Dept. of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
Psychosomatics. 2013 Mar-Apr;54(2):158-64. doi: 10.1016/j.psym.2012.04.007. Epub 2012 Dec 4.
The aims of this study were to examine the effects of a mindfulness-based stress reduction (MBSR) training intervention among cancer patients on levels of salivary cortisol, and further to explore if changes in psychological variables mediate intervention effects on cortisol.
Patients with a previous cancer diagnosis (n = 71) were recruited and randomized into an intervention group or a waiting-list control group. The intervention consisted of an 8-week MBSR training course.
There were no overall effects of the intervention on cortisol levels at 3-month or 6-month follow-up. However, a significant effect of moderation was found showing a different intervention effect on awakening cortisol among participants with varying baseline level of cortisol. Among those with initial low levels of cortisol, there was an increase from baseline to 3-month follow-up, and among those with initial high levels there was a decreased level of cortisol at 3-month follow-up. There was no association between changes in psychological outcomes and cortisol levels.
The results suggest an adjustment of cortisol levels as a result of MBSR. The study gives preliminary support indicating that MBSR can influence the hypothalamic-pituitary-adrenocortical (HPA) axis functioning. The importance of these findings for future research in the field of mindfulness and stress reduction among cancer patients are discussed.
本研究旨在探讨正念减压（MBSR）训练干预对癌症患者唾液皮质醇水平的影响，并进一步探讨心理变量的变化是否介导了干预对皮质醇的影响。
招募了有既往癌症诊断的患者（n=71），并将他们随机分为干预组或等待名单对照组。干预措施包括 8 周的 MBSR 培训课程。
在 3 个月或 6 个月的随访中，干预对皮质醇水平没有总体影响。然而，发现了一个显著的调节效应，表明在基线皮质醇水平不同的参与者中，干预对唤醒皮质醇的影响不同。在皮质醇初始水平较低的参与者中，从基线到 3 个月随访时有增加，而在初始皮质醇水平较高的参与者中，3 个月随访时皮质醇水平下降。心理结果的变化与皮质醇水平之间没有关联。
结果表明 MBSR 可以调节皮质醇水平。该研究初步支持 MBSR 可以影响下丘脑-垂体-肾上腺皮质（HPA）轴功能的观点。讨论了这些发现对癌症患者正念和减压领域未来研究的重要性。
