Medical study: against anxiety, mindfulness meditation!

Could mindfulness meditation be an alternative to drug therapy commonly used today in the treatment of anxiety? At least that is what a study that has just been published, co-led by Eric Bui, professor of psychiatry and researcher at the University of Caen, reveals.

Eric Bui holds an honors degree in psychiatry and a doctorate in neuroscience. After having been head of clinic for universities-hospital assistants at the Toulouse University Hospital, he flew to the United States for a one-year post-doctoral contract at Harvard University and Massachusetts General Hospital… There will ultimately stay 10 years.

In Boston, I specialized in post-traumatic stress and anxiety disorders, but especially in prolonged grief. This question was gradually emerging, only six research teams around the world were interested in it.

Eric Bui, professor of psychiatry, researcher at the University of Caen

Between 2012 and 2017, he notably served as Deputy Director of Research at the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital. “In particular, we have carried out a few randomized clinical trials (randomized), including one on the effectiveness of yoga for treating anxiety disorders, in comparison with cognitive behavioral therapy, which remains the reference for the treatment of psychiatric disorders. This work was the subject of a publication, in August 2020, in the prestigious American journal JAMA Psychiatry.

After teaching for 10 years at Harvard University’s medical school, Éric Bui joined theUFR Health from the University of Caen Normandy in September 2020. His research focuses on improving the management of post-traumatic stress. “ The objective is to develop, in France, research and treatment on the issue of prolonged bereavement. Since then, prolonged mourning has been recognized as a psychiatric pathology in May 2021, which is making things happen. »

A member of the International Society for the Study of Post-Traumatic Stress, Éric Bui is its president from 2020 to 2021. This learned society, created in 1985, brings together nearly 2,000 members from 40 countries.

After a first study published in 2013 in Boston comparing mindfulness meditation to psycho-education, Eric Bui, in collaboration with two psychiatry researchers from Georgetown and New York universities, conducted a clinical trial comparing a program of mindfulness meditation to a first-line antidepressant in the treatment of anxiety disorders.

Carried out on a sample of 276 people who randomly received either mindfulness meditation or the antidepressant (randomized trial), this study demonstrates that the effectiveness of mindfulness meditation is equivalent to that of medication for the treatment of anxiety disorders. Mindfulness meditation is also better tolerated, with fewer side effects than antidepressants.

Mindfulness training focuses attention on the present moment. Individuals train to view thoughts and feelings as transitory phenomena that are not necessarily a reflection of reality. This process improves emotion regulation and patients become less responsive to thoughts and feelings. Additionally, mindfulness is practiced with a non-judgmental and accepting attitude which, over time, seems to increase self-acceptance and self-compassion.

When I am worried, I observe my worry without judging it or judging myself. I let it pass like a cloud.

Eric Bui, professor of psychiatry and researcher at the University of Caen

276 adults with an anxiety disorder took part in the trial. For 8 weeks, they received either the mindfulness meditation program (MBSR) or an anti-depressant, escitalopram.

The mindfulness meditation program consists of weekly 2.5-hour classes, a one-day retreat in the fifth or sixth week, and daily 45-minute exercises to be done individually at home. Patients were taught the theory and practice of several forms of mindfulness meditation, such as breath awareness (focusing attention on the breath and body movements), sweeping movement (directing attention to a part of the body) and mindful movement (stretching and movement to create body awareness and increase interoceptive awareness).

The dose of escitalopram was initially 10 mg per day orally, increased to 20 mg per day by the second week if the drug was well tolerated or delayed if not. Treatment compliance was measured by pill count and patient report. Regular reviews were carried out with a clinician in weeks 1, 2, 4, 6 and 8. At the end of the trial, patients wishing to continue taking escitalopram were accompanied by a caregiver to do so.

The non-inferiority study aimed to prove that mindfulness meditation was as effective as escitalopram for anxiety disorders. At the end of the study, it turned out that the clinical efficacy was equivalent between the two treatments. In addition, at least one adverse event related to the study occurred in 78% of participants who received escitalopram compared to only 15% who received mindfulness meditation.