CHICAGO – An 8-week course in mindfulness-based stress reduction reduced the severity of irritable bowel syndrome symptoms 6 and 12 months later, compared with 8 weeks of participation in a control group, follow-up on 68 women found.
Scores for overall irritable bowel syndrome (IBS) severity on the IBS Severity Scale (IBS-SS) were similar between groups at baseline (284 in the intervention group and 288 in the control group) but had improved significantly more in the mindfulness training group at 6 months (scores decreased 151 and 108 points, respectively) and at 12 months (scores decreased 115 vs. 26 points, respectively) compared with baseline.
The investigators originally reported significant benefits from the mindfulness course, compared with the control group immediately after the group sessions and at 3 months of follow-up in the prospective, randomized, controlled trial involving 75 patients (Am. J. Gastroenterol. 2011;106:1678-88). The current follow-up to 6 and 12 months shows lasting symptomatic improvements from mindfulness training, Olafur S. Palsson, Psy.D., and his associates reported at the annual Digestive Disease Week.
Among the 68 patients who completed 1 year of follow-up in the current analysis, the 33 who got mindfulness training also showed significantly greater improvements in secondary outcomes, compared with the 35 patients in the support group, said Dr. Palsson, a professor of medicine at the University of North Carolina, Chapel Hill.
Scores on the IBS Quality of Life Instrument were similar between groups at baseline (65 in the mindfulness group and 67 in the control group) but improved significantly more in the mindfulness group by 12 months (by 15 vs. 3, respectively).
Scores for gut-focused anxiety on the Visceral Sensitivity Index – which were not significantly different between groups at baseline or immediately after the group sessions – improved significantly more in the mindfulness group than in the control group by 3 months and the gains remained significantly greater at 6 months (by 12 vs. 2, respectively) and at 12 months (by 9 vs. –1, respectively).
"To our knowledge, these follow-up findings demonstrate some of the longest-duration therapeutic effects of mindfulness training ever reported in a clinical trial," he said.
Both interventions consisted of eight weekly sessions and a half-day retreat. The control group attended a conventional support group. The mindfulness course was based on the Mindfulness-Based Stress Reduction Program of Jon Kabat-Zinn, Ph.D., and Saki F. Santorelli, Ed.D., both of the University of Massachusetts, Worcester.
The longitudinal study controlled for the effects of race and income (less than or at least $40,000/year). The results suggest that the impact of mindfulness training on bowel symptom severity and gut-focused anxiety are well maintained and that improvements in health-related quality of life develop gradually over many months after the training, Dr. Palsson said. General psychological well-being did not change significantly based on the training, he added.
Scores for mindfulness on the Five-Facet Mindfulness Questionnaire were higher at every follow-up in the mindfulness group, compared with the control group, but the differences were not statistically significant. Mindfulness scores peaked in the mindfulness group at around 6 months and were attenuated at 12 months.
Patients ranged in age from 19 to 71 years, with a mean age of 43 years. Most patients were white, and women who were minorities or had lower incomes were more likely to drop out of the trial over time.
The National Center for Complementary and Alternative Medicine funded the study. Dr. Palsson and his coinvestigators reported financial associations with Takeda Pharmaceuticals, Ono Pharmaceuticals, Ironwood Pharmaceuticals, Entera Health, and/or the Rome Foundation.
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