Summary

Research about the effects of mindfulness training in patients with medically unexplained symptoms. The included patients had symptoms that were not fully explained, during at least half a year. More than 150 patients took part in the study. The physical health did not significantly improve afther mindfulness training, but the vitality and social functioning did improve. Mindfulness training resulted in more awareness and acceptance of the symptoms. A portion of the patients reported behavioural change, they took better care of themselves and developed a more friendly attitude towards themselves.

Results

This study showed that mindfulness training in patients with medically unexplained did not significantly improve physical health, but did improve mental health. This means that the participants had more energy and felt less tired. In spite of their physical complaints, they developed more social activities. We discovered that the participants went through a process that created more acceptance for the situation, creating space to investigate how to take care of themselves, despite having complaints. The mindfulness training also proved to be cost effective within a year’s time.

Why

For people with medically unexplained symptoms there are not many proven effective therapies. Fairly good results have been achieved with cognitive behavioral therapy, but this therapy is not suitable for everyone. Mindfulness training is an experiential approach, with attention for the physical experience and the acceptance of difficult emotions. With this research we wanted to establish whether mindfulness training is a meaningful addition to the scarce arsenal of treatment options.

Goal

The purpose of the study was to establish the effectiveness of mindfulness training for patients with medically unexplained symptoms. In addition, we wanted to know which process was facilitating change: what do people really learn about this training and how does that translate into their behavior and experiences? And we have investigated whether the training is cost effective, which meant in this case: To what extent does the training lead to a decrease in overall health care costs?

Participants

It’s about patients who suffer from physical complaints for more than half a year, for which the cause has not been fully explained.

How

We conducted a randomized controlled trial, participants were randmized over mindfulness training and a waiting list, with the mindfulness training being offered later on. In addition, we conducted an interview study in which the participants were interviewed extensively about their experiences, at three moments during the year. And we have studied the costs of the mindfulness training combined with the total costs of care during one year.

When

The defence took place in 2013.

By whom

The research was conducted by a large team. There was close cooperation between the departments of general medicine and psychiatry of the Radboudumc. Many GPs in the region of Nijmegen have been involved. Hiske van Ravesteijn conducted the study. Anne Speckens and Chris van Weel were her promoters. Peter Lucassen, general practitioner and senior researcher, was her co-supervisor and Lea Peters-van Gemert was the research assistant. In addition, many have contributed to this research, they are mentioned in the research articles.

More information

Van Ravesteijn, H. J., Suijkerbuijk, Y. B., Langbroek, J. A., Muskens, E., Lucassen, P. L., van Weel, C., … & Speckens, A. E. (2014). Mindfulness-based cognitive therapy (MBCT) for patients with medically unexplained symptoms: Process of change. Journal of psychosomatic research, 77(1), 27-33


Van Ravesteijn, H., Lucassen P., Bor H., van Weel C., Speckens A. (2013). Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: A randomized controlled trial. Psychother Psychosom. 82, 299-310. doi: 10.1159/000348588

Van Ravesteijn, H., Grutters, J., Olde Hartman, T., Lucassen, P., Bor, H., van Weel, C., . . . Speckens, A. (2013). Mindfulness-based cognitive therapy for patients with medically unexplained symptoms: A cost-effectiveness study. J Psychosom Res, 74(3), 197-205. doi: 10.1016/j.jpsychores.2013.01.001