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The Effect of Osteopathic Manipulation on Anxiety and Depression in Medical Students

Journal: Journal of Osteopathic Medicine Date: 2018/11, 118(11):Pages: e162-e163. doi: Subito , type of study: controlled clinical trial


Keywords:

anxiety [37]
controlled clinical trial [283]
depression [48]
medical students [402]
OMT [2951]
osteopathic manipulative treatment [2973]
osteopathic medicine [1540]
USA [1086]

Abstract:

Introduction: Whether it is termed a mental illness, stress-related condition, psychiatric issue, or functional disorder, psychological dysfunction of individuals in today's society may be more frequent and incapacitating than any other disease or disorder. Medical students enrolled in colleges of osteopathic medicine (COMs) are not exempt from this phenomenon. Prior available studies suggest that the suicide rate among medical students is higher than in the age-matched population and that a reported that 3% to 15% of medical students have suicidal ideation during medical school training. Clearly, there is a high prevalence of stress, anxiety, depression, and burn-out in medical students. One of the tenets of osteopathic medicine is that the human being is a compilation of body, mind, and spirit. Researchers would like to investigate whether faculty at COMs can assist in improving the overall well-being of enrolled medical students. Specifically, researchers hoped to investigate osteopathic manipulative treatment (OMT) as it relates to the soma (body) and how it can affect a patient's mood (mind) and beliefs (spirit). Hypothesis: The goal of this study was to determine whether OMT assists participants in experiencing a change in mood, particularly in reference to depressive and anxious symptoms using the Beck Depression Inventory and the Spielberger State-Trait Anxiety Inventory surveys, respectively. Methods: This study was approved by the Touro IRB commission in 2018 (#1737). First- and second-year students enrolled at TouroCOM's Middletown Campus in New York, aged 21 to 45 years, were invited to participate in the study. No prior history of anxiety, depression, or having received OMT in the past were accounted for and no other particular criteria were used to exclude participants. In total, 20 participants were in the control group and 31 were in the experimental group. The study had a total duration of 5 days. Participants in both groups completed 2 surveys: the Beck Depression Inventory and the Spielberger State-Trait Anxiety Inventory to evaluate characteristic attitudes and symptoms of depression and measure of state and trait anxiety, respectively, on day 1 and day 5 of the duration of the study. The treatment group received osteopathic evaluations, diagnosis, and manipulative treatment to correct their somatic dysfunctions, optimize neuromusculoskeletal function, and decrease their somatic dysfunction severities on day 1 and day 3. No OMT was provided to the control group. Participants in the experimental group completed their surveys before receiving OMT. Data were analyzed using SPSS 24.0 software. Predefined thresholds (α) for P values were set at .05. Pearson correlations and paired t tests were conducted, as well as χ2 for inferential results. Results: Statistical analysis revealed P values of .017 and .045 relating state anxiety and trait anxiety, respectively. These results were statistically significant, suggesting an impact of OMT on reducing anxiety, with a greater effect on reducing how the individual anxiously responds to stressful situations (state anxiety). However, the role of OMT in decreasing depression symptoms remains to be seen, as results yielded a P value of .278. Conclusion: The decrease in reported anxiety symptoms may be due to improvements in the function of the autonomic nervous system as well as a regulatory effect on the hypothalamus-pituitary axis and its actions in response to stressful situations. A direct correlation can be noted between the beneficial effects of treatment of the body and the effects on the mind and spirit. Limitations of this study include the small quantity of participants, certain personality traits associated with medical students, and the short time frame over which measurements were taken. Future work includes increasing the patient participation pool, expanding to subset populations with mental health conditions, and measuring the effects of OMT over longer periods. Mental health researchers have long known that stress plays a strong role in various forms of anxiety and depressive disorders. Findings suggest a strong influence of the patient's physical body on the patient's overall anxiety state and a venue for additional treatments to standard of care, including OMT, to positively affect a patient's mood. OMM-trained faculty employed at COMs are in a unique situation in which they can contribute to improving student's overall well-being by engaging the tenet of osteopathic medicine stating that body, mind, and spirit are all integrated as 1 element.


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