West J Med 1998 Dec;169(6):356-63
Geraldine Brush Cancer Research Institute, California Pacific Medical Center, San Francisco, USA.
Various forms of distant healing (DH), including prayer and "psychic healing," are widely practiced, but insufficient formal research has been done to indicate whether such efforts actually affect health. We report on a double-blind randomized trial of DH in 40 patients with advanced AIDS. Subjects were pair-matched for age, CD4+ count, and number of AIDS-defining illnesses and randomly selected to either 10 weeks of DH treatment or a control group. DH treatment was performed by self-identified healers representing many different healing and spiritual traditions. Healers were located throughout the United States during the study, and subjects and healers never met. Subjects were assessed by psychometric testing and blood draw at enrollment and followed for 6 months. At 6 months, a blind medical chart review found that treatment subjects acquired significantly fewer new AIDS-defining illnesses (0.1 versus 0.6 per patient, P = 0.04), had lower illness severity (severity score 0.8 versus 2.65, P = 0.03), and required significantly fewer doctor visits (9.2 versus 13.0, P = 0.01), fewer hospitalizations (0.15 versus 0.6, P = 0.04), and fewer days of hospitalization (0.5 versus 3.4, P = 0.04). Treated subjects also showed significantly improved mood compared with controls (Profile of Mood States score -26 versus 14, P = 0.02). There were no significant differences in CD4+ counts. These data support the possibility of a DH effect in AIDS and suggest the value of further research.
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Altern Ther Health Med 1997 Nov;3(6):38-53
DESIGN: Randomized, controlled, double-blind study. PATIENTS: 496 volunteers: those who prayed (agents, n = 90) and those who were prayed for (subjects, n = 406). INTERVENTION: Agents were randomly assigned to either a directed or nondirected prayer group; photos and names of subjects were used as a focus. Subjects were randomly assigned to three groups: those prayed for by nondirected agents, a control group, and those prayed for by directed agents. Prayer was offered for 15 minutes daily for 12 weeks. Each subject was prayed for by three agents. MAIN OUTCOME MEASURES: Five pretest and posttest objective measures and six posttest subjective measures were taken. RESULTS: Subjects improved significantly on all 11 measures. Agents improved significantly on 10 measures. A significant positive correlation was found between the amount of prayer the agents did and their scores on the five objective tests. Agents had significantly better scores than did subjects on all objective measures. Subjects' views of the locus of God's action showed significance in three objective measures. Improvement on four objective measures was significantly related to subjects' belief in the power of prayer for others. Improvement on all II measures was significantly related to subjects' conviction concerning whether they had been assigned to a control or an experimental group. Possible explanations include the placebo/faith effect, the time displaced effect, and extraneous prayer.
Psychosom Med 1984 Jan-Feb;46(1):7-14
This study addressed the effects of a naturally occurring stressor on components of the immune response. Blood was drawn twice from 75 first-year medical students, with a baseline sample taken one month before their final examinations and a stress sample drawn on the first day of final examinations. Median splits on scores from the Holmes--Rahe Social Readjustment Rating Scale and the UCLA Loneliness Scale produced a 2 X 2 X 2 repeated measures ANOVA when combined with the trials variable. Natural killer (NK) cell activity declined significantly from the first to the second sample. High scorers on stressful life events and loneliness had significantly lower levels of NK activity. Total plasma IgA increased significantly from the first to second sample, while plasma IgG and IgM, C-reactive protein, and salivary IgA did not change significantly.
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Arch Intern Med 1997 Oct 27;157(19):2213-23
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
BACKGROUND: Previous studies have demonstrated that myocardial ischemia can be elicited by mental stress in the laboratory and during daily life and that ischemia induced by mental stress is associated with an increased risk for future cardiac events in patients with coronary artery disease. OBJECTIVES: To examine the extent to which ischemia induced by mental stress can be modified by exercise stress management, and to evaluate the impact of these interventions on clinical outcomes. METHODS: One hundred seven patients with coronary artery disease and ischemia documented during mental stress testing or ambulatory electrocardiographic monitoring were randomly assigned to a 4-month program of exercise or stress management training. Patients living at a distance from the facility formed a nonrandom, usual care comparison group. Myocardial ischemia was reassessed following treatment, and patients were contacted annually for as long as 5 years to document cardiac events, including death, nonfatal myocardial infarction, and cardiac revascularization procedures. RESULTS: Twenty-two patients (21%) experienced at least 1 cardiac event during a mean (+/- SD) follow-up period of 38 +/- 17 months. Stress management was associated with a relative risk of 0.26 compared with controls. The relative risk for the exercise group also was lower than that of controls, but the effect did not reach statistical significance. Stress management also was associated with reduced ischemia induced by mental stress and ambulatory ischemia. CONCLUSION: These data suggest that behavioral interventions offer additional benefit over and above usual medical care in cardiac patients with evidence of myocardial ischemia.
Psychosom Med 1995 Jan-Feb;57(1):5-15
Department of Psychiatry, Dartmouth Medical School, Lebanon, NH 03756, USA.
The purpose of this study was to examine the relationship of social support and religion to mortality after elective open heart surgery in older patients. Of the 232 patients included in the study, 21 died within 6 months of surgery. Three biomedical variables were significant predictors of mortality and selected as adjustment variables for a multivariate analysis: history of previous cardiac surgery; greater impairment in presurgery basic activities of daily living; and older age. Among the social support and religion variables, two were consistent predictors of mortality in the multivariate analyses: lack of participation in social or community groups and absence of strength and comfort from religion. These results suggest that in older persons lack of participation in groups and absence of strength and comfort in religion are independently related to risk for death during the 6-month period after cardiac surgery.
J Behav Med 1978 Mar;1(1):37-43
Blood pressure levels were examined with regard to church attendance patterns in a group of white male heads of households who appeared in the 1967-1969 follow-up examination of the Evans County Cardiovascular Epidemiologic Study. A consistent pattern of lower systolic and diastolic blood pressures among frequent church attenders was found compared to that of infrequent attenders which was not due to the effects of age, obesity, cigarette smoking, or socioeconomic status.
J Chronic Dis 1972 Dec;25(12):665-72
JAMA 1998 Nov 11;280(18):1569-75
Center for Alternative Medicine Research and Education, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass 02215, USA.
CONTEXT: A prior national survey documented the high prevalence and costs of alternative medicine use in the United States in 1990. OBJECTIVE: To document trends in alternative medicine use in the United States between 1990 and 1997. DESIGN: Nationally representative random household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997, respectively. PARTICIPANTS: A total of 1539 adults in 1991 and 2055 in 1997. MAIN OUTCOMES MEASURES: Prevalence, estimated costs, and disclosure of alternative therapies to physicians. RESULTS: Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8% in 1990 to 42.1% in 1997 (P < or = .001). The therapies increasing the most included herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. The probability of users visiting an alternative medicine practitioner increased from 36.3% to 46.3% (P = .002). In both surveys alternative therapies were used most frequently for chronic conditions, including back problems, anxiety, depression, and headaches. There was no significant change in disclosure rates between the 2 survey years; 39.8% of alternative therapies were disclosed to physicians in 1990 vs 38.5% in 1997. The percentage of users paying entirely out-of-pocket for services provided by alternative medicine practitioners did not change significantly between 1990 (64.0%) and 1997 (58.3%) (P=.36). Extrapolations to the US population suggest a 47.3% increase in total visits to alternative medicine practitioners, from 427 million in 1990 to 629 million in 1997, thereby exceeding total visits to all US primary care physicians. An estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and/or high-dose vitamins (18.4% of all prescription users). Estimated expenditures for alternative medicine professional services increased 45.2% between 1990 and 1997 and were conservatively estimated at $21.2 billion in 1997, with at least $12.2 billion paid out-of-pocket. This exceeds the 1997 out-of-pocket expenditures for all US hospitalizations. Total 1997 out-of-pocket expenditures relating to alternative therapies were conservatively estimated at $27.0 billion, which is comparable with the projected 1997 out-of-pocket expenditures for all US physician services. CONCLUSIONS: Alternative medicine use and expenditures increased substantially between 1990 and 1997, attributable primarily to an increase in the proportion of the population seeking alternative therapies, rather than increased visits per patient.
South Med J 1988 Jul;81(7):826-9
Medical Service, San Francisco General Medical Center, CA.
The therapeutic effects of intercessory prayer (IP) to the Judeo-Christian God, one of the oldest forms of therapy, has had little attention in the medical literature. To evaluate the effects of IP in a coronary care unit (CCU) population, a prospective randomized double-blind protocol was followed. Over ten months, 393 patients admitted to the CCU were randomized, after signing informed consent, to an intercessory prayer group (192 patients) or to a control group (201 patients). While hospitalized, the first group received IP by participating Christians praying outside the hospital; the control group did not. At entry, chi-square and stepwise logistic analysis revealed no statistical difference between the groups. After entry, all patients had follow-up for the remainder of the admission. The IP group subsequently had a significantly lower severity score based on the hospital course after entry (P less than .01). Multivariant analysis separated the groups on the basis of the outcome variables (P less than .0001). The control patients required ventilatory assistance, antibiotics, and diuretics more frequently than patients in the IP group. These data suggest that intercessory prayer to the Judeo-Christian God has a beneficial therapeutic effect in patients admitted to a CCU.
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