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Review
. 2013 Aug 26;8(8):e71834.
doi: 10.1371/journal.pone.0071834. eCollection 2013.

Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis

Affiliations
Review

Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis

Shaheen E Lakhan et al. PLoS One. .

Abstract

Background: Mindfulness-based therapy (MBT) has been used effectively to treat a variety of physical and psychological disorders, including depression, anxiety, and chronic pain. Recently, several lines of research have explored the potential for mindfulness-therapy in treating somatization disorders, including fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome.

Methods: Thirteen studies were identified as fulfilling the present criteria of employing randomized controlled trials to determine the efficacy of any form of MBT in treating somatization disorders. A meta-analysis of the effects of mindfulness-based therapy on pain, symptom severity, quality of life, depression, and anxiety was performed to determine the potential of this form of treatment.

Findings: While limited in power, the meta-analysis indicated a small to moderate positive effect of MBT (compared to wait-list or support group controls) in reducing pain (SMD = -0.21, 95% CI: -0.37, -0.03; p<0.05), symptom severity (SMD = -0.40, 95% CI: -0.54, -0.26; p<0.001), depression (SMD = -0.23, 95% CI: -0.40, -0.07, p<0.01), and anxiety (SMD = -0.20, 95% CI: -0.42, 0.02, p = 0.07) associated with somatization disorders, and improving quality of life (SMD = 0.39, 95% CI: 0.19, 0.59; p<0.001) in patients with this disorder. Subgroup analyses indicated that the efficacy of MBT was most consistent for irritable bowel syndrome (p<0.001 for pain, symptom severity, and quality of life), and that mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MCBT) were more effective than eclectic/unspecified MBT.

Conclusions: Preliminary evidence suggests that MBT may be effective in treating at least some aspects of somatization disorders. Further research is warranted.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA diagram showing number of screened, included, and excluded studies.
Figure 2
Figure 2. Funnel plot for pain.
Figure 3
Figure 3. Funnel plot for symptom severity.
Figure 4
Figure 4. Funnel plot for quality of life.
Figure 5
Figure 5. Funnel plot for depression.
Figure 6
Figure 6. Funnel plot for anxiety.
Figure 7
Figure 7. Forest plot showing the effect of mindfulness therapy on the symptom severity outcome measure.
Standardised mean difference between experimental and control group indicates that the mindfulness-based therapy group showed significantly more improvement than the control group, overall.
Figure 8
Figure 8. Forest plot showing the effect of type of mindfulness therapy on the symptom severity outcome measure.
Standardised mean difference between experimental and control group indicates that the MBSR and MCBT subgroups showed significantly more improvement than the control group, whereas the eclectic/unspecified subgroup did not.
Figure 9
Figure 9. Forest plot showing the effect of mindfulness therapy on the pain outcome measure.
Standardised mean difference between experimental and control group indicates that the mindfulness-based therapy group showed significantly more improvement than the control group, in only IBS.
Figure 10
Figure 10. Forest plot showing the effect of mindfulness therapy on the quality of life outcome measure.
Standardised mean difference between experimental and control group indicates that the mindfulness-based therapy group showed significantly more improvement than the control group, in only IBS.
Figure 11
Figure 11. Forest plot showing the effect of mindfulness therapy on the depression outcome measure.
Standardised mean difference between experimental and control group indicates that the mindfulness-based therapy group showed significantly more improvement than the control group, in only general somatization.
Figure 12
Figure 12. Forest plot showing the effect of mindfulness therapy on the anxiety outcome measure.
Standardised mean difference between experimental and control group indicates that the mindfulness-based therapy group had no statistically significant differemce than the control group.

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