Symptoms of Gulf War illness were improved significantly when mindfulness-based stress reduction was added to treatment as usual. Each mindfulness-based stress reduction class series met once per week (2.5 hours per session) for 8 weeks, plus a 7-hour session on a Saturday between weeks 6 and 7. Participants received instruction on mindfulness meditation practices, including body scan meditation, breathing meditation, gentle yoga, walking meditation, and loving-kindness meditation. The instructions for these practices were intended to foster increased awareness of thoughts, bodily sensations, and emotions, with an attitude of curiosity, openness, and acceptance. Throughout mindfulness-based stress reduction, participants were assigned to practice meditation led by audio CD for 30 to 45 minutes per day, 6 days per week.
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.
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-David J. Kearney, MD, Tracy L. Simpson, PhD, Carol A. Malte, MSW, Benjamin Felleman, PhD, Michelle E. Martinez, BA, Stephen C. Hunt, MD
This article originally appeared in the February 2016 issue of The American Journal of Medicine.
