***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE In this pilot study we sought to develop and test a modified form of mindfulness-based stress reduction ( MBSR-tics ) for the treatment of Tourette Syndrome ( TS ) and Chronic Tic Disorder ( CTD ) . Our specific aims were : 1 ) To determine the feasibility and acceptability of an 8-week trial of MBSR-tics  in individuals 16 and older with TS or CTD and 2 ) To determine the efficacy of an 8-week trial of MBSR-tics in individuals 16 and older with TS or CTD . METHODS Eighteen individuals age 16 - 67 completed an uncontrolled open trial of MBSR-tics . The intervention consisted of 8 weekly 2-hour classes and one 4hour retreat in the fifth or sixth week of the program . Symptomatic assessment s were performed at baseline , post-treatment , and one-month follow-up . RESULTS MBSR-tics proved to be a feasible and acceptable intervention . It result ed in significant improvement in tic severity and tic-related impairment . 58.8 % of subjects were deemed treatment responders . Therapeutic gains were maintained at 1-month follow-up . Improvements in tic severity were correlated with increases in self-reported levels of mindfulness . CONCLUSIONS This small open pilot study provides preliminary support for the feasibility , acceptability , and efficacy of MBSR-tics for individuals 16 or older with TS or CTD . A larger r and omized controlled trial with blind assessment is necessary to confirm these initial , promising findings . Trial Registration Partners Clinical Trials Registry Number 2011P000606 ( clinical trials.partners.org ) Objective : To investigate the effectiveness of mindfulness-based therapy ( MT ) and social support ( SS ) in patients with drug-resistant epilepsy . Methods : We performed an assessor-blinded r and omized control trial . Sixty patients with drug-resistant epilepsy were r and omly allocated to MT or SS ( 30 per group ) . Each group received 4 biweekly intervention sessions . The primary outcome was the change in the total score of the Patient-Weighted Quality of Life in Epilepsy Inventory ( QOLIE-31-P ) . Secondary outcomes included seizure frequency , mood symptoms , and neurocognitive functions . The assessors were blinded to the patient 's intervention grouping . Results were analyzed using general linear model with repeated measure . Results : Following intervention , both the MT ( n = 30 ) and SS ( n = 30 ) groups had an improved total QOLIE-31-P , with an improvement of + 6.23 for MT ( 95 % confidence interval [ CI ] + 4.22 to + 10.40 ) and + 3.30 for SS ( 95 % CI + 1.03 to + 5.58 ) . Significantly more patients in the MT group had a clinical ly important improvement in QOLIE-31-P ( + 11.8 or above ) compared to those who received SS ( 11 patients vs 4 patients ) . Significantly greater reduction in depressive and anxiety symptoms , seizure frequency , and improvement in delayed memory was observed in the MT group compared with the SS group . Conclusions : We found benefits of short-term psychotherapy on patients with drug-resistant epilepsy . Mindfulness therapy was associated with greater benefits than SS alone in quality of life , mood , seizure frequency , and verbal memory . Classification of evidence : This study provides Class II evidence that mindfulness-based therapy significantly improves quality of life in patients with drug-resistant epilepsy Objective : Health-related quality of life ( HRQOL ) is often much reduced among individuals with multiple sclerosis ( MS ) , and incidences of depression , fatigue , and anxiety are high . We examined effects of a mindfulness-based intervention ( MBI ) compared to usual care ( UC ) upon HRQOL , depression , and fatigue among adults with relapsing-remitting or secondary progressive MS . Methods : A total of 150 patients were r and omly assigned to the intervention ( n = 76 ) or to UC ( n = 74 ) . MBI consisted of a structured 8-week program of mindfulness training . Assessment s were made at baseline , postintervention , and 6 months follow-up . Primary outcomes included disease-specific and disease-aspecific HRQOL , depression , and fatigue . Anxiety , personal goal attainment , and adherence to homework were secondary outcomes . Results : Attrition was low in the intervention group ( 5 % ) and attendance rate high ( 92 % ) . Employing intention-to-treat analysis , MBI , compared with UC , improved nonphysical dimensions of primary outcomes at postintervention and follow-up ( p < 0.002 ) ; effect sizes , 0.4–0.9 posttreatment and 0.3–0.5 at follow-up . When analyses were repeated among subgroups with clinical ly relevant levels of preintervention depression , fatigue , or anxiety , postintervention and follow-up effects remained significant and effect sizes were larger than for the total sample . Conclusions : In addition to evidence of improved HRQOL and well-being , these findings demonstrate broad feasibility and acceptance of , as well as satisfaction and adherence with , a program of mindfulness training for patients with MS . The results may also have treatment implication s for other chronic disorders that diminish HRQOL . Classification of evidence : This trial provides Class III evidence that MBI compared with UC improved HRQOL , fatigue , and depression up to 6 months postintervention Positive affect predicts improved glycemic control and longevity in adults with type 2 diabetes . We tested Developing Affective HeaLth to Improve Adherence ( DAHLIA ) , a self-paced online intervention for type 2 diabetes that teaches positive affect skills such as savoring , gratitude , and acts of kindness . Participants ( n = 49 ) were r and omized to the five-week DAHLIA course or an emotion-reporting wait-list control . DAHLIA was understood and accepted by participants and showed good retention ( 78 % ) . At post-intervention , DAHLIA participants showed a significantly greater decrease in depression than controls ( −4.3 vs. + 0.6 points on the CES-D , p = 0.05 ) . Secondary analyses found that this effect was considerably stronger in intervention recipients recruited online than those recruited in person . Intervention recipients recruited online also showed significantly increased positive affect , reduced negative affect , and reduced perceived stress . There were no effects on measures of diabetes-specific efficacy or sense of burden , or preliminary measures of health behaviors . This successful feasibility and efficacy trial provides support for a larger trial focusing more specifically on health behavior CONTEXT Pain and depression are the most common physical and psychological symptoms in primary care , respectively . Moreover , they co-occur 30 % to 50 % of the time and have adverse effects on quality of life , disability , and health care costs . OBJECTIVE To determine if a combined pharmacological and behavioral intervention improves both depression and pain in primary care patients with musculoskeletal pain and comorbid depression . DESIGN , SETTING , AND PATIENTS R and omized controlled trial ( Stepped Care for Affective Disorders and Musculoskeletal Pain [ SCAMP ] ) conducted at 6 community-based clinics and 5 Veterans Affairs general medicine clinics in Indianapolis , Indiana . Recruitment occurred from January 2005 to June 2007 and follow-up concluded in June 2008 . The 250 patients had low back , hip , or knee pain for 3 months or longer and at least moderate depression severity ( Patient Health Question naire 9 score > or = 10 ) . INTERVENTION Patients were r and omly assigned to the intervention ( n = 123 ) or to usual care ( n = 127 ) . The intervention consisted of 12 weeks of optimized antidepressant therapy ( step 1 ) followed by 6 sessions of a pain self-management program over 12 weeks ( step 2 ) , and a continuation phase of therapy for 6 months ( step 3 ) . MAIN OUTCOME MEASURES Depression ( 20-item Hopkins Symptom Checklist ) , pain severity and interference ( Brief Pain Inventory ) , and global improvement in pain at 12 months . RESULTS At 12 months , 46 of the 123 intervention patients ( 37.4 % ) had a 50 % or greater reduction in depression severity from baseline compared with 21 of 127 usual care patients ( 16.5 % ) ( relative risk [ RR ] , 2.3 ; 95 % confidence interval [ CI ] , 1.5 - 3.2 ) , corresponding to a much lower number of patients with major depression ( 50 [ 40.7 % ] vs 87 [ 68.5 % ] , respectively ; RR , 0.6 [ 95 % CI , 0.4 - 0.8 ] ) . Also , a clinical ly significant ( > or = 30 % ) reduction in pain was much more likely in intervention patients ( 51 intervention patients [ 41.5 % ] vs 22 usual care patients [ 17.3 % ] ; RR , 2.4 [ 95 % CI , 1.6 - 3.2 ] ) , as was global improvement in pain ( 58 [ 47.2 % ] vs 16 [ 12.6 % ] , respectively ; RR , 3.7 [ 95 % CI , 2.3 - 6.1 ] ) . More intervention patients also experienced benefits in terms of the primary outcome , which was a combined improvement in both depression and pain ( 32 intervention patients [ 26.0 % ] vs 10 usual care patients [ 7.9 % ] ; RR , 3.3 [ 95 % CI , 1.8 - 5.4 ] ) . CONCLUSION Optimized antidepressant therapy followed by a pain self-management program result ed in substantial improvement in depression as well as moderate reductions in pain severity and disability . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00118430 The effect of a grateful outlook on psychological and physical well-being was examined . In Studies 1 and 2 , participants were r and omly assigned to 1 of 3 experimental conditions ( hassles , gratitude listing , and either neutral life events or social comparison ) ; they then kept weekly ( Study 1 ) or daily ( Study 2 ) records of their moods , coping behaviors , health behaviors , physical symptoms , and overall life appraisal s. In a 3rd study , persons with neuromuscular disease were r and omly assigned to either the gratitude condition or to a control condition . The gratitude-outlook groups exhibited heightened well-being across several , though not all , of the outcome measures across the 3 studies , relative to the comparison groups . The effect on positive affect appeared to be the most robust finding . Results suggest that a conscious focus on blessings may have emotional and interpersonal benefits Objective . To investigate possible neurobehavioral changes secondary to a mindfulness based intervention ( MBI ) training for individuals living with Parkinson 's disease ( PD ) . Background . In the context of complementary medicine , MBIs are increasingly being used for stress reduction and in patient population s coping with chronic illness . The use of alternative and complementary medicine may be higher in patients with chronic conditions such as PD . However , behavioral effects of mindfulness training in PD have not yet been reported in the literature and this points to an unmet need and warrants further examination . Methods . A total of 27 out of 30 PD patients completed a r and omized controlled longitudinal trial .  Question naires and the UPDRS I – IV were obtained at baseline and 8-week follow-up . Results . Significant changes after the MBI were found including a 5.5 point decrease on the UPDRS motor score , an increase of 0.79 points on Parkinson 's disease question naire ( PDQ-39 ) pain item , and a 3.15 point increase in the Five Facet Mindfulness Question naire observe facet . Conclusions . To the best of our knowledge , this is the first quantitative analysis of neurobehavioral effects of MBI in PD Background Parkinson ’s disease ( PD ) is the second commonest neurodegenerative disease in developed countries . Current treatment for PD is pharmacologically focused and can have significant side-effects . There is increasing interest in holistic approaches including mindfulness to help manage the challenges associated with living with PD . We hypothesised that there would be an improvement in PD associated function and wellbeing in participants after participating in a 6-week mindfulness-based lifestyle program , and that these improvements would be sustainable at 6 months . Our primary objective was to determine changes in function and wellbeing associated with PD . Methods An exploratory prospect i ve , mixed- method , r and omised control trial incorporating a before and after design with a waitlist control , with an embedded qualitative component was conducted in 2012–2013 . Participants included community living adults with disability congruent to H&Y Stage 2 PD , aged 18–75 , fluent in spoken and written English and able to attend at least four of six sessions of the program . Participants were r and omised to the intervention or wait-list control groups at two locations . All participants in the wait-list control group eventually received the intervention . Two r and omisation codes were created for each location . Allocation to the intervention or wait-list control was by r and om number generation . The program facilitator and participants were blinded to participant data . Results Group 1 included 35 participants and group 2 ( the waitlist control ) , 37 . Data was analysed from 24 ( group 1 ) and 33 ( group 2 ) participants .  The intervention group , compared to the waitlist control , showed a small improvement in function and wellbeing associated with P 
    Output:
    
These interventions were shown to improve quality of life , reduce symptomatic distress , and depressive symptoms .
CONCLUSION PPIs promote well-being among patients with neurological deficits .