UNASSIGNED: Adopting lifestyle interventions is pivotal in coronary artery disease (CAD) management and prevention to amplify cardiovascular and mental well-being. This study aims to quantify the effect of mindfulness-based interventions (MBIs) on anxiety, depression and stress in CAD patients.
UNASSIGNED: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching four electronic databases (PubMed, CENTRAL, Scopus, and Science Direct) through December 2023. The risk of bias was assessed using the PEDro tool, and the study outcomes were expressed as standard mean difference at 95% CI.
UNASSIGNED: Out of 1838 yielded results, eight RCTs involving 623 participants with a mean age of 56.96 ± 4.89 met the prespecified eligibility criteria. The pooled results showed a statistically significant and beneficial effect of MBIs on CAD patients\' mental health status in regards to anxiety (SMD = -0.83; 95% CI [-1.19, -0.46], p < 0.001), depression (SMD = - 0.86; 95% CI [-1.14, -0.58], p < 0.001), and stress (SMD = -0.69; 95% CI [-1.27, -0.12], p = 0.02). The subgroup sensitivity analyses based on the region (Asia vs. Europe) indicated a statistically non-significant subgroup effect of MBIs on anxiety (I 2 = 63.9%, p = 0.10) and depression (I 2 = 25.8%, p = 0.25), and a significant effect on stress (I 2 = 80.0%, p = 0.03). Although the methodological quality of the trials was generally satisfactory, all studies lacked allocation concealment and blinding. Additionally, gender imbalances, and inadequate follow-up may have potentially compromised the validity of the trials.
UNASSIGNED: Mindfulness-based interventions are beneficial for improving CAD patients\' anxiety, depression and stress symptoms. Nevertheless, it is imperative to conduct more rigorous and robust studies with an equal gender ratio and long-term follow-up.

UNASSIGNED: Despite numerous papers focusing on mindfulness at work, our knowledge about how flow experience and stress as indicators of optimal functioning and wellbeing at work evolve over time during the common mindfulness-based stress reduction (MBSR) program remains limited. Drawing from the transactional model of flow and stress, we argue that a build-up of mindfulness over the training duration not only leads to a decrease in stress but also an increase in flow experience. Thereby, we examine the moderating role of emotional exhaustion amplifying the beneficial effects of mindfulness.
UNASSIGNED: In a quasi-experimental study, 91 participants completed weekly questionnaires over the course of 8 weeks. Forty six participants in the experimental group took part in the MBSR program, while 45 participants were part of an inactive control group.
UNASSIGNED: Mindfulness and flow showed a significant linear increase over time, whereas stress exhibited a linear decrease. Those who participated in the MBSR training reported an increase in mindfulness that positively and negatively predicted the trajectories of flow and stress, respectively. Emotional exhaustion amplified the effects of the trajectory of mindfulness on the trajectories of flow and stress.
UNASSIGNED: These findings suggest that mindfulness can not only reduce stress but can also foster the autotelic experience of flow, especially for chronically depleted individuals. However, more research is necessary to replicate these results and address the limitations of the current study, including the quasi-experimental design, the use of self-report measures, as well as the dropout during the study period.

UNASSIGNED: The aim of this research was to compare the effectiveness of mindfulness-based stress reduction and compassion-focused on the severity of digestive symptoms in patients with irritable bowel syndrome (IBS).
UNASSIGNED: The research method was of semi-experimental type with pre-test, post-test, follow-up, and experimental and control groups. The population included patients with IBS in Isfahan city, 45 of them were selected by convenience sampling method and randomly assigned to three groups (15 in each group). Then, the patients of one experimental group received eight sessions of 90 minutes of a mindfulness-based stress reduction program, while the other experimental group received eight sessions of 90 minutes of compassion-focused therapy. The measurement tools included the severity of IBS scale and a short clinical interview. Research data were analyzed using variance analysis with repeated measures on one factor (mixed design).
UNASSIGNED: The results showed that both methods of intervention had been equally effective on the severity of disease symptoms (P<0.01).
UNASSIGNED: Both intervention methods can be used as a complementary treatment for patients with IBS.

UNASSIGNED: Following the COVID-19 global emergency, health students were faced with increased workloads, university closures, study interruptions, loss of peer support networks, and the challenges of volunteer work in hospitals. These factors caused health students to experience significant stress and anxiety, highlighting the necessity of psychological interventions for this group. Several studies have reported that a mindfulness-based stress reduction (MBSR) protocol offers valuable coping skills for traumatic events. This study aimed to investigate the impact of Mindfulness-Based Stress Reduction (MBSR) on stress, anxiety, and depression among nursing students at Qom University of Medical Sciences during the COVID-19 pandemic.
UNASSIGNED: This experimental study was conducted on 72 nursing students from the nursing faculty of Qom University of Medical Sciences in 2020. The sampling was conducted using stratified sampling, and the allocation method employed was simple randomization. MBSR intervention based on social networks was implemented for the experimental group. The Stress-Anxiety-Depression Assessment Questionnaire (DASS-21) was completed by both groups before the study commenced, immediately after, and 2 months post-intervention. Data were analyzed in SPSS-16 using t-test, chi-square, and repeated measures analysis.
UNASSIGNED: Analysis of variance with repeated measures showed that in the experimental group, the effect of time on the average score of stress, anxiety, and depression is significant (p < 0.001). The t-test showed significant differences between the two groups in terms of stress, anxiety, and depression scores immediately after the intervention (p < 0.001) and in the follow-up phase (p < 0.001).
UNASSIGNED: MBSR based on social networks is effective and applicable in reducing stress, anxiety, and depression among nursing students during the COVID-19 pandemic. It is suggested that MBSR should be included in the curriculum of nursing students so that they can have the necessary mental preparation to face acute critical conditions such as COVID-19.

UNASSIGNED: Research indicates that exam anxiety may decline with mindfulness-based interventions but there is a lack of research on adolescents\' accounts of the processes involved. We explored high-school students\' descriptions of how they perceived and applied mindfulness in managing anxiety-inducing thoughts related to academic performance following an 8-week Mindfulness-Based Stress Reduction (MBSR) course.
UNASSIGNED: Post-course individual semi-structured interviews with 22 high school students (2 males, mean age 17.8 years) were transcribed verbatim and analysed using reflexive thematic analysis.
UNASSIGNED: The analyses identified six themes: (1) Noticing and attending to the attention-binding \"maelstrom\" of anxious thoughts and feelings (2) Attending to the breath to cope with the maelstrom, (3) \"removing\" and \"getting rid of\" anxious thoughts (4) Being able to \"think\" (5) awareness of more helpful thoughts, and (6) Agency and control. The findings are discussed in light of the Buddhist notion of \"unwholesome thoughts\" and the distinction between thought suppression and the use of breathing as a benign distraction. We propose that mindfulness encompasses both a receptive, nonjudgmental awareness and an active, intentional redirection of attention.
UNASSIGNED: Mindfulness training aided participants by enhancing their capacity to disengage from fear-engaging thoughts, thereby maintaining them within their window of tolerance and facilitating cognitive processing.

Multiple sclerosis (MS) is a chronic neurological disease frequently associated with significant fatigue, anxiety, depression, and stress. These symptoms are difficult to treat, and prominently contribute to the decreases in quality of life observed with MS. The underlying mechanisms of these \"silent\" symptoms are not well understood and include not just the psychological responses to a chronic disease, but also biological contributions from bidirectional psycho-neuro-immune (dys)regulation of systemic inflammatory biology. To address these issues, we conducted a prospective, observational pilot study to investigate the psychological, biological, and neuroarchitecture changes associated with a mindfulness-based stress reduction (MBSR) program in MS. The overarching hypothesis was that MBSR modulates systemic and central nervous system inflammation via top-down neurocognitive control over forebrain limbic areas responsible for the neurobiological stress response. 23 patients were enrolled in MBSR and assessed pre/post-program with structural 3 T MRI, behavioral measures, hair cortisol, and blood measures of peripheral inflammation, as indexed by the Conserved Transcriptional Response to Adversity (CTRA) profile. MBSR was associated with improvements across a variety of behavioral outcomes, as well as on-study enlargement of the head of the right hippocampus. The CTRA analyses revealed that greater inflammatory gene expression was related to worse patient-reported anxiety, depression, stress, and loneliness, in addition to lower eudaimonic well-being. Hair cortisol did not significantly change from pre- to post-MBSR. These results support the use of MBSR in MS and elucidate inflammatory mechanisms related to key patient-reported outcomes in this population.

UNASSIGNED: Hundreds of trials have evaluated Mindfulness-Based Stress Reduction (MBSR), but in the United States, it is generally not covered by health insurance. Consequently, the aims were to identify the following: (1) key questions to make decisions about if, how, and when MBSR should be covered by health insurance; (2a) barriers and (2b) facilitators to understand and resolve for MBSR to be covered by health insurance; and (3) highest priority evidence needed to inform health insurance coverage decisions.
UNASSIGNED: Key informants (n = 26) included health insurers, healthcare administrators, policymakers, clinicians, MBSR instructors, and MBSR students. An initial pool of items related to the study aims was generated through qualitative interviews. Through the Delphi process, participants rated, discussed, and re-rated each item\'s relevance. Items were required to reach a consensus of ≥ 80% agreement to be retained for final inclusion.
UNASSIGNED: Of the original 149 items, 42 (28.2%) met the ≥ 80% agreement criterion and were retained for final inclusion. The most highly rated items informing whether MBSR should be covered by health insurance included research demonstrating that MBSR works and that it is not harmful. The most highly rated barriers to coverage were that MBSR is not a medical treatment and patient barriers to attendance. Highly rated facilitators included the potential of MBSR to address common mental health and psychosomatic problems. Finally, understanding what conditions are effectively treated with MBSR and the impact of MBSR on stress were rated as the highest priority evidence needed to inform health insurance coverage decisions.
UNASSIGNED: Findings highlight priorities for future research and policy efforts to advance health insurance coverage of MBSR in the United States.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12671-024-02366-x.

BACKGROUND: Depression is a common and serious psychological condition, which seriously affects individual well-being and functional ability. Traditional treatment methods include drug therapy and psychological counseling; however, these methods have different degrees of side effects and limitations. In recent years, nonconvulsive electrotherapy (NET) has attracted increasing attention as a noninvasive treatment method. However, the clinical efficacy and potential mechanism of NET on depression are still unclear. We hypothesized that NET has a positive clinical effect in the treatment of depression, and may have a regulatory effect on serum inflammatory factors during treatment.
OBJECTIVE: To assess the effects of NET on depression and analyze changes in serum inflammatory factors.
METHODS: This retrospective study enrolled 140 patients undergoing treatment for depression between May 2017 and June 2022, the observation group that received a combination of mindfulness-based stress reduction (MBSR) and NET treatment (n = 70) and the control group that only received MBSR therapy (n = 70). The clinical effectiveness of the treatment was evaluated by assessing various factors, including the Hamilton Depression Scale (HAMD)-17, self-rating idea of suicide scale (SSIOS), Pittsburgh Sleep Quality Index (PSQI), and levels of serum inflammatory factors before and after 8 wk of treatment. The quality of life scores between the two groups were compared. Comparisons were made using t and χ2 tests.
RESULTS: After 8 wk of treatment, the observation group exhibited a 91.43% overall effectiveness rate which was higher than that of the control group which was 74.29% (64 vs 52, χ2 = 7.241; P < 0.05). The HAMD, SSIOS, and PSQI scores showed a significant decrease in both groups. Moreover, the observation group had lower scores than the control group (10.37 ± 2.04 vs 14.02 ± 2.16, t = 10.280; 1.67 ±0.28 vs 0.87 ± 0.12, t = 21.970; 5.29 ± 1.33 vs 7.94 ± 1.35, t = 11.700; P both < 0.001). Additionally, there was a notable decrease in the IL-2, IL-1β, and IL-6 in both groups after treatment. Furthermore, the observation group exhibited superior serum inflammatory factors compared to the control group (70.12 ± 10.32 vs 102.24 ± 20.21, t = 11.840; 19.35 ± 2.46 vs 22.27 ± 2.13, t = 7.508; 32.25 ± 4.6 vs 39.42 ± 4.23, t = 9.565; P both < 0.001). Moreover, the observation group exhibited significantly improved quality of life scores compared to the control group (Social function: 19.25 ± 2.76 vs 16.23 ± 2.34; Emotions: 18.54 ± 2.83 vs 12.28 ± 2.16; Environment: 18.49 ± 2.48 vs 16.56 ± 3.44; Physical health: 19.53 ± 2.39 vs 16.62 ± 3.46; P both < 0.001) after treatment.
CONCLUSIONS: MBSR combined with NET effectively alleviates depression, lowers inflammation (IL-2, IL-1β, and IL-6), reduces suicidal thoughts, enhances sleep, and improves the quality of life of individuals with depression.

Objective: The aim of this study was to synthesize the available evidence on the clinical efficacy of different relaxation exercises on intraocular pressure (IOP) reduction. Methods: A systemic search of PubMed, Embase, Cochrane CENTRAL, and Web of Science was undertaken from the earliest record to 10 April 2024. Peer-reviewed studies that reported on healthy individuals and glaucoma patients engaging in relaxation exercises for at least three weeks were included. The primary outcome was changes in IOP levels from baseline, before the commencement of relaxation exercises, to post-exercise. Our statistical analysis employed a random-effects model, with effect sizes reported using Hedges\' g. Results: Twelve studies were included, totaling 764 eyes (mean participant age ranging from 21.07 to 69.50 years). Relaxation exercises significantly reduced IOP, with Hedges\' g being -1.276 (95% CI: -1.674 to -0.879) and I2 = 84.4%. Separate subgroup analyses showed that breathing exercises (Hedges\' g = -0.860, p < 0.0001), mindfulness-based stress reduction (MBSR) (Hedges\' g = -1.79, p < 0.0001), and ocular exercises (Hedges\' g = -0.974, p < 0.0001) were associated with reduced IOP levels. The reduction in IOP following the relaxation exercises was found to be associated with baseline IOP either greater than (Hedges\' g = -1.473, p < 0.0001) or less than 21 mmHg (Hedges\' g = -1.22, p < 0.0001). Furthermore, this effect persisted with follow-up durations of less than (Hedges\' g = -1.161, p < 0.0001) and more than one month (Hedges\' g = -1.324, p < 0.0001). Conclusions: The current meta-analysis indicates that relaxation exercises can significantly reduce IOP levels. Relaxation exercises are a potential class of novel treatments for glaucoma patients that deserve further evaluation.

We qualitatively explored the impact of preoperative mindfulness-based stress reduction (MBSR) on total knee arthroplasty (TKA) experiences. Participants (n = 10) who received MBSR prior to TKA participated in semi-structured interviews concerning their experiences with MBSR and its perceived impact on surgery. We analyzed interviews according to reflexive thematic analysis, and coded data into three main themes: 1) Impact of MBSR on surgery experiences; 2) Contributors to change; and 3) Motivations for participation. Participants noted they were able to relax, feel more confident, and cope more effectively during the preoperative period, and that others in their lives noticed positive changes following their participation in MBSR. Participants\' openness to mindfulness and health-related beliefs and may have contributed to the positive impacts they experienced from MBSR. Participants described being motivated to participate in MBSR to help them prepare for their surgery and to learn new coping strategies. Participants described a strong level of commitment to the intervention. With further research, integration of MBSR into prehabilitation for TKA may be appropriate.