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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
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Alternative Therapy (Yoga, Acupuncture, etc.)
      #13947 - 07/14/03 01:48 PM

All articles pertaining to alternative therapies such as yoga, acupuncture, meditation, etc. and digestive health research should be posted here.

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HeatherAdministrator

Reged: 12/09/02
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Stress Management for Gastrointestinal Disorders:The Use of Kundalini Yoga Meditation Techniques new
      #13960 - 07/14/03 02:18 PM

Full Text of: Shannahoff Khalsa: Gastroenterol Nurs, Volume 25(3).May/June 2002.126-129

Gastroenterology Nursing (C) The Society of Gastroenterology Nurses & Associates 2002.
All Rights Reserved.

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Volume 25(3) May/June 2002 pp 126-129
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Complementary Healthcare Practices: Stress Management for Gastrointestinal Disorders: The Use of Kundalini Yoga Meditation Techniques

[Departments] Shannahoff-Khalsa, David Section Editor(s): Krebs, Kathleen BS, RN

About the Department Editor: Kathleen Krebs, BS, RN, is the new editor of the Complementary Healthcare Practices column. Kathleen has received clinical training in Mind/Body Medicine from Harvard University's Mind/Body Medical Institute under the medical direction of Dr. Herbert Benson. In her role at Allegheny General Hospital's Integrated Medicine Program, Kathleen provides instruction in stress management, mind/body medicine, and healthy lifestyle strategies, and helps to integrate conventional and natural therapies for patients with acute and chronic conditions. Kathleen works with a large gastroenterology practice at Allegheny General Hospital and has been a member of SGNA since 1998.

About the Author: David Shannahoff-Khalsa is Director, The Research Group for Mind-Body Dynamics, Institute for Nonlinear Science (mail code 0402), University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0402 (e-mail dsk@ucsd.edu). Contact the author for more information about the use of Kundalini Yoga meditation techniques.

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Outline

Overview of the Techniques
Summary
References

Graphics

Table 1
Table 2
Table 3

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It is well known that stress exacerbates the symptoms of irritable bowel syndrome (IBS) and other functional gastrointestinal (GI) disorders. Drossman et al. (1999) hypothesized that functional GI disorders result from the dysregulation of "brain-gut" neuroenteric systems. They suggest the primary origin of functional GI disorders is not a disease of any GI organ or the brain, but the interaction of both. These disorders may, therefore, benefit from techniques that can alter the activities of
the central nervous system (CNS), autonomic nervous system (ANS), and enteric nervous system (ENS).

Recently, Kundalini Yoga meditation techniques (Shannahoff-Khalsa et al., 1999) have been demonstrated to have a dramatically beneficial effect on obsessive compulsive disorders (OCD), one of the most disabling of the anxiety disorders (Rapoport, 1990). OCD has a lifelong prognosis and is estimated to be the fourth most common psychiatric disorder following phobias, substance abuse, and the major depressive disorders. OCD is twice as common as schizophrenia and panic disorder (Rasmussen & Eisen,1990). OCD often begins during childhood or adolescence, has a lifetime prevalence rate of 2.5% to 5.0% (Rasmussen &
Eisen, 1990), and has proven to be refractory to traditional insight-oriented psychotherapy (Jenike, 1990). Also, 40% to 60% of patients exhibit only minimal improvement or no change with serotonin reuptake inhibitors alone (Goodman, 1992). As many as one-third are unimproved after apparently adequate drug treatment (Goodman, 1992), yielding a drug-treatment-resistant patient (Goodman, et al., 1992). In addition, medication in responders produces only a 30% to 60% symptom reduction and patients tend to remain chronically symptomatic to some degree despite the best of pharmacologic interventions (Jenike, 1992).

These OCD statistics are similar to those of IBS and other GI disorders for incidence and treatment success rates. While Kundalini Yoga meditation techniques have not yet been tested specifically for IBS or other GI disorders, they have a longstanding history over thousands of years as therapies for stress management, anxiety disorders, and a wide range of other psychiatric disorders (Shannahoff-Khalsa, 1991). The intent here is to help familiarize therapists and clinicians that may want to increase their repertoire of tools in the alternative medicine domain for the treatment of "brain-gut" disorders.

Overview of the Techniques

While there are 11 techniques in the meditation protocol specific for OCD (Shannahoff-Khalsa, 1997), including a breathing pattern specific for treating OCD (not listed below), these techniques can be employed for the stress-related exacerbation conditions of GI disorders. Several are described here. In addition to these, in the OCD-specific protocol, there is a 3-minute technique to help individuals learn to manage fears, a 5-minute technique for turning negative thoughts into positive thoughts, a technique that only requires a few breaths to help meet mental challenges, and an 11-minute technique for tranquilizing the angry mind. Whether practicing in a group or by oneself, the first technique, "tuning in" is always employed. Tuning in helps to induce a meditative state of mind and can provide the individual with the experience of being in a womb of blissful healing energy, especially when practiced beyond the minimum requirement of three repetitions (Table 1).

This technique helps to create a meditative state of mind and is always used as a precursor to the other techniques. There is no upper time limit for this technique; the longer the better.

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TABLE 1 Technique 1 "Tuning In"
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Techniques 2, Spine Flexing, and 3, Shoulder Shrug (Table 2), are also used to help induce an energized and positive state of being that can help the patient when engaging in the other techniques. These techniques increase metabolism, uplift the spirit, and induce the healthy glandular changes that give the energetic experience of vitality. These are helpful precursors to the other techniques. They help set the mood and increase metabolism.

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TABLE 2 Techniques 2 & 3 for Vitality
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Techniques 4, 5, and 6 (see Table 3) are all useful for managing anxiety, emotional stress, and mental tension-conditions that are believed to play an elementary role in the disturbance of the "brain-gut" connection. Technique 4 for reducing anxiety, stress, and mental tension is a powerful technique that induces a calm and quiet mind within minutes. It works even if you are feeling absolutely insane. In fact, in ancient times it was used to treat insanity. It can also be used to curb a restless and stressed mind and to bring an inner stillness and extraordinary experience of mental silence and well-being.

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TABLE 3 Techniques 4, 5, & 6 for Reducing Anxiety, Stress, and Mental Tension
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Technique 5 helps to alleviate emotional stress. Yogis also claim it helps rejuvenate the nervous, glandular, and
cardiovascular systems. This technique helps build respiratory capacity. The more slowly and deeply you breathe, the more relaxed you will be. Technique 6 takes about 75 seconds once learned and helps strip away any residual mental tension, especially after employing techniques 4 and 5. It can also be used independently.

Summary

Techniques in this protocol are from the system of Kundalini Yoga as taught by Yogi Bhajan (Master of Kundalini Yoga). They have a long-standing history of use for the management of stress, anxiety, and a wide variety of psychiatric and other disorders. While they have not been rigorously tested for the treatment of IBS or other functional GI disorders during modern times, they are likely to prove beneficial for helping the GI patient manage the daily stress that is often found to exacerbate and perhaps perpetuate the symptoms and conditions of the functional bowel or "brain-gut" disorders. Helping a patient to manage stress and achieve a profound sense of relaxation is likely to tend to the "brain" side of the "brain-gut" disorder, and thus help reduce these inter-system disorders.

References

1. Drossman, D.A., Creed, F.H., Olden, K.W., Svedlund, J., Toner, B.B., Whitehead, W.E. (1999). Psychological aspects of the functional gastrointestinal disorders. Gut, 45(suppl. 2), 1125-1130.

2. Goodman, W.K., McDougle, C.J., Price, L.H. (1992). Pharmacotherapy of obsessive compulsive disorder. Journal of Clinical Psychiatry, 53, 29-37. [Medline Link] [PsycINFO Link] [BIOSIS Previews Link]

3. Goodman, W.K., McDougle, C.J., Barr, L.C., Aronson, S.C., Price, L.H. (1993). Biological approaches to treatment-resistant obsessive compulsive disorder. Journal of Clinical Psychiatry, 54, 16-26. [Medline Link] [PsycINFO Link] [BIOSIS Previews Link]

4. Jenike, M.A. (1990). Psychotherapy of the patient with obsessive compulsive personality disorder. In M.A. Jenike, L. Baer, W.E. Minichiello (Eds.). Obsessive-compulsive disorders: Theory and management. St. Louis: Mosby-Year Book.

5. Jenike, M.A. (1992). Pharmacologic treatment of obsessive compulsive disorders. Psychiatric Clinics of North America, 15, 895-919. [Medline Link] [PsycINFO Link]

6. Rapoport, J.L. (1990). The waking nightmare: An overview of obsessive compulsive disorder. Journal of Clinical Psychiatry, 51, 25-28. [Medline Link] [PsycINFO Link] [BIOSIS Previews Link]

7. Rasmussen, S.A., Eisen, J.L. (1990). Epidemiology of obsessive compulsive disorder. Journal of Clinical Psychiatry, 51, 10-13. [Medline Link] [PsycINFO Link] [BIOSIS Previews Link]

8. Shannahoff-Khalsa, D.S. (1991). Stress technology medicine: A new paradigm for stress and considerations for
self-regulation. In M. Brown, G. Koob, C. Rivier (Eds.). Stress: Neurobiology and neuroendocrinology (pp. 647-686). New York: Marcel Dekker.

9. Shannahoff-Khalsa, D.S. (1997). Yogic techniques are effective in the treatment of obsessive compulsive disorders, In E. Hollander D Stein (Eds.). Obsessive-compulsive disorders: Diagnosis, etiology, and treatment (pp. 283-329). New York: Marcel Dekker.

10. Shannahoff-Khalsa, D.S., Ray, L.E., Levine, S., Gallen, C.C., Schwartz, B.J., Sidorowich, J.J. (1999). Randomized
controlled trial of yogic meditation techniques for patients with obsessive compulsive disorders. CNS Spectrums: The International Journal of Neuropsychiatric Medicine, 4( 12), 34-46.

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Accession Number: 00001610-200205000-00008
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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
A Systematic Review of Alternative Therapies in IBS new
      #13978 - 07/14/03 03:17 PM

Spanier et al. Arch Intern Med.2003; 163: 265-274.

A Systematic Review of Alternative Therapies in IBS

A recent study conducted by the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Northwestern University Medical School, Chicago, IL found that irritable bowel syndrome is a common disorder associated with a significant burden of illness, poor quality of life, high rates of absenteeism, and high health care utilization. Management can be difficult and treatment unrewarding; these facts have led physicians and patients toward alternative therapies. They explored a variety of treatments that exist beyond the scope of commonly used therapies for irritable bowel syndrome. Guarded optimism exists for traditional Chinese medicine and psychological therapies, but further well-designed trials are needed. Oral cromolyn sodium may be useful in chronic unexplained diarrhea and appears as effective as and safer than elimination diets. The roles of lactose and fructose intolerance remain poorly understood. Alterations of enteric flora may play a role in irritable bowel syndrome, but supporting evidence for bacterial overgrowth or probiotic therapy is lacking.

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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
Acupuncture treatment for irritable bowel syndrome. new
      #14129 - 07/15/03 06:42 PM

Digestion. 2001;64(2):100-3.

Acupuncture treatment for irritable bowel syndrome. A double-blind controlled study.

Fireman Z, Segal A, Kopelman Y, Sternberg A, Carasso R.

Department of Gastroenterology, Hillel Yaffe Medical Center, Hadera, Israel. fireman@hillel-yaffe.health.gov.il

BACKGROUND/AIM: Irritable bowel syndrome is one of the most common gastrointestinal disorders in Western society, affecting around 15% of the population, especially young adults. The cause(s) of irritable bowel syndrome and effective treatment(s) have remained elusive. This study aimed at exploring the therapeutic value of acupuncture by comparing the responses of irritable bowel syndrome sufferers to true acupuncture versus sham acupuncture in a controlled double-blind study. METHODS: Twenty-five patients who fulfilled the Rome criteria (irritable bowel syndrome symptoms persisting for more than 1 year) comprised the final study population. They were recruited through a 'call for' bulletin sent to gastroenterologists practicing in the region of our medical center. True acupuncture was performed at LI-4 (colonic meridian, needle only) and sham acupuncture at BL-60 (urinary vesicle meridian, needle only). Patient assignment to one of the two groups was random. RESULTS: The effect of the first true acupuncture on overall symptoms and abdominal pain was a clear and significant improvement (p = 0.05). No comparable effect was seen in the second session. CONCLUSIONS: Although the true acupuncture results were consistently better, no difference was found between the two groups in the overall statistical analysis. We could not show a therapeutic benefit of this treatment modality in irritable bowel syndrome. Copyright 2001 S. Karger AG, Basel

Publication Types:
Clinical Trial
Randomized Controlled Trial

PMID: 11684823 [PubMed - indexed for MEDLINE]
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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
Effectiveness of acupuncture for treatment of childhood constipation. new
      #14130 - 07/15/03 06:43 PM

Dig Dis Sci. 2001 Jun;46(6):1270-5.

Effectiveness of acupuncture for treatment of childhood constipation.

Broide E, Pintov S, Portnoy S, Barg J, Klinowski E, Scapa E.

Institute of Gastroenterology, Liver Disease and Nutrition, Assaf Harofeh Medical Center, Zerifin, Israel.

The aim of the present study was to examine the influence of acupuncture on chronic constipation in children and to investigate their basal plasma panopioid level and the changes of this treatment. Seventeen children constipated for at least six months were treated by five weekly placebo acupuncture sessions, followed by 10 weekly true acupuncture sessions. Their parents filled a bowel habit questionnaire. Panopioid activity was measured at time 0 and after 5, 10, and 15 acupuncture sessions. The frequency of bowel movements in males increased more gradually compared to females and reached a maximal improvement only after 10 true acupuncture sessions, from 1.4 +/- 0.6/week to 4.4 +/- 0.6/week and females from 1.4 +/- 0.3/week up to 5.6 +/- 1.2/week. The basal panopioid activity was lower in constipated children as compared to the control population and increased gradually up to control level after 10 true acupuncture sessions. This study is the first to describe a successful treatment by acupuncture of constipated children.

Publication Types:
Clinical Trial

PMID: 11414304 [PubMed - indexed for MEDLINE]
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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
Acupuncture for gastrointestinal and hepatobiliary disorders. new
      #14131 - 07/15/03 06:45 PM

J Altern Complement Med. 1999 Feb;5(1):27-45.

Acupuncture for gastrointestinal and hepatobiliary disorders.

Diehl DL.

Division of Digestive Diseases, UCLA School of Medicine, USA.

Acupuncture has been used for various gastrointestinal (GI) conditions. Voluminous data support the effect of acupuncture on the physiology of the GI tract, including acid secretion, motility, neurohormonal changes, and changes in sensory thresholds. Much of the neuroanatomic pathway of these effects has been identified in animal models. A large body of clinical evidence supports the effectiveness of acupuncture for suppressing nausea associated with chemotherapy, postoperative state, and pregnancy. Prospective randomized controlled trials have also shown the efficacy of acupuncture for analgesia for endoscopic procedures, including colonoscopy and upper endoscopy. Acupuncture has also been used for a variety of other conditions including postoperative ileus, achalasia, peptic ulcer disease, functional bowel diseases (including irritable bowel syndrome and nonulcer dyspepsia), diarrhea, constipation, inflammatory bowel disease, expulsion of gallstones and biliary ascariasis, and pain associated with pancreatitis. Although there are few prospective randomized clinical studies, the well-documented physiological basis of acupuncture effects on the GI tract, and the extensive history of successful clinical use of acupuncture, makes this a promising modality that warrants further investigation.

Publication Types:
Review
Review, Tutorial

PMID: 10100029 [PubMed - indexed for MEDLINE]
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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
The role of acupuncture in the treatment of irritable bowel syndrome new
      #14132 - 07/15/03 06:45 PM

Hepatogastroenterology. 1997 Sep-Oct;44(17):1328-30.

The role of acupuncture in the treatment of irritable bowel syndrome: a pilot study.

Chan J, Carr I, Mayberry JF.

Gastrointestinal Research Unit, Leicester General Hospital, England.

BACKGROUND/AIMS: The aim of this pilot study was to investigate the potential value of acupuncture in the treatment of irritable bowel syndrome (IBS). METHODOLOGY: The study was an open design study of 7 patients with established irritable bowel syndrome in which assessment was by a diary card. RESULTS: The results showed a significant improvement both in general well-being and in symptoms of bloating. CONCLUSIONS: Acupuncture seems to be effective in the treatment of irritable bowel syndrome and merits further study.

Publication Types:
Clinical Trial

PMID: 9356848 [PubMed - indexed for MEDLINE]
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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
Yoga-based guided relaxation reduces sympathetic activity new
      #14134 - 07/15/03 06:50 PM

Psychol Rep. 2002 Apr;90(2):487-94.

Yoga-based guided relaxation reduces sympathetic activity judged from baseline levels.

Vempati RP, Telles S.

Swami Vivekananda Yoga Research Foundation, Chamarajpet, Bangalore, India.

35 male volunteers whose ages ranged from 20 to 46 years were studied in two sessions of yoga-based guided relaxation and supine rest. Assessments of autonomic variables were made for 15 subjects, before, during, and after the practices, whereas oxygen consumption and breath volume were recorded for 25 subjects before and after both types of relaxation. A significant decrease in oxygen consumption and increase in breath volume were recorded after guided relaxation (paired t test). There were comparable reductions in heart rate and skin conductance during both types of relaxation. During guided relaxation the power of the low frequency component of the heart-rate variability spectrum reduced, whereas the power of the high frequency component increased, suggesting reduced sympathetic activity. Also, subjects with a baseline ratio of LF/HF > 0.5 showed a significant decrease in the ratio after guided relaxation, while subjects with a ratio < or = 0.5 at baseline showed no such change. The results suggest that sympathetic activity decreased after guided relaxation based on yoga, depending on the baseline levels.

PMID: 12061588 [PubMed - indexed for MEDLINE]
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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
Recovery from stress in two different postures and in a yogic relaxation posture. new
      #14143 - 07/15/03 09:09 PM

Indian J Physiol Pharmacol. 1998 Oct;42(4):473-8.

Recovery from stress in two different postures and in Shavasana--a yogic relaxation posture.

Bera TK, Gore MM, Oak JP.

Scientific Research Department, Kaivalyadhama S.M.Y.M. Samiti, Lonavla.

The recovery from induced physiological stress in Shavasana (a yogic relaxation posture) and two other postures (resting in chair and resting supine posture) was compared. Twenty one males and 6 females (age 21-30 yrs) were allowed to take rest in one of the above postures immediately after completing the scheduled treadmill running. The recovery was assessed in terms of Heart Rate (HR) and Blood pressure (BP). HR and BP were measured before and every two minutes after the treadmill running till they returned to the initial level. The results revealed that the effects of stress was reversed in significantly (P < 0.01) shorter time in Shavasana, compared to the resting posture in chair and a supine posture.

PMID: 10874346 [PubMed - indexed for MEDLINE]
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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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HeatherAdministrator

Reged: 12/09/02
Posts: 7393
Loc: Seattle, WA
Meditation-based stress reduction intervention in the treatment of anxiety disorders new
      #14146 - 07/15/03 09:11 PM

Gen Hosp Psychiatry. 1995 May;17(3):192-200.

Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders.

Miller JJ, Fletcher K, Kabat-Zinn J.

Department of Psychiatry, University of Massachusetts Medical Center, Worcester 01655, USA.

A previous study of 22 medical patients with DSM-III-R-defined anxiety disorders showed clinically and statistically significant improvements in subjective and objective symptoms of anxiety and panic following an 8-week outpatient physician-referred group stress reduction intervention based on mindfulness meditation. Twenty subjects demonstrated significant reductions in Hamilton and Beck Anxiety and Depression scores postintervention and at 3-month follow-up. In this study, 3-year follow-up data were obtained and analyzed on 18 of the original 22 subjects to probe long-term effects. Repeated measures analysis showed maintenance of the gains obtained in the original study on the Hamilton [F(2,32) = 13.22; p < 0.001] and Beck [F(2,32) = 9.83; p < 0.001] anxiety scales as well as on their respective depression scales, on the Hamilton panic score, the number and severity of panic attacks, and on the Mobility Index-Accompanied and the Fear Survey. A 3-year follow-up comparison of this cohort with a larger group of subjects from the intervention who had met criteria for screening for the original study suggests generalizability of the results obtained with the smaller, more intensively studied cohort. Ongoing compliance with the meditation practice was also demonstrated in the majority of subjects at 3 years. We conclude that an intensive but time-limited group stress reduction intervention based on mindfulness meditation can have long-term beneficial effects in the treatment of people diagnosed with anxiety disorders.

PMID: 7649463 [PubMed - indexed for MEDLINE]
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