September/October 2011, Volume 4, Issue 5
“At 7-month follow-up, the improvements in the total posttraumatic stress disorder and depression scores were largely maintained, and the decreased sense of hopelessness was fully maintained despite ongoing violent conflict and economic hardship.”

FEATURED ARTICLES:

Editor’s Log: Chiropractic Identity:
Charting Our Future Roles »

Chiropractic in an Integrative Cancer
Center: Interview with Jeff Sklar, DC »

Yoga and Health: Interview with
Sandra McLanahan, MD »

Risks of Acetaminophen »

Chiropractic and Manual Therapies
Research »

Nutrition Update »

Exercise and Fitness Report »

CAM in Review »

Mind-Body News

Health News

The Daily HIT Blog

MIND-BODY News
When reading reports on new research, it is important to remember that no single study should be seen as providing the whole truth. The following reports offer helpful clues but in most cases further research is needed before firm conclusions can be drawn.
Mind-Body Skills Training Effective for PTSD
and Depression in Gaza Study

Staples JK, Abdel A, A. J, Gordon JS. Mind-body skills groups for posttraumatic stress disorder and depression symptoms in Palestinian children and adolescents in Gaza. International Journal of Stress Management. June 27, 2011.

A mind-body skills group program was evaluated to determine its effects on symptoms of posttraumatic stress disorder (PTSD) and depression, and on hopelessness in children and adolescents in Gaza. The 10-session mind-body skills groups included meditation, guided imagery, breathing techniques, autogenic training, biofeedback, genograms, and self-expression through words, drawings, and movement. Data were analyzed from 129 children and adolescents meeting criteria for PTSD. Significant improvements in PTSD and depression symptoms and a significant decrease in a sense of hopelessness were observed immediately following participation in the program. At 7-month follow-up, the improvements in the total PTSD and depression scores were largely maintained, and the decreased sense of hopelessness was fully maintained despite ongoing violent conflict and economic hardship.

Bright Light Treatment Helps Nonseasonal Depression

Lieverse R, Van Someren EJ, Nielen MM, Uitdehaag BM, Smit JH, Hoogendijk WJ. Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial. Archives of General Psychiatry. Jan 2011;68(1):61-70.

CONTEXT: Major depressive disorder (MDD) in elderly individuals is prevalent and debilitating. It is accompanied by circadian rhythm disturbances associated with impaired functioning of the suprachiasmatic nucleus, the biological clock of the brain. Circadian rhythm disturbances are common in the elderly. Suprachiasmatic nucleus stimulation using bright light treatment (BLT) may, therefore, improve mood, sleep, and hormonal rhythms in elderly patients with MDD. OBJECTIVE: To determine the efficacy of BLT in elderly patients with MDD. DESIGN: Double-blind, placebo-controlled randomized clinical trial. SETTING: Home-based treatment in patients recruited from outpatient clinics and from case-finding using general practitioners&apos; offices in the Amsterdam region. PARTICIPANTS: Eighty-nine outpatients 60 years or older who had MDD underwent assessment at baseline (T0), after 3 weeks of treatment (T1), and 3 weeks after the end of treatment (T2). Intervention Three weeks of 1-hour early-morning BLT (pale blue, approximately 7500 lux) vs placebo (dim red light, approximately 50 lux). MAIN OUTCOME MEASURES: Mean improvement in Hamilton Scale for Depression scores at T1 and T2 using parameters of sleep and cortisol and melatonin levels. RESULTS: Intention-to-treat analysis showed Hamilton Scale for Depression scores to improve with BLT more than placebo from T0 to T1 (7%; 95% confidence interval, 4%-23%; P = .03) and from T0 to T2 (21%; 7%-31%; P = .001). At T1 relative to T0, get-up time after final awakening in the BLT group advanced by 7% (P < .001), sleep efficiency increased by 2% (P = .01), and the steepness of the rise in evening melatonin levels increased by 81% (P = .03) compared with the placebo group. At T2 relative to T0, get-up time was still advanced by 3% (P = .001) and the 24-hour urinary free cortisol level was 37% lower (P = .003) compared with the placebo group. The evening salivary cortisol level had decreased by 34% in the BLT group compared with an increase of 7% in the placebo group (P = .02). CONCLUSIONS: In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment.

Internet-Based Cognitive Behavioral Therapy with
Mindfulness Training Helps Irritable Bowel Syndrome

Andersson E, Ljotsson B, Smit F, et al. Cost-effectiveness of internet-based cognitive behavior therapy for irritable bowel syndrome: results from a randomized controlled trial. BMC Public Health. 2011;11(1):215.

BACKGROUND: Irritable Bowel Syndrome (IBS) is highly prevalent and is associated with a substantial economic burden. Cognitive behavior therapy (CBT) has been shown to be effective in treating IBS. The aim of this study was to evaluate the cost-effectiveness of a new treatment alternative, internet-delivered CBT based on exposure and mindfulness exercises. METHODS: Participants (N = 85) with IBS were recruited through self-referral and were assessed via a telephone interview and self-report measures on the internet. Participants were randomized to internet-delivered CBT or to a discussion forum. Economic data was assessed at pre-, post- and at 3-month and 1 year follow-up. RESULTS: Significant cost reductions were found for the treatment group at $16,806 per successfully treated case. The cost reductions were mainly driven by reduced work loss in the treatment group. Results were sustained at 3-month and 1 year follow-up. CONCLUSIONS: Internet-delivered CBT appears to generate health gains in IBS treatment and is associated with cost-savings from a societal perspective.

van der Oord S, Bögels S, Peijnenburg D. The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents. Journal of Child and Family Studies. 2011:1-9.

Integrative Mind-Body Approaches Helpful for Chronic
Nonspinal Pain at Veterans Administration Clinic

Smeeding SJ, Bradshaw DH, Kumpfer KL, Trevithick S, Stoddard GJ. Outcome evaluation of the Veterans Affairs Salt Lake City Integrative Health Clinic for Chronic Nonmalignant Pain. The Clinical Journal of Pain. Feb 2011;27(2):146-155.

OBJECTIVES: the purpose of this longitudinal outcome study was to investigate the effectiveness of the Integrative Health Clinic and Program, an innovative outpatient clinical service that provides nonpharmacologic, biopsychosocial interventions using research based mind-body skills and complementary and alternative therapies. The study assessed improvement in chronic nonmalignant pain and related depression, anxiety, and health-related quality of life. METHODS: the study was a retrospective post-hoc quasi-experimental design with a group analysis comparing chronic nonspinal-related pain (CNSP) (eg, joint pain, headache, and fibromyalgia) (n=53) to chronic spinal-related pain (CSP) (eg, back pain and neck pain) (n=88). Data were collected at intake and up to 4 follow-up visits. Hierarchical Linear Modeling was used for statistical analysis. Outcome measures included: Quality of Life (Short Form-36), the Beck Depression Inventory, and Beck Anxiety Inventory. RESULTS: there were statistically significant differences within and between the CNSP and CSP groups across all follow-up visits. For the CNSP group, depression, anxiety, and bodily pain significantly improved with moderate-to-large effect sizes at 6 months (Cohen&apos;s d=0.74, 0.53, and 0.66, respectively) and these benefits persisted across all follow-up visits. The CSP group showed an improvement trend in bodily pain (Cohen&apos;s d=0.26). DISCUSSION: significant study findings revealed that the greatest improvement after participation in Integrative Health Clinic and Program were seen in the CNSP group with benefits persisting to 24 months in mood and in some health-related quality of life subcategories.