Complementary Alternative Cardiovascular Medicine

Chapter 8 / Meditation and CVD 131
modality using cognitive therapy and MBSR called mindfulness-based
cognitive therapy (MBCT). MBCT patients who had three or more previous
depressive episodes showed a much lower relapse rate (37%) than
the treatment as usual (TAU) group (66%) during the 1-yr study period.
Relapse rates for the MBCT and TAU groups did not differ for patients
who had only one or two previous depressive episodes (59).
There have been numerous uncontrolled studies of the impact of
meditation on psychological symptoms. Kabat-Zinn (60–62) reports
findings from several studies of his MBSR program with patients with
chronic pain that indicate reductions on self-report measures of presentmoment
pain, negative body image, inhibition of activity by pain symptoms,
mood disturbance, and psychological symptomatology, including
depression and anxiety (60–62). These results were maintained for up to
4 yr after the meditation training, with the exception of the measure of
present-moment pain (62). The subjects in this study had received previous
treatment for their chronic pain, with little or no results, making the
positive findings even more impressive in this treatment-resistant
group (60–62).
Kabat-Zinn’s research studying the impact of MBSR programs on
anxiety and panic disorder (63,64) has demonstrated significant reductions
in the severity of symptoms from baseline to postintervention.
Subjects were rigorously assessed using Diagnostic and Statistical
Manual (DSM)-III-R criteria for generalized anxiety disorder or panic
disorder with or without agoraphobia. Clinically and statistically significant
posttreatment reductions were found in both subjective and objective
symptoms of anxiety and depression, and these results were
maintained at the 3-yr follow-up. Unfortunately, 50% of the patients in
the study were also being treated with psychotropic medications during
the MBSR program and approx 50% received additional treatment for
their anxiety disorder after the MBSR treatment, making it difficult to
establish the relative therapeutic contribution of each intervention (63,64).
Despite the methodological flaws, the preponderance of evidence
regarding the impact of MBSR programs on psychological symptoms
does suggest that it may be a useful intervention. However, what is clear
from this research is the need for additional, more rigorous research
investigating this promising clinical tool.
Adverse Impact of Meditation
Although the clinical use of meditation strategies has shown several
positive effects in decreasing autonomic arousal and mediating psychological
and stress symptoms, there is a small body of literature that
suggests there may be some potential adverse meditation effects (65–69).