A revered contemplative practice for centuries, meditation has recently inspired research into its therapeutic value for everything from anxiety disorders to heart attack prevention.
A painful, progressive autoimmune disease, rheumatoid arthritis (RA) is associated with a high risk of depression—double the risk of the healthy population, by conservative estimates—and various forms of psychological distress. Increasingly, RA patients are turning to alternative therapies like meditation to ease the toll of their disease.
Mindfulness-Based Stress Reduction (MBSR) is a meditation training program developed by Dr. Kabat-Zinn and colleagues at the University of Massachusetts Medical School. MBSR teaches participants to relate differently to thoughts and emotions, and continually focus the mind on the present moment to increase clarity and calmness. The program has been shown to improve psychological symptoms in patients with fibromyalgia, cancer, and multiple sclerosis, among other conditions. Researchers with the University of Maryland School of Medicine set out to assess the effect of this meditation therapy on depressive symptoms, psychological distress, general well-being, and disease activity among RA patients. Featured in the October 2007 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare), their study supports the potential benefits of prescribing a course in MBSR along with the conventional course of physical and pharmacological therapy.
Recruited through community health fairs and ads in Baltimore newspapers, 63 adult RA patients were selected to participate in this novel pilot study. Averaging 54 years in age, participants were mostly female, white, married, college educated, and comfortably middle-class. None had a history of psychiatric illness, alcohol or drug addiction, or other chronic pain disorders. All patients remained under their rheumatologist's care and continued to take their routine medications throughout the study.
Through random assignment, 31 of the participants received intensive MBSR therapy, starting with an 8-week training course followed by a 4-month maintenance program. The remaining 32 participants were designated to a waitlist, agreeing to attend assessment sessions in exchange for free MBSR training after the study's end. At baseline, and again at 2 months and 6 months into the study, both groups of participants underwent psychological and rheumatological examinations. To evaluate depressive symptoms and psychological distress, researchers used the Symptom Checklist-90-Revised, a self-report questionnaire widely recognized for its reliability and validity. Overall well-being was measured by the Psychological Well-Being Scales, comprised of questions designed to gauge positive outlook and approach to coping with difficulties. RA disease status was assessed by the Disease Activity Score in 28 joints (DAS-28).