Long-Term Effects of the Transcendental Meditation and Mindfulness Programs

Most studies on Mindfulness Based Stress Reduction (MBSR) are over an 8 week period, and there are only a few long-term studies of a year or more on MBSR or other mindfulness programs. (1-6) By contrast, there are several long-term studies on the Transcendental Meditation technique.

Examples of Long-Term Effects of the Transcendental Meditation Program

Transcendental Meditation	Mindfulness
Decreased Mortality (7): 18.8 years maximum, 7.6 years mean follow up; RCT, N = 202. -23% decreased all-cause mortality -30% decreased cardiovascular mortality -49% cancer mortality	No Studies on Mortality.
Decreased Recidivism Among Former Prison Inmates: 15 years, 12.2 years average followup (8). RCS, N = 248. 43.5% reduction in recidivism controlling for 22 demographics permanent rehabilitation less severe re-offending synergistic effect; TM + therapy was greater that the effects of TM and therapy added together, indicating that TM enhances the effects of therapy.	No Studies on Recidivism.
Decreased Medical Expenditures: 14 years, pre and post intervention, 6 year post intervention (9). RCS, N = 2,836. -13.8% annual reduction in physicians costs	No Studies on Medical Expenditures.
Decreased Medical Care Utilization: 11 years (10). RCS, N = 693 TM, 600,000 norms. -74% hospital days/1000 -55% outpatient visits/1000 -63% total medical expenditures Note: Similar results were found comparing TM subjects to a matched control group of 4,148 people over 4 years.	Medical Utilization: 1 year (11).UPP, N = 73 total, 47 chronic care, 36 Spanish. total group, non-significant decreases in total visits, chronic care visits, or the number of acute visits chronic care subgroup;-24% chronic care visits Spanish subgroup; -22% total visits, -34% chronic care visits
Increased Personality Development: 10 Years (12) PCS, N = 136. increased ego development increased moral reasoning increased intimacy motivation	No Studies on Personality Development
Decreased Coronary Heart Disease Events: 9 years maximum, 5.4 years mean followup (13, 14). RCT, N = 201. -47% all-cause mortality, myocardial infarction, strokes -24% cardiovascular mortality, revascularizations, cardiovascular hospitalization -4.9 mm Hg systolic blood pressure decreased anger expression	No Studies on Coronary Heart Disease Events.
Decreased Medical Expenditures Among High Cost People: 6 years, Five years followup(15). RCS, N = 284. -28% cumulative reduction in physician costs	No Studies on Medical Expenditures.
Decreased Medical Care Utilization: 5 years (16). RCS, N = 694 to 2119 for TM, 1468 mean; 22,440 total for five control groups, 600,000 norms. -63% inpatient medical -71% inpatient surgical -59% outpatient medical -56% outpatient surgical	See above, reference 11.

RCT = Randomized Controlled Trial: subjects were randomly allocated to receive the TM or Control treatment in a prospective study. RCS = Retrospective Cohort Study: subjects who learned TM were compared on outcomes over time with similar control subjects who did not learn TM, using archival data. PCT = Prospective Controlled Trial: in a prospective study, subjects who had learned TM were compared on standard tests over time with similar control subjects who did not learn TM. UPP = uncontrolled Pre-Post experiment: subjects were measured before and after treatment, no control group.

References

1. Baer RA. Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review. Psychology: Science & Practice. 2003;10(2):125-43.

2. Grossman P. Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research. 2004;57(1):35-43.

3. Ospina MB, Bond K, Karkhaneh M, Buscemi N, Dryden DM, Barnes V, et al. Clinical Trials of Meditation Practices in Health Care: Characteristics and Quality. The journal of alternative and complementary medicine. 2008;14(10):1199-213.

4. Himelstein S. Meditation research: the state of the art in correctional settings. Int J Offender Ther Comp Criminol. 2011 Jun;55(4):646-61.

5. Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med. 2009 May;15(5):593-600.

6. Chiesa A, Serretti A. Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Research. 2011;187(3):441-53.

7. Schneider RH, Alexander CN, Staggers F, Rainforth M, Salerno JW, Hartz A, et al. Long-term effects of stress reduction on mortality in persons > 55 years of age with systemic hypertension. Am J Cardiol. 2005;95(9):1060-4.

8. Rainforth M, Bleick C, Alexander CN, Cavanaugh KL. The Transcendental Meditation program and criminal recidivism in Folsom State

Prisoners: A 15-year follow-up study. Journal of Offender Rehabilitation. 2003;36:181-204.

9. Herron R, Hillis S. The impact of the Transcendental Meditation program on government payments to physicians in Quebec: An update. American Journal of Health Promotion. 2000;14(5):284-93.

10. Orme-Johnson DW, Herron RE. An innovative approach to reducing medical care utilization and expenditures. The American Journal of Managed Care. 1997;3(1):135-44.

11. Roth B, Stanley TW. Mindfulness-based stress reduction and healthcare utilization in the inner city: preliminary findings. Altern Ther Health Med. 2002 Jan-Feb;8(1):60-2, 4-6.

12. Chandler H, Alexander C, Heaton D, Grant J. Transcendental Meditation and postconventional self-development: a 10-year longitudinal study. Journal of Social Behavior and Personality. 2005;17(1):93-122.

13. Schneider R, Grim C, Rainforth M, Kotchen T, Nidich S, Gaylord-King C, et al. Stress reduction in the secondary prevention of cardiovascular disease: a randomized controlled trial of Transcendental Meditation and health education in African Americans. Arch Int Med. 2011:in review.

14. Schneider R, Nidich S, Kotchen J, Kotchen T, Grim C, Rainforth M, et al. Effects of Stress Reduction on Clinical Events in African Americans with Coronary Heart Disease: A Randomized Controlled Trial. . Circulation. 2009;120:S461.

15. Herron RE. Changes in Physician Costs Among High-Cost Transcendental Meditation Practitioners Compared With High-Cost Nonpractitioners Over 5 Years. American Journal of Health Promotion. 2011;26(1):56-60.

16. Orme-Johnson D. Medical care utilization and the Transcendental Meditation program. Psychosom Med. 1987 Sep-Oct;49(5):493-507.