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Janssen LE, Gieskes AA, Kok M, de Groot CJM, Oudijk MA, de Boer MA. Stress-reducing interventions in pregnancy for the prevention of preterm birth: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2023; 44:2281238. [PMID: 38064297 DOI: 10.1080/0167482x.2023.2281238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/04/2023] [Indexed: 12/18/2023] Open
Abstract
Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Maternal stress during pregnancy is an established risk factor for PTB. We aimed to review the effects of stress-reducing interventions during pregnancy on PTB. Studies reporting on stress-reducing interventions during pregnancy and PTB rates in general low-risk obstetric populations were included. PTB rates, low birth weight (LBW) rates, mean gestational age and birth weight, maternal anxiety and stress, and adverse perinatal outcomes were investigated. Data were extracted using a standardized extraction form, pooled effect sizes were calculated with the random effects model. Ten studies with a total of 4.816 women were included. The interventions included Pilates, yoga, a multidisciplinary stress reduction program, combination therapy (combining mindfulness, yoga, music, baby bonding, and education), and hypnosis. The incidence of PTB was significantly lower in the intervention group (RR 0.50, 95% CI 0.35 - 0.71). The overall quality of the included studies was low, and the risk of bias was high. In conclusion, this study provides evidence supporting the potential efficacy of stress-reducing interventions in reducing the incidence of PTB in low-risk women. We propose a RCT of high quality to determine the effectiveness of stress-reducing interventions in reducing PTB risk.
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Affiliation(s)
- Laura E Janssen
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Adelia A Gieskes
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Marjolein Kok
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Christianne J M de Groot
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Martijn A Oudijk
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Marjon A de Boer
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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Oska C, Nakamura M. Alternative Psychotherapeutic Approaches to the Treatment of Eczema. Clin Cosmet Investig Dermatol 2022; 15:2721-2735. [PMID: 36540723 PMCID: PMC9760032 DOI: 10.2147/ccid.s393290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/07/2022] [Indexed: 08/11/2023]
Abstract
INTRODUCTION Patients with eczema suffer from high psychological burden, often caused and exacerbated by chronic pruritus, which leads to a vicious itch-scratch cycle. Although much of the literature focuses on treating the physiological factors that lead to pruritus, little attention has been given to the cognitive, behavioral, and social factors associated with the itch-scratch cycle. We conducted a literature review to investigate whether treatments aimed at psychosocial factors could be effective for patients with eczema. METHODS A systematic literature review was conducted through PubMed and EMBASE. Original investigative articles that focused on psychotherapeutic interventions for eczema and/or eczema-related psychological morbidities were reviewed. RESULTS Psychotherapeutic interventions alongside standard medical care are shown to be beneficial compared to conventional treatments alone, both for eczema and for eczema-associated psychological symptoms. Such interventions include meditation and mindfulness, stress-reduction, habit-reversal training, hypnotherapy, music therapy, massage therapy, and standard psychological treatments such as cognitive behavioral therapy. CONCLUSION It is important to recognize the reciprocal relationship between eczema and psychosocial distress. Alternative treatment options to address psychological factors associated with eczema can improve disease trajectory and quality of life.
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Affiliation(s)
- Caroline Oska
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mio Nakamura
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
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DiRenzo DD, Hunt C, Sibinga EM, Gould NF, Shah AA, Bartlett SJ, Bingham CO. Feasibility and acceptability of using a meditation app in adults with rheumatic disease. Explore (NY) 2022; 18:523-525. [PMID: 34801408 PMCID: PMC9081288 DOI: 10.1016/j.explore.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Meditation is a stress-reduction and contemplative technique that can improve emotional distress in people with chronic disease and may be especially beneficial for patients with rheumatic diseases. However, patient access to in-person programs is challenging. The goal of this pilot study was to evaluate the feasibility/acceptability associated with physician-directed use of a widely available smartphone application (app), Calm©. METHODS In this single-arm, pre-post intervention study with recruitment over a 10-month period, adults with rheumatic disease were asked to use the app for ≥5 min/day for 30 days. Participants completed sociodemographic surveys and validated health related quality of life (HRQL) questionnaires from the Patient Reported Outcomes Information System (PROMIS) and NIH Toolbox at baseline and 30-days. RESULTS Thirty-five participants who were mostly well-educated (66% ≥college degree) females (91%) with a mean age of 50 (SD 13) completed baseline questionnaires; 18 participants completed post-study questionnaires ("full completers"). Full completers had higher baseline stress, anxiety, pain, and patient global assessment scores (p's <0.05) compared to partial completers. Full completers who provided data used the app on average for 283 min/30 days (SD 257; n = 16) and showed significant improvements in fatigue (-7.6 T-Score units, p = 0.017), with trends for improvement in perceived stress, anxiety, sleep disturbance, self-efficacy for managing symptoms, and pain intensity (p's <0.15). CONCLUSIONS A 30-day meditation, stress-reduction app used by patients with rheumatic disease revealed that this is a feasible non-pharmacologic modality to target HRQL and problematic symptoms like fatigue. More rigorous study on app use and potential effect is needed.
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Affiliation(s)
- Dana D DiRenzo
- The Johns Hopkins University, Baltimore, MD, United States.
| | - Carly Hunt
- The Johns Hopkins University, Baltimore, MD, United States.
| | | | - Neda F Gould
- The Johns Hopkins University, Baltimore, MD, United States.
| | - Ami A Shah
- The Johns Hopkins University, Baltimore, MD, United States.
| | - Susan J Bartlett
- The Johns Hopkins University, Baltimore, MD, United States; McGill University, Montreal, QC, Canada.
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Fessell DP. Pets and Procedures: Bringing Comfort and Care. Ann Surg Open 2022; 3:e143. [PMID: 37600096 PMCID: PMC10431366 DOI: 10.1097/as9.0000000000000143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/07/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- David P. Fessell
- From the Department of Radiology, University of Michigan Health System, Ann Arbor, MI (retired)
- Ross School of Business, University of Michigan, Ann Arbor, MI
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Meaney S, Leitao S, Olander EK, Pope J, Matvienko-Sikar K. The impact of COVID-19 on pregnant womens' experiences and perceptions of antenatal maternity care, social support, and stress-reduction strategies. Women Birth 2021; 35:307-316. [PMID: 33994134 PMCID: PMC9051126 DOI: 10.1016/j.wombi.2021.04.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/06/2021] [Accepted: 04/29/2021] [Indexed: 02/02/2023]
Abstract
Background The COVID-19 pandemic has impacted on maternity care, supports and women’s mental health. Aim The aim of this study was to assess pregnant women’s satisfaction with antenatal care and social support and to examine stress-reduction strategies women used during the pandemic. Methods An online survey was conducted between June and July 2020. Pregnant women, aged over 18 years were recruited. The survey included closed and open-ended questions to assess women’s perceptions and satisfaction with their antenatal care, social support, and stress-reduction strategies. Descriptive statistics and multivariate analysis were used for quantitative analyses; qualitative content analysis was used for open-ended questions. Findings 573 pregnant women completed the survey. Women reported low levels of social support which was predicted by women’s mental health and demographic factors and was related to public health and maternity service restrictions. Women reported that restrictions implemented in the maternity services limited their face-to face interactions with healthcare professionals and meant their partners could not attend antenatal appointments or support them in the postpartum period in the maternity setting. The lack of information on COVID-19 and pregnancy meant women had greater uncertainty about pregnancy and birth. Discussion Our findings indicate how the lack of access to antenatal care and reduced perceived social support as a result of the restrictions implemented in response to the COVID-19 pandemic, potentially intensifies pregnancy specific stress. Conclusions There is a need for the provision of supportive care, both formally and informally, particularly with women who may be more vulnerable during a pandemic.
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Affiliation(s)
- Sarah Meaney
- National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, University College Cork, Ireland
| | - Sara Leitao
- National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, University College Cork, Ireland
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, UK
| | - Johanna Pope
- School of Public Health, University College Cork, Ireland
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Park CL, Finkelstein-Fox L, Sacco SJ, Braun TD, Lazar S. How does yoga reduce stress? A clinical trial testing psychological mechanisms. Stress Health 2021; 37:116-126. [PMID: 32797683 PMCID: PMC10159010 DOI: 10.1002/smi.2977] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
Yoga interventions can reduce stress, but the mechanisms underlying that stress reduction remain largely unidentified. Understanding how yoga works is essential to optimizing interventions. The present study tested five potential psychosocial mechanisms (increased mindfulness, interoceptive awareness, spiritual well-being, self-compassion and self-control) that have been proposed to explain yoga's impact on stress. Forty-two participants (62% female; 64% White) in a yoga program for stress reduction completed surveys at baseline (T1), mid-intervention (T2) and post-intervention (12 weeks; T3). We measured two aspects of stress, perceived stress and stress reactivity. Changes were assessed with paired t-tests; associations between changes in mechanisms were tested in residual change models. Only stress reactivity decreased, on average, from T1 to T3. Except for self-compassion, all psychosocial mechanisms increased from T1 to T3, with minimal changes from T2 to T3. Except for self-control, increases in each mechanism were strongly associated with decreases in both measures of stress between T1 and T2 and decreases in perceived stress from T1 to T3 (all p's < 0.05). Increased psychosocial resources are associated with stress reduction. Yoga interventions targeting these resources may show stronger stress reduction effects. Future research should test these linkages more rigorously using active comparison groups and larger samples.
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Affiliation(s)
- Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Shane J Sacco
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Tosca D Braun
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Sara Lazar
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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Unno K, Furushima D, Hamamoto S, Iguchi K, Yamada H, Morita A, Horie H, Nakamura Y. Stress-Reducing Function of Matcha Green Tea in Animal Experiments and Clinical Trials. Nutrients 2018; 10:E1468. [PMID: 30308973 DOI: 10.3390/nu10101468] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/04/2018] [Accepted: 10/09/2018] [Indexed: 01/02/2023] Open
Abstract
Theanine, a major amino acid in green tea, exhibits a stress-reducing effect in mice and humans. Matcha, which is essentially theanine-rich powdered green tea, is abundant in caffeine. Caffeine has a strong antagonistic effect against theanine. The stress-reducing effect of matcha was examined with an animal experiment and a clinical trial. The stress-reducing effect of matcha marketed in Japan and abroad was assessed based on its composition. The stress-reducing effect of matcha in mice was evaluated as suppressed adrenal hypertrophy using territorially-based loaded stress. High contents of theanine and arginine in matcha exhibited a high stress-reducing effect. However, an effective stress-reducing outcome was only possible when the molar ratio of caffeine and epigallocatechin gallate (EGCG) to theanine and arginine was less than two. Participants (n = 39) consumed test-matcha, which was expected to have a stress-reducing effect, or placebo-matcha, where no effect was expected. Anxiety, a reaction to stress, was significantly lower in the test-matcha group than in the placebo group. To predict mental function of each matcha, both the quantity of theanine and the ratios of caffeine, EGCG, and arginine against theanine need to be verified.
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Gärtner M, Irrmischer M, Winnebeck E, Fissler M, Huntenburg JM, Schroeter TA, Bajbouj M, Linkenkaer-Hansen K, Nikulin VV, Barnhofer T. Aberrant Long-Range Temporal Correlations in Depression Are Attenuated after Psychological Treatment. Front Hum Neurosci 2017; 11:340. [PMID: 28701943 PMCID: PMC5488389 DOI: 10.3389/fnhum.2017.00340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/12/2017] [Indexed: 01/21/2023] Open
Abstract
The spontaneous oscillatory activity in the human brain shows long-range temporal correlations (LRTC) that extend over time scales of seconds to minutes. Previous research has demonstrated aberrant LRTC in depressed patients; however, it is unknown whether the neuronal dynamics normalize after psychological treatment. In this study, we recorded EEG during eyes-closed rest in depressed patients (N = 71) and healthy controls (N = 25), and investigated the temporal dynamics in depressed patients at baseline, and after attending either a brief mindfulness training or a stress reduction training. Compared to the healthy controls, depressed patients showed stronger LRTC in theta oscillations (4-7 Hz) at baseline. Following the psychological interventions both groups of patients demonstrated reduced LRTC in the theta band. The reduction of theta LRTC differed marginally between the groups, and explorative analyses of separate groups revealed noteworthy topographic differences. A positive relationship between the changes in LRTC, and changes in depressive symptoms was observed in the mindfulness group. In summary, our data show that aberrant temporal dynamics of ongoing oscillations in depressive patients are attenuated after treatment, and thus may help uncover the mechanisms with which psychotherapeutic interventions affect the brain.
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Affiliation(s)
- Matti Gärtner
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin FranklinBerlin, Germany
| | - Mona Irrmischer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit AmsterdamAmsterdam, Netherlands
| | - Emilia Winnebeck
- Dahlem Center for Neuroimaging of Emotions, Freie Universität BerlinBerlin, Germany
| | - Maria Fissler
- Dahlem Center for Neuroimaging of Emotions, Freie Universität BerlinBerlin, Germany
| | - Julia M Huntenburg
- Dahlem Center for Neuroimaging of Emotions, Freie Universität BerlinBerlin, Germany
| | - Titus A Schroeter
- Dahlem Center for Neuroimaging of Emotions, Freie Universität BerlinBerlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin FranklinBerlin, Germany
| | - Klaus Linkenkaer-Hansen
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit AmsterdamAmsterdam, Netherlands
| | - Vadim V Nikulin
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin FranklinBerlin, Germany.,Center for Cognition and Decision Making, National Research University Higher School of EconomicsMoscow, Russia.,Department of Neurology and Clinical Neurophysiology, Charité-Universitätsmedizin Berlin, Campus Benjamin FranklinBerlin, Germany
| | - Thorsten Barnhofer
- Dahlem Center for Neuroimaging of Emotions, Freie Universität BerlinBerlin, Germany
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