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Mind-body medicine: State of the science, implications for practice
Author(s): Astin JA, Shapiro SL, Eisenberg DM, Forys KL
Source: JOURNAL OF THE AMERICAN BOARD OF FAMILY PRACTICE    Volume: 16    Issue: 2    Pages: 131-147    Published: MAR-APR 2003  
Times Cited: 83     References: 159     
Abstract: Background: Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to examine the efficacy of representative psychosocial-mind-body interventions, including relaxation, (cognitive) behavioral therapies, meditation, imagery, biofeedback, and hypnosis for several common clinical conditions.

Methods: An electronic search was undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a manual search of the reference sections of relevant articles for related clinical trials and reviews of the literature. Studies examining mind-body interventions for psychological disorders were excluded. Owing to space limitations, studies examining more body-based therapies, such as yoga and tai chi chuan, were also not included. Data were extracted from relevant systematic reviews, meta-analyses, and randomized controlled trials.

Results: Drawing principally from systematic reviews and meta-analyses, there is considerable evidence of efficacy for several mind-body therapies in the treatment of coronary artery disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence, chronic low back pain, disease and treatment-related symptoms of cancer, and improving postsurgical outcomes. We found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis. Additional research is require to clarify the relative efficacy of different mind-body therapies, factors (such as specific patient characteristics) that might predict more or less successful outcomes, and mechanisms of action. Research is also necessary to examine the cost offsets associated with mind-body therapies.

Conclusions: There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions. (J Am Board Fain Pract 2003;16:131-47.).

Document Type: Review
Language: English
Reprint Address: Astin, JA (reprint author), Calif Pacific Med Ctr, 2300 Calif St,Rm 207, San Francisco, CA 94115 USA
Addresses:
1. Calif Pacific Med Ctr, San Francisco, CA 94115 USA
2. Vet Adm, Palo Alto, CA USA
3. Harvard Univ, Sch Med, Cambridge, MA 02138 USA
4. Univ Maryland, Baltimore, MD 21201 USA
Publisher: AMER BOARD FAMILY PRACTICE, 2228 YOUNG DR, LEXINGTON, KY 40505 USA
Subject Category: Medicine, General & Internal
IDS Number: 683JX
ISSN: 0893-8652
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