Posted 03.21.2017 | by AMRA
People with generalized anxiety disorder (GAD) suffer from excessive and uncontrollable worry concerning a broad array of everyday matters (work, money, health, relationships, etc.) along with a range of physical symptoms (headache, fatigue, muscle tension, etc.) associated with stress. As a result, people with GAD often miss days at work and tend to use medical and mental health services at a higher rate than the average person.
GAD is often treated with medication and psychotherapy, and in recent years, mindfulness-based interventions have been added as an additional treatment alongside more traditional approaches.
In a secondary analysis of a previously published randomized, controlled clinical trial, Hoge et al. [Journal of Psychosomatic Medicine] investigated whether Mindfulness-Based Stress Reduction (MBSR) reduced the number of GAD sufferers’ missed days at work and the number of their visits to primary care and mental health care professionals to a greater degree than a stress management education (SME) control.
The 57 individuals with GAD (mean age = 39; 56% female; 83% Caucasian) whose data were analyzed in this study were a subset of a larger cohort of individuals with GAD who were randomly assigned to either a standard 8-week MBSR program or an 8-week SME program. The SME program covered topics relevant to stress including time management, nutrition, exercise, and sleep.
The subgroup of patients whose data was included in this analysis completed the World Health Organization Health Performance and Work Questionnaire (HPQ) at baseline, after intervention, and at 24-week follow-up. The HPQ is a self-report measure of illness-related absences from work and visits to primary care and mental health professionals.
At immediate post-intervention, the MBSR group had significantly decreased the number of partial days (from 1.4 days to 0.5 days a month) they had missed employment due to physical or mental health problems, whereas the control group increased (from 0.7 to 1.2 days a month) their partial days of work missed. This between groups difference in partial days missed was no longer significant at 24-week follow-up. There were no significant changes over time, however, in full days of work missed or in health care utilization.
The amount of home mindfulness practice MBSR participants engaged in during the follow-up period had associations that trended towards significance with both mental health utilization and partial days of work missed. The more participants practiced, the less they missed partial workdays (r = -.45) or visited mental health professionals (r = -.43).
The study shows a decrease in partial workdays missed for MBSR participants with GAD, and a tendency for mental health care utilization and partial days missed to decrease with increased mindfulness practice. It lends support to previous research demonstrating the benefits of MBSR for persons with anxiety disorders. Previous studies failed to measure partial workdays missed, but this may be the most sensitive measure of how anxiety disorders impact work performance, as employees with GAD may come late to work, or leave early depending on their mental state. A relatively high post-intervention dropout rate (19%) for MBSR participants limited power to detect differences at 24-week follow-up.
Hoge, E. A., Guidos, B. M., Mete, M., Bui, E., Pollack, M. H., Simon, N. M., & Dutton, M. A. (2017). Effects of mindfulness meditation on occupational functioning and health care utilization in individuals with anxiety. Journal of Psychosomatic Research, 95, 7-11.