title: Mindfulness-based Stress Reduction in Addition to Usual Care Is Associated with Improvements in Pain, Fatigue, and Cognitive Failures Among Veterans with Gulf War Illness.
abstract: BACKGROUND
  Many Gulf War I veterans report ongoing negative health consequences. The constellation of pain, fatigue, and concentration/memory disturbances is referred to as "Gulf War illness." Prior research suggests that mindfulness-based stress reduction may be beneficial for these symptoms, but mindfulness-based stress reduction has not been studied for veterans with Gulf War illness. The objective of this trial was to conduct a pilot study of mindfulness-based stress reduction for veterans with Gulf War illness.
  
  
  METHODS
  Veterans (N = 55) with Gulf War illness were randomly assigned to treatment as usual plus mindfulness-based stress reduction or treatment as usual only. Mindfulness-based stress reduction was delivered in 8 weekly 2.5-hour sessions plus a single 7-hour weekend session. Pain, fatigue, and cognitive failures were the primary outcomes, assessed at baseline, after mindfulness-based stress reduction, and 6 months follow-up. Secondary outcomes included symptoms of posttraumatic stress disorder and depression.
  
  
  RESULTS
  In intention-to-treat analyses, at 6-month follow-up, veterans randomized to mindfulness-based stress reduction plus treatment as usual reported greater reductions in pain (f = 0.33; P = .049), fatigue (f = 0.32; P = .027), and cognitive failures (f = 0.40; P < .001). Depressive symptoms showed a greater decline after mindfulness-based stress reduction (f = 0.22; P = .050) and at 6 months (f = 0.27; P = .031) relative to treatment as usual only. Veterans with posttraumatic stress disorder at baseline randomized to mindfulness-based stress reduction plus treatment as usual experienced significantly greater reductions in symptoms of posttraumatic stress disorder after mindfulness-based stress reduction (f = 0.44; P = .005) but not at 6 months follow-up (f = 0.31; P = .082).
  
  
  CONCLUSIONS
  Mindfulness-based stress reduction in addition to treatment as usual is associated with significant improvements in self-reported symptoms of Gulf War illness, including pain, fatigue, cognitive failures, and depression.
authors.affiliation: VA Puget Sound Health Care System, Department of Medicine, Seattle, Wash; Department of Medicine, University of Washington School of Medicine, Seattle. Electronic address: david.kearney@va.gov.
authors.forename: David J
authors.initials: DJ
authors.lastname: Kearney
authors.affiliation: Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Health Care System, Seattle, Wash; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Simpson
authors.affiliation: Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Health Care System, Seattle, Wash.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Malte
authors.affiliation: VA Puget Sound Health Care System, Seattle, Wash.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Felleman
authors.affiliation: VA Puget Sound Health Care System, Seattle, Wash.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Martinez
authors.affiliation: VA Puget Sound Health Care System, Department of Medicine, Seattle, Wash; Department of Medicine, University of Washington School of Medicine, Seattle.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Hunt
mesh_terms: D000328:Adult; D003863:Depression / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D026441:Mind-Body Therapies; D018923:Persian Gulf Syndrome / Q000628:therapy*; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy; D013315:Stress, Psychological
keywords: Complementary and alternative medicine; Gulf War illness; Mindfulness; Veterans