Original article
Alternative mind–body therapies used by adults with medical conditions,☆☆

https://doi.org/10.1016/j.jpsychores.2008.12.003Get rights and content

Abstract

Objective

Mind–body therapies (MBT) are used by 16.6% of adults in the United States. Little is known about the patterns of and reasons for use of MBT by adults with common medical conditions.

Methods

We analyzed data on MBT use from the 2002 National Health Interview Survey Alternative Medicine Supplement (n=31,044). MBT included relaxation techniques (deep breathing exercises, guided imagery, meditation, and progressive muscle relaxation), yoga, tai chi, and qigong. To identify medical conditions associated with use of MBT overall and of individual MBT, we used multivariable models adjusted for sociodemographic factors, insurance status, and health habits. Among users of MBT (n=5170), we assessed which medical conditions were most frequently treated with MBT, additional rationale for using MBT, and perceived helpfulness.

Results

We found a positive association between MBT use and several medical conditions including various pain syndromes and anxiety/depression. Among adults using MBT to treat specific medical conditions, MBT was most commonly used for anxiety/depression and musculoskeletal pain syndromes. More than 50% of respondents used MBT in conjunction with conventional medical care, and 20% used MBT for conditions they thought conventional medicine would not help. Overall, we found high rates (68–90%) of perceived helpfulness of MBT for specific medical conditions.

Discussion

MBT is commonly used by patients with prevalent medical conditions. Further research is needed to determine the reasons for widespread use of MBT for treatment of specific medical conditions and to evaluate the efficacy of MBT.

Introduction

The National Center for Complementary and Alternative Medicine characterizes mind–body medicine as a wide range of healing practices that share a common intention “to enhance the mind's capacity to affect bodily function and symptoms” [1]. While mind–body practices, such as cognitive behavioral therapy (CBT) and group therapy, can comprise part of standard conventional care, the term mind–body medicine is often used more broadly in the medical literature to include alternative mind–body therapies (MBT), such as meditation, yoga, and tai chi, that have been used specifically for treatment of medical and psychological conditions. MBT remains one of the most commonly used domains of complementary and alternative medicine (CAM) in the United States, with nearly one in five adults using at least one form of MBT annually [2].

Evidence suggests that when alternative MBT are part of a CBT program that includes cognitive restructuring and behavioral modification, it is effective for treating insomnia [3], [4], arthritis [5], [6], and back pain [7]. Furthermore, there is limited evidence that individual MBT, such as progressive muscle relaxation and yoga, may effectively treat insomnia [8], [9] and low back pain [10]. However, the efficacy of MBT for many other chronic conditions is unknown. Despite the popularity of MBT for some medical conditions, little is known about the medical conditions for which adults are using MBT and their motivations for use. As evidence on the efficacy of MBT begins to emerge, understanding patterns of MBT use for treatment of specific conditions would help identify diseases with potential underuse and barriers to use, as well as potential risks of MBT use by specific clinical populations. Furthermore, exploring MBT for conditions in which there is no proven efficacy may also help further our understanding of the medical and psychosocial needs of patients with chronic medical conditions and guide future areas of research.

In this context, we examined the patterns of MBT use, which medical conditions were associated with MBT use, and for which conditions MBT was being used as a treatment by US adults. In addition, we further explored the rationale for MBT use and its perceived helpfulness in treating specific medical and psychological conditions.

Section snippets

Data source

The National Health Interview Survey (NHIS) is an in-person household survey of the civilian, noninstitutionalized US population. The Basic Module consists of three components: the Family Core, Sample Adult Core, and Sample Child Core. The Family Core collects information on sociodemographic characteristics, health status, insurance status, and health care access and utilization for each family member. Households are selected for face-to-face interveiws in English and/or Spanish using a

Sample characteristics and use of MBT

Overall, 16.6% of US adults, representing an estimated 34.1 million Americans, used at least one MBT in the past year. Table 1 lists the prevalence of use of MBT therapies in the United States. Relaxation techniques were commonly used. Among individual therapies, deep breathing exercises were most commonly used (11.4%), followed by meditation (7.5%), and yoga (5.0%). Use of hypnosis and biofeedback remains relatively uncommon among US adults.

Table 2 presents characteristics of MBT users

Discussion

We found that US adults with various pain syndromes, anxiety/depression, and insomnia were more likely to use alternative MBT compared to adults without these conditions. Among adults using MBT to treat specific medical conditions, MBT was most commonly used to treat anxiety/depression and musculoskeletal pain syndromes. More than 50% of these respondents reported MBT use in conjunction with conventional medical care, 30% used MBT because a conventional medical professional recommended it, and

Conclusion

In summary, we found that MBT is commonly used in the United States and identified a wide range of medical conditions that were associated with MBT use. MBT is most often used to treat anxiety/depression and musculoskeletal pain syndromes. Although there is high prevalence of use and perceived helpfulness of MBT, current data on the efficacy of MBT for treatment of most medical conditions are limited. Thus a schism continues to exist between our scientific knowledge of these therapies and their

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  • Cited by (0)

    This study was supported by Grant R03 AT002236 from the National Center for Complementary and Alternative Medicine [1] National Institutes of Health (NIH). Dr. Bertisch was supported by an Institutional National Research Service Award (T32AT00051-06) from the National Institutes of Health. Dr. Wee was supported by a grant from the National Institute of Diabetes, Digestive, and Kidney Diseases (K23DK02962) at the time the study was conducted. Dr. Phillips is supported by a Mid-Career Investigator Award (K24AT000589) from the NCCAM, NIH.

    ☆☆

    This manuscript was presented in part at the Society of General Internal Medicine National Conference, Los Angeles, CA, April 2006. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NCCAM, nor of the National Institutes of Health.

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