Effect of Mindfulness-Based Stress Reduction Program on Psychological Symptoms, Quality of Life, and Symptom Severity in Patients with Somatic Symptom Disorder

May combine two claims. The quote only partly states this claim.

There were no significant differences between the MBSR+venlafaxine and venlafaxine-alone groups in SF-36 subscales, except for a significant difference in the general health subscale.

“According to the results obtained from the SF-36 subscales, there were no significant differences between the two groups in this regard. However, there was just a significant difference between the MBSR and the control groups regarding the scores obtained from the general health of the SF-36 subscale.”

May combine two claims. The quote only partly states this claim.

In patients with somatic symptom disorder, the MBSR+venlafaxine group had significantly lower post-intervention scores for depression, anxiety, stress, and their severities compared to the venlafaxine-alone group.

“The intervention group obtained significantly lower scores in depression, anxiety, stress, and their severities, compared to the control group.”

• Also stated in: § Results · plain

  “These two tables show the significantly reduced levels of SSD severity, depression, anxiety, and stress in the MBSR group, compared to the control group.”

• Also stated in: § Results · plain

  “The mean score of depression, anxiety, and stress and PHQ-15 score was significantly different between intervention and control groups after study”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The mean age of participants was 37.08 ± 8.26 years and 37.8% were male.

“This study included 37 patients with SSD who referred to Shariati Psychosomatic Clinic, Isfahan, Iran, with a mean age of 37.08 ± 8.26 years. It should be noted that 37.8% of the participants were male.”

The quote only partly states this claim.

The distribution of SSD severity after intervention was significantly different between the MBSR+venlafaxine and venlafaxine-alone groups (P=0.013).

“The SSD severity distribution was significantly different between intervention and control groups after study”

• Also stated in: § Results · plain

  “In the MBSR group, about 15.8% (n = 3), 31.6% (n = 6) and 52.6% (n = 10) had severe, moderate, and mild SSD, respectively, although after intervention, these variables were 0% (n = 0), 21.1% (n = 4), and 57.9% (n = 11), respectively, and 21% (n = 4) were normal without diagnosis of SSD.”

May combine two claims. The quote only partly states this claim.

In patients with somatic symptom disorder, the MBSR+venlafaxine group had significantly greater reduction in the number of physical symptoms, their severity, and the severity of SSD compared to the venlafaxine-alone group.

“Moreover, the number of physical symptoms, their severity, and the severity of SSD were significantly decreased more in the intervention group rather than the controls.”

• Also stated in: § Results · plain

  “Moreover, there was a decrease in the physical symptoms of the patients and their severity assessed by PHQ-15.”

• Also stated in: § Results · plain

  “The SSD severity distribution was significantly different between intervention and control groups after study”

Classified as probably not a substantial claim.

The study included 37 patients with SSD (19 in the intervention group and 18 in the control group) after exclusions.

“Finally, the data were collected from 37 patients (19 and 18 cases in the intervention and the control groups, respectively) [Figure 1].”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The SF-36 has validity and reliability evaluated in previous studies.

“The validity and reliability of this questionnaire were evaluated in previous studies.[25]”

• cites [25] Motamed N Ayatollahi AR Zare N Sadeghi-Hassanabadi A Validity and reliability of the Persian translation of the SF-36 version 2 questionnaire East Mediterr Health J 2005 11 349 57 16602453Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

On the molecular level, dopamine and melatonin are increased, serotonin activity is modulated, and cortisol and norepinephrine are decreased.

“On the molecular level, dopamine and melatonin are found to be increased, followed by modulating serotonin activity and decreases in cortisol as well as norepinephrine.[30]”

• cites [30] Esch T The neurobiology of meditation and mindfulness Meditation-Neuroscientific Approaches and Philosophical Implications 2014 New- York Springer 153 73 sourceNot checked yet

  Not checked in the free run.

May combine two claims.

MBSR added to venlafaxine can significantly reduce the severity of SSD, as well as the number and severity of physical symptoms in patients with SSD.

“The MBSR accompanied by prescribing venlafaxine can significantly reduce the severity of SSD, as well as the number and severity of physical symptoms.”

• Also stated in: § Conclusion · plain

  “A significant reduction of SSD as well as the severity and number of physical symptoms can be obtained as a result of MBSR accompanied by the prescription of venlafaxine.”

• Also stated in: § Discussion · plain

  “In conclusion, MBSR + venlafaxine can significantly reduce the severity of SSD, number, and severity of physical symptoms.”

May combine two claims.

Baseline age and gender did not differ significantly between the intervention and control groups.

“The mean age of participants in the intervention and control groups was 38.21 ± 8.55 years and 35.89 ± 7.97 years, respectively (P value = 0.39). About 31.6% (n = 6) in the MBSR group and 44.4% (n = 8) were male (P value = 0.42) [Table 2].”

• Also stated in: § Results · plain

  “It can be seen that there is no difference between the two groups in terms of age and gender.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The severity of disorder and symptoms was assessed in addition to the quantitative evaluation of these variables.

“Moreover, the severity of disorder and symptoms was assessed in addition to the quantitative evaluation of these variables.”

Classified as probably not a substantial claim.

MBSR affects attention style by focusing on the present moment with nonjudgmental behavior.

“The main mechanism includes the effects on one's attention style. The MBSR is focusing on the present moment considering nonjudgmental behavior.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Standard tools were used for measuring variables, mostly used in population-based studies.

“The other advantage is the utilization of standard tools for measuring variables that were mostly used in population-based studies.”

Classified as probably not a substantial claim.

The severity of SSD was evaluated using the DSM IV criteria by a psychiatrist before and after the intervention.

“The severity of SSD was evaluated using the DSM IV criteria by a psychiatrist before and after the intervention.”

Classified as probably not a substantial claim.

The definitive diagnosis was made by a specialist or resident psychiatrist according to a clinical interview based on the DSM.

“The definitive diagnosis was made by a specialist or resident psychiatrist according to a clinical interview based on the DSM.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The findings of this study are consistent with other studies showing that mindfulness approaches had effects on psychological symptoms and complaints, symptoms of medical diseases, and medically unexplained symptoms.

“This finding is consistent with the results of other studies in which they revealed that mindfulness approaches had effects on psychological symptoms and complaints (e.g., anxiety, depression, well-being, quality of life, and interpersonal problems), the symptoms of medical diseases,[161718192027] as well as medically unexplained symptoms.[22]”

• cites [161718192027]Not checked yet

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• cites [22] van Ravesteijn HJ Suijkerbuijk YB Langbroek JA Muskens E Lucassen PL van Weel C Mindfulness-based cognitive therapy (MBCT) for patients with medically unexplained symptoms: Process of change J Psychosom Res 2014 77 27 33 24913338 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Patients were randomly assigned into two groups through a randomization block design (10 blocks of size 2).

“Then, the patients were assigned randomly into two groups of MBSR + venlafaxine or venlafaxine alone through randomization block design (10 blocks with size of 2 in order to compose two groups of 20) [Figure 1].”

Classified as probably not a substantial claim.

The sample size was calculated as 46 patients (23 per group) based on a comparison of two means formula (95% CI, Type II error 0.2, SD 9.16 and 8.75).

“The sample size of this study was calculated as 46 patients (23 patients per group) based on a comparison of two mean formulas (95% confidence interval: 1.96, Type II error: 0.2, SD: 9.16 and 8.75).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The DASS-21 has confirmed validity and reliability in previous studies.

“This questionnaire has been widely used in previous studies with confirmed validity and reliability.[24]”

• cites [24] Asghari A Saed F Dibajnia P Psychometric properties of the Depression Anxiety Stress Scales-21 (DASS-21) in a non-clinical Iranian sample Int J Psychol 2008 2 82 102Not checked yet

  Not checked in the free run.

May combine two claims.

The study had no follow-up after treatment; variables were measured only before and immediately after the intervention.

“On the other hand, the patients had no follow-ups after finishing the treatments, and variables were just measured before and immediately after the intervention.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The study was open-label.

“This open-label randomized controlled clinical trial was conducted on SSD patients who were referred by all physicians to Shariati Psychosomatic Clinic and the Psychiatric Clinic of Noor Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, during 2017–2018.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The PHQ-15 has validity and reliability evaluated in previous studies.

“The validity and reliability of this questionnaire were evaluated in previous studies.[26]”

• cites [26] Rezayat F Dehgannayeri N Relationship between depression and self-efficacy in nursing students Iran J Nurs 2013 26 54 63Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Written informed consent was obtained from all patients.

“Written informed consent was obtained from all patients, and they were all informed of the research procedure.”

May combine two claims.

MBSR added to venlafaxine can reduce depression, anxiety, stress, and their severity in patients with SSD.

“Moreover, it can reduce depression, anxiety, stress, and their severity.”

• Also stated in: § Conclusion · plain

  “In addition, stress, depression, anxiety and their severity can also be reduced.”

• Also stated in: § Discussion · plain

  “Moreover, it reduces the levels of depression, anxiety, stress, and their severity.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The study protocol was approved by the Ethics Committee of Isfahan University of Medical Sciences and registered in IRCT.

“The study protocol was approved by the Ethics Committee of Isfahan University of Medical Sciences (ethics approval code: IR.MUI.REC.1397.3.107), Isfahan, Iran, and also registered in IRCT (IRCT20180909040974N2).”

May combine two claims.

There is evidence associated with the effectiveness of MBSR on psychological problems such as quality of life, sleep disturbance disorders, mood disorders, fatigue, and stress level in different medical conditions including rheumatoid arthritis, fibromyalgia, cancer, chronic pain, and multiple sclerosis.

“There are some evidence associated with the effectiveness of MBSR on psychological problems, such as quality of life, sleep disturbance disorders, mood disorders, fatigue, and stress level in different medical conditions, including rheumatoid arthritis,[16] fibromyalgia,[17] cancer,[18] chronic pain,[19] and multiple sclerosis.[202122]”

• cites [16] Dalili Z Bayazi MH The effectiveness of mindfulness-based cognitive therapy on the illness perception and psychological symptoms in patients with rheumatoid arthritis Complement Ther Clin Pract 2019 34 139 44 30712718 sourceNot checked yet

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• cites [17] Pleman B Park M Han X Price LL Bannuru RR Harvey WF Mindfulness is associated with psychological health and moderates the impact of fibromyalgia Clin Rheumatol 2019 38 1737 45 30644003 PMC6545163 sourceNot checked yet

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• cites [18] Lengacher CA Reich RR Post-White J Moscoso M Shelton MM Barta M Mindfulness based stress reduction in post-treatment breast cancer patients: An examination of symptoms and symptom clusters J Behav Med 2012 35 86 94 21506018 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

MBSR is a self-regulation approach that was first used to prevent depression recurrence.

“Mindfulness-based stress reduction (MBSR) is a self-regulation approach that was first used to prevent depression recurrence.[14]”

• cites [14] Nyklícek I Kuijpers KF Effects of mindfulness-based stress reduction intervention on psychological well-being and quality of life: Is increased mindfulness indeed the mechanism? Ann Behav Med 2008 35 331 40 18535870 PMC2517090 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The Netherlands Study of Depression and Anxiety found that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder.

“The Netherlands Study of Depression and Anxiety was conducted on 2008 individuals consisting of 1367 patients with a depressive disorder and/or anxiety disorder. The results of the aforementioned study showed that all types of depressive and anxiety disorders were independently related to somatic symptoms, except for dysthymic disorder.[11]”

• cites [11] Bekhuis E Boschloo L Rosmalen JG Schoevers RA Differential associations of specific depressive and anxiety disorders with somatic symptoms J Psychosom Res 2015 78 116 22 25524436 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

MBSR is used for stress reduction and emotion management by increasing awareness for what is happening in each moment in an accepting manner without getting caught up in habitual thoughts, emotions, and behavioral patterns.

“The MBSR is also used for stress reduction and emotion management by increasing awareness for what is happening in each moment in an accepting manner without getting caught up in habitual thoughts, emotions, and behavioral patterns.[15]”

• cites [15] De Vibe MF Bjørndal A Fattah S Dyrdal GM Halland E Tanner-Smith EE Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults: A systematic review and meta-analysis Campbell systematic reviews 2017 13 (1) 1 264Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim. May combine two claims.

This treatment should help SSD patients to reduce depression, anxiety, symptoms, and their severities along with improving quality of life.

“This treatment should help SSD patients to reduce the depression, anxiety, symptoms, and their severities along with improving the quality of life.[12131415]”

• cites [12131415]Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Depression, anxiety, and SSD have overlap in diagnostic criteria that can lead to an increased likelihood of co-occurrence.

“Depression, anxiety, and SSD have overlap in diagnostic criteria that can lead to an increased likelihood of co-occurrence.[9]”

• cites [9] American Psychiatric Association Diagnostic and statistical manual of mental disorders BMC Med 2013 17 133 7Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

One of these syndromes can act as a risk factor for other syndromes.

“In addition, one of these syndromes can act as a risk factor for other syndromes.”

• cites [10] Norton PJ Paulus DJ Toward a unified treatment for emotional disorders: Update on the science and practice Behav Ther 2016 47 854 68 27993337 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

About one-third of SSD patients suffer from anxiety or depression, and 50% of cases have both conditions simultaneously.

“There is evidence that about one-third of SSD patients are suffering from anxiety or depression; moreover, 50% of the cases had these two conditions simultaneously.[78]”

• cites [78]Not checked yet

  Not checked in the free run.

May combine two claims.

Medical treatment in SSD patients is not reported to be useful, so there is an obvious need for complementary medicine.

“Since medical treatment in SSD patients is not reported to be useful, there is an obvious need for complementary medicine.[16]”

• cites [16] Dalili Z Bayazi MH The effectiveness of mindfulness-based cognitive therapy on the illness perception and psychological symptoms in patients with rheumatoid arthritis Complement Ther Clin Pract 2019 34 139 44 30712718 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

MBSR influences structural changes in the brain responsible for controlling thoughts, emotions, physical complaints, and neurotransmitter changes affecting mood, anxiety, and stress.

“Accordingly, the MBSR is influenced by structural changes in the brain responsible for controlling thoughts, emotions, physical complaints, and neurotransmitter changes affecting mood, anxiety, and stress.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Anxiety can be a risk factor for depression or SSD.

“On the other hand, anxiety can be a risk factor for depression or SSD.[10]”

• cites [10] Norton PJ Paulus DJ Toward a unified treatment for emotional disorders: Update on the science and practice Behav Ther 2016 47 854 68 27993337 sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The remarkable effects of the MBSR program on variables in this study may be explained by the number of physical symptoms, depression, anxiety, and stress.

“The remarkable effects of the MBSR program on variables in this study may be explained by the number of physical symptoms, depression, anxiety, and stress.”