A guided mindfulness-based stress reduction program was as effective as use of the gold-standard drug — the common antidepressant escitalopram — for patients with anxiety disorders, according to results of a first-of-its-kind, randomized clinical trial led by researchers at Georgetown University Medical Center.
The findings appear in JAMA Psychiatry on November 9, 2022, and follow the October 11, 2022, announcement by the United States Preventive Services Task Force that, for the first time, recommended screening for anxiety disorders due to their high prevalence.
The clinicians recruited 276 patients between June 2018 and February 2020 from three hospitals in Boston, New York City and Washington, D.C., and randomly assigned people to either mindfulness-based stress reduction (MBSR) or escitalopram. Patients’ anxiety symptoms were assessed upon enrollment and again at completion of the intervention at eight weeks, along with post-treatment assessments at 12 and 24 weeks after enrollment. The examinations were conducted in a blinded manner — the trained clinical evaluators did not know whether the patients they were assessing received the drug or MBSR.
In both the medication and mindfulness groups, the average score after treatment dropped from a moderate to a mild level of anxiety.
Those who went through the mindfulness intervention attended a weekly 2.5-hour class with a teacher, completed daily home exercises for 45 minutes, and were on a retreat for one day five or six weeks after the course. The treatments included the following exercises:
- Breath awareness – involves paying attention to the breath while allowing thoughts to arise and pass through the mind before letting them go.
- Body scanning – means paying attention to different parts of the body
- Mindful movement – includes stretching the body in different positions and noticing what sensations this causes.
The authors believe the finding helps support the use of meditation as a viable intervention, especially for people who are not comfortable seeing a psychiatrist or who experience negative side effects from medication.
“Our study provides evidence for clinicians, insurers and health care systems to recommend, include and provide reimbursement for mindfulness-based stress reduction as an effective treatment for anxiety disorders because mindfulness meditation currently is reimbursed by very few providers,” says Elizabeth Hoge, MD, director of the Anxiety Disorders Research Program. “A big advantage of mindfulness meditation is that it doesn’t require a clinical degree to train someone to become a mindfulness facilitator. Additionally, sessions can be done outside of a medical setting, such as at a school or community center.”
Source: JAMA Network | Valor Econômico