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Mindfulness-based Stress Reduction in Addition to Usual Care Is Associated with Improvements in Pain, Fatigue, and Cognitive Failures Among Veterans with Gulf War Illness - 15/01/16

Doi : 10.1016/j.amjmed.2015.09.015 
David J. Kearney, MD a, b, , Tracy L. Simpson, PhD c, d, Carol A. Malte, MSW c, Benjamin Felleman, PhD e, Michelle E. Martinez, BA e, Stephen C. Hunt, MD a, b
a VA Puget Sound Health Care System, Department of Medicine, Seattle, Wash 
b Department of Medicine, University of Washington School of Medicine, Seattle 
c Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Health Care System, Seattle, Wash 
d Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle 
e VA Puget Sound Health Care System, Seattle, Wash 

Requests for reprints should be addressed to David J. Kearney, MD, Seattle VAMC 111GI, 1660 S. Columbian Way, Seattle, WA 98108.Seattle VAMC 111GI1660 S. Columbian WaySeattleWA98108

Abstract

Background

Many Gulf War I veterans report ongoing negative health consequences. The constellation of pain, fatigue, and concentration/memory disturbances is referred to as “Gulf War illness.” Prior research suggests that mindfulness-based stress reduction may be beneficial for these symptoms, but mindfulness-based stress reduction has not been studied for veterans with Gulf War illness. The objective of this trial was to conduct a pilot study of mindfulness-based stress reduction for veterans with Gulf War illness.

Methods

Veterans (N = 55) with Gulf War illness were randomly assigned to treatment as usual plus mindfulness-based stress reduction or treatment as usual only. Mindfulness-based stress reduction was delivered in 8 weekly 2.5-hour sessions plus a single 7-hour weekend session. Pain, fatigue, and cognitive failures were the primary outcomes, assessed at baseline, after mindfulness-based stress reduction, and 6 months follow-up. Secondary outcomes included symptoms of posttraumatic stress disorder and depression.

Results

In intention-to-treat analyses, at 6-month follow-up, veterans randomized to mindfulness-based stress reduction plus treatment as usual reported greater reductions in pain (f = 0.33; P = .049), fatigue (f = 0.32; P = .027), and cognitive failures (f = 0.40; P < .001). Depressive symptoms showed a greater decline after mindfulness-based stress reduction (f = 0.22; P = .050) and at 6 months (f = 0.27; P = .031) relative to treatment as usual only. Veterans with posttraumatic stress disorder at baseline randomized to mindfulness-based stress reduction plus treatment as usual experienced significantly greater reductions in symptoms of posttraumatic stress disorder after mindfulness-based stress reduction (f = 0.44; P = .005) but not at 6 months follow-up (f = 0.31; P = .082).

Conclusions

Mindfulness-based stress reduction in addition to treatment as usual is associated with significant improvements in self-reported symptoms of Gulf War illness, including pain, fatigue, cognitive failures, and depression.

El texto completo de este artículo está disponible en PDF.

Keywords : Complementary and alternative medicine, Gulf War illness, Mindfulness, Veterans


Esquema


 Funding: This trial was funded by a grant from the VA Office of Research and Development (5I01CX000313-02).
 Conflict of Interest: None.
 Authorship: All authors had access to the data and played a role in writing this manuscript.


© 2016  Publicado por Elsevier Masson SAS.
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