual analog scale and had concomitant increased perceived stress were randomized to an 8-week meditation program (jyoti meditation) with weekly 90-minute classes (n = 45) or to a home-based exercise program (n = 44) with a wait list offer for meditation. Both groups were instructed to practice at home. Outcomes were assessed at baseline and after 8 weeks. Primary outcome measure was change of mean pain at rest (visual analog scale score) from baseline to week 8. Secondary outcomes included pain at motion, functional disability, pain-related bothersomeness, perceived stress, quality of life, and psychological outcomes. Patients had neck pain for a mean of 11 years. Eighteen patients in the meditation group and 16 patients in the exercise group were lost to follow-up. Meditation training significantly reduced pain when compared to the exercise group after 8 weeks (reduction of 45.5 ± 23.3 mm to 21.6 ± 17.2 mm in the meditation group, and 43.8 ± 22.0 mm to 37.7 ± 21.5 mm in the exercise group; mean difference: 13.2 mm [95% confidence interval: 2.1, 24.4; P = .02]). Pain-related bothersomeness decreased more in the meditation group (group difference 11.0 mm [95% confidence interval: 1.0, 21.0; P = .03]). No significant treatment effects were found for pain at motion, psychological scores, and quality of life, although the meditation group showed nonsignificant greater improvements compared to the exercise group. In conclusion, meditation may support chronic pain patients in pain reduction and pain coping. Further well-designed studies including more active control comparisons and longer-term follow-up are warranted., Perspective: This article presents the results of a randomized controlled trial on the clinical effects of an 8-week meditation program or self-care exercise in patients with chronic neck pain. Meditation reduced pain at rest but not disability and might be a useful treatment option for pain management of chronic neck pain., (Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.)

Unlabelled: Yoga has been found effective in the treatment of chronic low back pain. We aimed to evaluate the effectiveness of Iyengar yoga in chronic neck pain by means of a randomized clinical trial. Seventy-seven patients (aged 47.9 ± 7.9, 67 female) with chronic neck pain who scored >40 mm on a 100-mm visual analog scale (VAS) were randomized to a 9-week Iyengar yoga program with weekly 90-minute classes (n = 38) or to a self-care/exercise program (n = 38). Patients were examined at baseline and after 4 and 10 weeks. The primary outcome measure was change of mean pain at rest (VAS) from baseline to week 10. Secondary outcomes included pain at motion, functional disability, quality of life (QOL), and psychological outcomes. Twelve patients in the yoga group and 11 patients in the self-care/exercise group were lost to follow-up, with higher study nonadherence in the self-care group (5 versus 10 patients). Mean pain at rest was reduced from 44.3 ± 20.1 to 13.0 ± 11.6 at week 10 by yoga and from 41.9 ± 21.9 to 34.4 ± 21.1 by self-care/exercise (group difference: -20.1, 95% confidence interval: -30.0, -10.1; P < .001). Pain at motion was reduced from 53.4 ± 18.5 to 22.4 ± 18.7 at week 10 by yoga and from 49.4 ± 22.8 to 39.9 ± 21.5 by self-care/exercise (group difference: -18.7, 95% confidence interval: -29.3, -8.1; P < .001). Significant treatment effects of yoga were also found for pain-related apprehension, disability, QOL, and psychological outcomes. Sensitivity analyses suggested minimal influence of dropout rates. Both programs were well tolerated. In this preliminary trial, yoga appears to be an effective treatment in chronic neck pain with possible additional effects on psychological well-being and QOL. The effectiveness of yoga in chronic neck pain should be further tested by comparative effectiveness studies with longer observation periods., Perspective: This article presents the results of a randomized controlled trial on the clinical effects of a 9-week yoga program or self-care exercise in patients with chronic neck pain. Yoga led to superior pain relief and functional improvements and might be a useful treatment option for chronic neck pain., (Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.)

The text outlines the relation between psychosomatic medicine as an established medical discipline and the emerging concept of mind-body medicine from a historical, clinical and epistemological perspective. Limitations and contributions of both disciplines are discussed and the opportunities within the concept of Integrative Medicine are outlined. Whereas psychosomatic medicine is perceived as a form of transformation through a primarily verbal discoursive relationship, mind-body medicine claims healing through increased traditional techniques of the relaxation response, increased awareness, mindfulness, increasing des-identification and health-promoting lifestyle modification. It becomes clear that mind-body medicine seems to be epistemologically the broader theoretical framework, whereas in a clinical context the combination of both disciplines appears to be complementary and synergistic. The connection between psychosomatic medicine and mind-body medicine can make an important and exemplary contribution to the concept of Integrative Medicine., (Copyright © 2012 S. Karger AG, Basel.)

Distress is an increasing public health problem. We aimed to investigate the effects of an Iyengar yoga program on perceived stress and psychological outcomes in distressed women and evaluated a potential dose-effect relationship. Seventy-two female distressed subjects were included into a 3-armed randomized controlled trial and allocated to yoga group 1 (n = 24) with twelve 90 min sessions over 3 months, yoga group 2 (n = 24) with 24 sessions over 3 months, or a waiting list control group (n = 24). The primary outcome was stress perception, measured by Cohen Stress Scale; secondary outcomes included state trait anxiety, depression, psychological and physical quality of life (QOL), profile of Mood States, well being, and bodily complaints. After three months, women in the yoga groups showed significant improvements in perceived stress (P = 0.003), state trait anxiety (P = 0.021 and P = 0.003), depression (P = 0.008), psychological QOL (P = 0.012), mood states being (P = 0.007), and bodily complaints well(P = 0.012) when compared to controls. Both yoga programs were similarly effective for these outcomes; however, compliance was better in the group with fewer sessions (yoga group 1). Dose effects were seen only in the analysis of group-independent effects for back pain, anxiety, and depression. These findings suggest that Iyengar yoga effectively reduces distress and improves related psychological and physical outcomes. Furthermore, attending twice-weekly yoga classes was not superior to once-weekly classes, as a result of limited compliance in the twice-weekly group.

Objective: Gua sha is a traditional East Asian healing technique where the body surface is press-stroked with a smooth-edged instrument to intentionally raise therapeutic petechiae. A traditional indication of Gua sha is neck pain; no data from controlled trials exist to support this claim. The researchers aimed to investigate the effectiveness of Gua sha in the symptomatic treatment of chronic neck pain., Design: The study was designed as an open randomized controlled clinical trial., Setting: The study was set in Kliniken Essen-Mitte, Academic Teaching Hospital of the University Duisburg-Essen, Germany., Subjects: Forty-eight outpatients (58.5±8.0 years; 41 female) with chronic mechanical neck pain were the subjects of the study., Intervention: Patients were randomized into Gua sha (N=24) or control groups (N=24) and followed up for 7 days. Gua sha patients were treated once with Gua sha, while control patients were treated with a local thermal heat pad., Outcome Measures: Primary outcome was change of neck pain severity after 1 week as assessed by visual analog scale. Secondary outcomes included pain at motion, the neck disability index (NDI) and quality-of-life (Short-Form [36] Health Survey)., Results: Neck pain severity after 1 week improved significantly better in the Gua sha group compared with the control group (group difference -29.9 mm, 95% confidence interval: -43.3; -16.6 mm; P<0.001). Significant treatment effects were also found for pain at motion, scores on the NDI, and dimensions of quality-of-life. The treatment was safe and well tolerated., Conclusion: Gua sha has beneficial short-term effects on pain and functional status in patients with chronic neck pain. The value of Gua sha in the long-term management of neck pain and related mechanisms remains to be clarified., (Wiley Periodicals, Inc.)

Corticotropin-releasing factor (CRF) 1 receptor (CRF(1)) activation in the brain is a core pathway orchestrating the stress response. Anatomical data also support the existence of CRF signaling components within the colon. We investigated the colonic response to intraperitoneal (ip) injection of cortagine, a newly developed selective CRF(1) peptide agonist. Colonic motor function and visceral motor response (VMR) were monitored by using a modified miniaturized pressure transducer catheter in adult conscious male Sprague-Dawley rats and C57Bl/6 mice. Colonic permeability was monitored by the Evans blue method and myenteric neurons activation by Fos immunohistochemistry. Compared with vehicle, cortagine (10 microg/kg ip) significantly decreased the distal colonic transit time by 45% without affecting gastric transit, increased distal and transverse colonic contractility by 35.6 and 66.2%, respectively, and induced a 7.1-fold increase in defecation and watery diarrhea in 50% of rats during the first hour postinjection whereas intracerebroventricular (icv) cortagine (3 microg/rat) had lesser effects. Intraperitoneal (ip) cortagine also increased colonic permeability, activated proximal and distal colonic myenteric neurons, and induced visceral hypersensitivity to a second set of phasic colorectal distention (CRD). The CRF antagonist astressin (10 mug/kg ip) abolished ip cortagine-induced hyperalgesia whereas injected icv it had no effect. In mice, cortagine (30 microg/kg ip) stimulated defecation by 7.8-fold, induced 60% incidence of diarrhea, and increased VMR to CRD. Stresslike colonic alterations induced by ip cortagine in rats and mice through restricted activation of peripheral CRF(1) receptors support a role for peripheral CRF(1) signaling as the local arm of the colonic response to stress.

Selye pioneered the concept of biological stress in 1936, culminating in the identification of the corticotropin-releasing factor (CRF) signaling pathways by Vale's group in the last two decades. The characterization of the 41 amino-acid CRF and other peptide members of the mammalian CRF family, urocortin 1, urocortin 2, and urocortin 3, and the cloning of CRF(1) and CRF(2) receptors, which display distinct affinity for CRF ligands, combined with the development of selective CRF receptor antagonists enable us to unravel the importance of CRF(1) receptor in the stress-related endocrine (activation of pituitary-adrenal axis), behavioral (anxiety/depression, altered feeding), autonomic (activation of sympathetic nervous system), and immune responses. The activation of CRF(1) receptors is also one of the key mechanisms through which various stressors impact the gut to stimulate colonic propulsive motor function and to induce hypersensitivity to colorectal distension as shown by the efficacy of the CRF(1) receptor antagonists in blunting these stress-related components. The importance of CRF(1) signaling pathway in the visceral response to stress in experimental animals provided new therapeutic approaches for treatment of functional bowel disorder such as irritable bowel syndrome, a multifactor functional disorder characterized by altered bowel habits and visceral pain, for which stress has been implicated in the pathophysiology and is associated with anxiety-depression in a subset of patients.

Background: The facial affective behavior of traumatized patients and of a healthy control group was compared., Sampling and Methods: Data of 15 videotaped clinical interviews of traumatized inpatients and of 15 healthy women (absence of mental/psychiatric disorder according to ICD-10) were ascertained. The affective facial expression of both groups was coded with the Emotional Facial Acting Coding System. Afterwards, the mimic analysis was correlated with gazing behavior and the emotional experience. The patients reported their traumatic experiences and the healthy women their main complaints., Results: The traumatized patients showed neither a reduction of overall facial expressions nor a reduced frequency of facial affects in comparison to the healthy control group. The control group, however, showed significantly more 'genuine joy'. The traumatized patients showed significantly more anger., Conclusions: The traumatized patients did not show a significant reduction of overall facial expression. A more detailed analysis showed that on the one hand, stabilizing elements of relationships, such as genuine joy, appear significantly less on the face of traumatized patients as compared with the healthy women. On the other hand, the expression of anger was brought into the relationship significantly more often by the traumatized patients during face-to-face interaction (clinical interview). This indicates the importance of distance regulation interaction patterns of traumatized patients., (Copyright (c) 2007 S. Karger AG, Basel.)

Obsessive-compulsive symptoms are clinically unspecific and can be found in numerous disorders. Within the framework of psychotherapeutically treatable illnesses, the classical obsessive-compulsive neurosis can be distinguished from early anancastia in the case of borderline personality disorder. The text refers to some aspects of the obsessive-compulsive disorder within these earlier disorders. At least five characteristics can be discussed: In the course of this, the varying functions of obsessive-compulsive symptoms for the inner-psychological organization become clear and specifically show that on a low structural level, symptoms do not appear to be primarily pathological but are a part of a "quasi-physiological" and ego-sustaining mechanism. What remains open to discussion in the end is, whether there may be an important substratum for the basis of a historiographical biology as called repeatedly for from psychosomatic theory repeatedly. In addition to this, the awareness of both forms is an important requirement for treatment.

The "Gestaltkreis" represents an important part in the psychosomatic theory-discussion, which can be understood as an incomplete contribution towards a general theory of emotions. Especially the relationship between perception and motion requires further consideration. Instead of a causal attribution, cyclic complementaries are important. Furthermore different degrees of organisation within the body-scheme and the affect-apparatus are mentioned.

The "Situationskreis" represents some of the most important parts of the psychosomatic theory-formation. It describes the relationship between individual and environment as a "cyclic" process of interpretation, which is characterized of an inner tentative action. Uexküll indeed mentions affective aspects in his "Situationskreis", but doesn't apply them consequently. From a psychology of affects and emotions several additional points are possible; first in the meaning of non-verbal moments, then in a differentiation of the constructivistic position, in the assumption of internalization terms, in a radicalisation of the historical statement and in problematizing the demanded method.

Psychotherapeutic theories have a lamarcistic trait in interpreting psychogeneous symptoms and signs. In the theory of Ch. Darwin the mechanism of selection plays an important role to interpret evolutionary processes. According to the psychotherapeutic process early infant relation-ships, the relation between description and structure, the six components of the affect and the convergence between non-verbal interaction and motivation are important.