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Objectives Despite the long-term use and evidence-based efficacy of meditation and mindfulness-based interventions, there is still a lack of data about the possible unwanted effects (UEs) of these practices. The aim of this study was to evaluate the occurrence of UEs among meditation practitioners, considering moderating factors such as the type, frequency, and lifetime duration of the meditation practices. Methods An online survey was developed and disseminated through several websites, such as Spanish-, English- and Portuguese-language scientific research portals related to mindfulness and meditation. After excluding people who did not answer the survey correctly or completely and those who had less than two months of meditation experience, a total of 342 people participated in the study. However, only 87 reported information about UEs. Results The majority of the practitioners were women from Spain who were married and had a University education level. Practices were more frequently informal, performed on a daily basis, and followed by focused attention (FA). Among the participants, 25.4% reported UEs, showing that severity varies considerably. The information requested indicated that most of the UEs were transitory and did not lead to discontinuing meditation practice or the need for medical assistance. They were more frequently reported in relation to individual practice, during focused attention meditation, and when practising for more than 20 minutes and alone. The practice of body awareness was associated with UEs to a lesser extent, whereas focused attention was associated more with UEs. Conclusions This is the first large-scale, multi-cultural study on the UEs of meditation. Despite its limitations, this study suggests that UEs are prevalent and transitory and should be further studied. We recommend the use of standardized questionnaires to assess the UEs of meditation practices. ; Network for Prevention and Health Promotion in primary Care - Institute de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain) ; European Union ERDF funds (FEDER "Una manera de hacer Europa") ; Red de Excelencia PROMOSAM ; Ministry of Economy and Competitiveness (Spain) (Plan Nacional I+D+I) ; Univ Valencia, Valencia, Spain ; Inst Salud Carlos III, CIBER Fisiopatol Obesidad Nutr CIBEROBN, Madrid, Spain ; Univ Fed Sao Paulo, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, Brazil ; Hosp Israelita Albert Einstein, Sao Paulo, Brazil ; Hosp Santa Creu & Sant Pau, Barcelona, Spain ; Inst Invest Biomed Sant Pau IIB SantPau, Barcelona, Spain ; Univ Autonoma Barcelona, Psychiat & Legal Med Dept, Barcelona, Spain ; Inst Salud Carlos III, Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain ; Hosp Univ Miguel Servet, Zaragoza, Spain ; Inst Aragones Ciencias Salud, Zaragoza, Spain ; Red Invest Actividades Prevenc Promoc Salud REDIA, Zaragoza, Spain ; Univ Fed Sao Paulo, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, Brazil ; Web of Science

International audience Standardized neurofeedback (NF) protocols have been extensively evaluated in attention-deficit/hyperactivity disorder (ADHD). However, such protocols do not account for the large EEG heterogeneity in ADHD. Thus, individualized approaches have been suggested to improve the clinical outcome. In this direction, an open-label pilot study was designed to evaluate a NF protocol of relative upper alpha power enhancement in fronto-central sites. Upper alpha band was individually determined using the alpha peak frequency as an anchor point. 20 ADHD children underwent 18 training sessions. Clinical and neurophysiological variables were measured pre- and post-training. EEG was recorded pre- and post-training, and pre- and post-training trials within each session, in both eyes closed resting state and eyes open task-related activity. A power EEG analysis assessed long-term and within-session effects, in the trained parameter and in all the sensors in the (1-30) Hz spectral range. Learning curves over sessions were assessed as well. Parents rated a clinical improvement in children regarding inattention and hyperactivity/impulsivity. Neurophysiological tests showed an improvement in working memory, concentration and impulsivity (decreased number of commission errors in a continuous performance test). Relative and absolute upper alpha power showed long-term enhancement in task-related activity, and a positive learning curve over sessions. The analysis of within-session effects showed a power decrease ("rebound" effect) in task-related activity, with no significant effects during training trials. We conclude that the enhancement of the individual upper alpha power is effective in improving several measures of clinical outcome and cognitive performance in ADHD. This is the first NF study evaluating such a protocol in ADHD. A controlled evaluation seems warranted due to the positive results obtained in the current study.

Background: Only a small number of articles have investigated the relationship between mindfulness-based interventions (MBIs) and biomarkers. The aim of this systematic review was to study the effect of MBIs on specific biomarkers (cytokines, neuropeptides and C-reactive protein (CRP)) in both healthy subjects and cancer patients. Methods: A search was conducted using PubMed, EMBASE, PsycINFO and the Cochrane library between 1980 and September 2016. Results: A total of 13 studies with 1110 participants were included. In the healthy population, MBIs had no effect on cytokines, but were found to increase the levels of the neuropeptide insulin-like growth factor 1 (IGF-1). With respect to neuropeptide Y, despite the absence of post-intervention differences, MBIs may enhance recovery from stress. With regard to CRP, MBIs could be effective in lower Body Mass Index (BMI) individuals. In cancer patients, MBIs seem to have some effect on cytokine levels, although it was not possible to determine which specific cytokines were affected. One possibility is that MBIs might aid recovery of the immune system, increasing the production of interleukin (IL)-4 and decreasing interferon gamma (IFN-gamma). Conclusions: MBIs may be involved in changes from a depressive/carcinogenic profile to a more normalized one. However, given the complexity and different contexts of the immune system, and the fact that this investigation is still in its preliminary stage, additional randomized controlled trials are needed to further establish the impact of MBI programmes on biomarkers in both clinical and non-clinical populations. ; Instituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness ; Network for Prevention and Health Promotion in primary Care from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain) ; European Union ERDF funds ; Aragon Hlth Sci Inst IACS, Zaragoza, Spain ; Showa Univ, Dept Psychiat, Sch Med, Tokyo, Japan ; Primary Care Prevent & Hlth Promot Res Network RE, Barcelona, Spain ; Univ Zaragoza, Miguel Servet Univ Hosp, Dept Psychiat, Zaragoza, Spain ; Univ Zaragoza, Fac Social & Human Sci, Dept Psychol & Sociol, Teruel, Spain ; Fed Univ Sao Paulo UNIFESP, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, Brazil ; Hosp Israelita Albert Einstein, Sao Paulo, Brazil ; Univ Zaragoza, Fac Hlth Sci & Sports, Huesca, Spain ; Univ Balearic Isl, Res Inst Hlth Sci IUNICS, Palma De Mallorca, Spain ; Fed Univ Sao Paulo UNIFESP, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, Brazil ; Instituto de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness: PI13/01637 ; Network for Prevention and Health Promotion in primary Care from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain): RD12/0005 ; Web of Science

Background: There are few studies devoted to assessing the impact of meditation-intensive retreats on the well-being, positive psychology, and personality of experienced meditators. We aimed to assess whether a 1-month Vipassana retreat: (a) would increase mindfulness and well-being ; (b) would increase prosocial personality traits ; and (c) whether psychological changes would be mediated and/or moderated by non-attachment. Method: A controlled, non-randomized, pre-post-intervention trial was used. The intervention group was a convenience sample (n = 19) of experienced meditators who participated in a 1-month Vipassana meditation retreat. The control group (n = 19) comprised matched experienced meditators who did not take part in the retreat. During the retreat, the mean duration of daily practice was 8-9 h, the diet was vegetarian and silence was compulsory. The Experiences Questionnaire (EQ), Non-attachment Scale (NAS), Positive and Negative Affect Schedule (PANAS), Satisfaction With Life Scale (SWLS), Temperament Character Inventory Revised (TCI-R-67), Five Facets Mindfulness Questionnaire (FFMQ), Self-Other Four Immeasurables (SOFI) and the MINDSENS Composite Index were administered. ANCOVAs and linear regression models were used to assess pre-post changes and mediation/moderation effects. Results: Compared to controls, retreatants showed increases in non-attachment, observing, MINDSENS, positive-affect, balance-affect, and cooperativeness ; and decreases in describing, negative-others, reward-dependence and self-directedness. Non-attachment had a mediating role in decentring, acting aware, non-reactivity, negative-affect, balance-affect and self-directedness ; and a moderating role in describing and positive others, with both mediating and moderating effects on satisfaction with life. Conclusions: A 1-month Vipassana meditation retreat seems to yield improvements in mindfulness, well-being, and personality, even in experienced meditators. Non-attachment might facilitate psychological improvements of meditation, making it possible to overcome possible ceiling effects ascribed to non-intensive practices. ; Mninisterio de Economía y Empresas ; Network for Prevention and Health Promotion in Primary Care grant from the Institute de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness ; European Union ERDF funds ; Ctr Invest Blomed Red Salud Mental, Primary Care Prevent & Hlth Promot Res Network, Fac Hlth & Sport Sci, Zaragoza, Spain ; Ctr Invest Blomed Red Salud Mental, Primary Care Prevent & Hlth Promot Res Network, Inst Aragones Ciencias Salud, Zaragoza, Spain ; Univ Valencia, Dept Personal Evaluat & Psychol Treatment, Valencia, Spain ; CIBERObn Giber Physiopathol Obes & Nutr, Santiago De Compostela, Spain ; Univ Autonoma Barcelona, Hosp Santa Creu & St Pau Barcelona, Spain Ctr Invest Biomed Red Salud Mental, Dept Psicol Clin & Salut,CIBERSAM,Serv Psiquiatri, Madrid, Spain ; Univ Fed Sao Paulo, Dept Prevent Med, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, Sao Paulo, Brazil ; Hosp Israelita Albert Einstein, Sao Paulo, Brazil ; Univ Complutense Madrid, Red PROMOSAM, Psychopathol, Valencia, Spain ; Baraka Inst, San Sebastian, Spain ; Miguel Servet Hosp, Zaragoza, Spain ; Univ Zaragoza, Ctr Invest Biomed Red Salud Mental, Inst Aragones Ciencias Salud, RedIAPP, Zaragoza, Spain ; Mente Aberta – Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil ; MINECO: PSI2012-35500 ; Network for Prevention and Health Promotion in Primary Care grant from the Institute de Salud Carlos III of the Spanish Ministry of Economy and Competitiveness: RD12/0005 ; Web of Science

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes performed better than controls, with similar effect size (ES). The efficacy of abbreviated mindfulness programmes may be similar to that of a standard MBI programme, making them potentially more accessible for a larger number of populations. Nevertheless, further studies with more powerful designs to compare the non-inferiority of the abbreviated protocol and addressing clinical populations are warranted. ; CNPq (Brazil) at the University of Zaragoza, Spain ; Network for Prevention and Health Promotion in primary Care grant from the Instituto de Salud Carlos III of the Ministry of Economy and Competitiveness (Spain) ; European Union ERDF funds (FEDER "Una manera de hacer Europa") ; Univ Fed São Paulo, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, São Paulo, Brazil ; Hosp Israelita Albert Einstein, São Paulo, Brazil ; Univ Zaragoza, Fac Hlth Sci & Sports, Huesca, Spain ; Ctr Invest Biomed Red Salud Mental, Primary Care Prevent & Hlth Promot Res Network Re, Zaragoza, Spain ; Univ San Jorge, Fac Hlth Sci, Zaragoza, Spain ; Univ Zaragoza, Miguel Servet Hosp, Zaragoza, Spain ; Univ Fed São Paulo, Mente Aberta Brazilian Ctr Mindfulness & Hlth Pro, São Paulo, Brazil ; Instituto de Salud Carlos III: RD12/0005/0006 ; Web of Science

Objective: The aim of the present study was to elucidate the effects of Mindfulness-based interventions (MBIs) on salivary cortisol levels in healthy adult populations. Method: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), published between January 1980 and June 2015 in PubMed, EMBASE, PsycINFO and the Cochrane library. The PRISMA and Cochrane guidelines were followed. The pooled effect sizes were calculated with the random-effects model, using Hedges' g-values, and heterogeneity was measured using the 12 statistic. The contribution of different characteristics of participants and programmes were assessed by meta-regression models, using beta coefficients. Results: Five RCTs with 190 participants in total were included in this systematic review. The overall effect size (ES) for improving the state of health related to cortisol levels was moderately low (g = 0.41 ; p = 0.025), although moderate heterogeneity was found (I-2 = 55 ; p = 0.063). There were no significant differences between active (g = 0.33 ; p = 0.202) and passive (g = 0.48 ; p = 0.279) controls, but significant differences were found when comparing standard (g = 0.81 ; p = 0.002) and raw (g = 0.03 ; p = 0.896) measures. The percentage of women in each study was not related to ES. Nevertheless, age (beta = 0.03 ; p = 0.039), the number of sessions (beta = 0.33 ; p = 0.007) and the total hours of the MBI (beta = 0.06 ; p = 0.005) were significantly related to ES, explaining heterogeneity (R-2 = 1.00). Conclusions: Despite the scarce number of studies, our results suggest that MBIs might have some beneficial effect on cortisol secretion in healthy adult subjects. However, there is a need for further RCTs implemented in accordance with standard programmes and measurements of salivary cortisol under rigorous strategies in healthy adult populations. ; Network for Prevention and Health Promotion in Primary Care from Institute de Salud Carlos III of the Ministry of Economy and Competitiviness (Spain) ; European Union ERDF funds ; Aragon Hlth Sci Inst, Primary Care, Zaragoza, Spain ; Showa Univ, Sch Med, Dept Psychiat, Tokyo, Japan ; Univ Zaragoza, Fac Hlth Sci & Sports, Zaragoza, Spain ; Primary Care Prevent & Hlth Promot Res Network, Barcelona, Spain ; Univ Zaragoza, Miguel Servet Univ Hosp, Dept Psychiat, Zaragoza, Spain ; Univ Fed Sao Paulo, Mente Aberta Brazilian Ctr Mindfulness & Hlth Rom, Dept Prevent Med, Sao Paulo, Brazil ; Hosp Israelite Albert Einsteih, Sao Paulo, Brazil ; Univ Balearic Isl, Res Inst Hlth Sci, Palma De Mallorca, Spain ; Department of Preventive Medicine, "Mente Aberta" Brazilian Centre for Mindfulness and Health Promotion, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil ; Network for Prevention and Health Promotion in Primary Care from Institute de Salud Carlos III of the Ministry of Economy and Competitiviness (Spain): RD12/0005 ; Web of Science

Fibromyalgia (FM) is a prevalent, chronic, disabling, pain syndrome that implies high healthcare costs. Economic evaluations of potentially effective treatments for FM are needed. The aim of this study was to analyze the cost-utility of Mindfulness-Based Stress Reduction (MBSR) as an add-on to treatment-as-usual (TAU) for patients with FM compared to an adjuvant multicomponent intervention (FibroQoL) and to TAU. We performed an economic evaluation alongside a 12 month, randomized, controlled trial; data from 204 (68 per study arm) of the 225 patients (90.1%) were included in the cost-utility analyses, which were conducted both under the government and the public healthcare system perspectives. The main outcome measures were the EuroQol (EQ-5D-5L) for assessing Quality-Adjusted Life Years (QALYs) and improvements in health-related quality of life, and the Client Service Receipt Inventory (CSRI) for estimating direct and indirect costs. Incremental cost-effectiveness ratios (ICERs) were also calculated. Two sensitivity analyses (intention-to-treat, ITT, and per protocol, PPA) were conducted. The results indicated that MBSR achieved a significant reduction in costs compared to the other study arms (p < 0.05 in the completers sample), especially in terms of indirect costs and primary healthcare services. It also produced a significant incremental effect compared to TAU in the ITT sample (Delta QALYs = 0.053, p < 0.05, where QALYs represents quality-adjusted life years). Overall, our findings support the efficiency of MBSR over FibroQoL and TAU specifically within a Spanish public healthcare context.