Meditation Programs for Psychological Stress and Well-being

JAMA Intern Med. 2014;174(3):357-368

A Systematic Review and Meta-analysis

Importance  Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation.

Objective  To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health–related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations.

Evidence Review  We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals.

Maharishi Ayur-Veda: Guru's marketing scheme promises the world eternal 'perfect health'

Andrew A. Skolnick
JAMA, Medical News & Perspectives
Oct. 2, 1991


IF THE CLAIMS of Maharishi Mahesh Yogi prove true, those who follow him soon will be blessed with eternal youth, "perfect health," and the "strength of an elephant." They will be able to "walk through walls," make themselves "invisible," and "fly through the air" without the benefit of machines.


In addition, there will be no more war or crime. Automobile accidents will be a thing of the past, and even the weather will have to obey their collective consciousness.


Such are the widely promoted claims of the Transcendental Meditation (TM) movement and Maharishi Ayur-Veda, some of which were presented by authors Deepak Chopra, MD, Hari M. Sharma, MD, FRCPC, and Brihaspati Dev Triguna, in their "Letter From New Delhi" ("Maharishi Ayur-Veda: Modern Insights Into Ancient Medicine," JAMA.1991;265:2633-2637).


According to a number of experts on religious cults, Maharishi Mahesh Yogi, the Hindu swami from India, began his rise to fame and great fortune in the 1960s when the Beatles rock group briefly joined his following of worshipers. Today, he leads many thousands of devoted followers who are dedicated to bringing about his widely publicized "Master Plan to Create Heaven on Earth. "Many of these disciples are prominent in science, medicine, education, sports, entertainment, and the news media. According to Indian newspaper reports, his master plan has created an empire for the guru conservatively estimated to be worth more than $2 billion. But according to representatives of the TM movement, the Maharishi's plan to turn earth into heaven is not just wishful thinking; they say they have more than 500 scientific studies to prove they can do it.


Among them now is the "Letter From New Delhi," which is being pointed to throughout the TM movement as a sign that the Maharishi's plan is gaining scientific respectability. However, among many authorities on quackery and long-time watchers of this movement, the article in JAMA has brought anger and dismay. (Please see Letters, pages 1769 through 1774.) They say that Maharishi Ayur-Veda is not traditional Indian medicine, but the latest of the Maharishi's schemes to boost the declining numbers of people taking TM courses, through which the movement recruits new members.

This June, members of the TM community in Fairfield, Iowa, were called to a special assembly at one of the Maharishi International University's "Golden Domes of Pure Knowledge" to celebrate the news of JAMA's publication of "Letter From New Delhi." The same month, The Fairfield (Iowa) Source, a monthly newspaper that is run by members of the movement, reported that the "Letter From New Delhi" was "the lead article in JAMA."(The newspaper has since published a correction identifying it as the first article in the issue rather than the lead scientific article--a subtle but important difference.)

Failure to Disclose Connections

What the newspaper didn't report was what editors of THE JOURNAL learned shortly after the article was published: The authors are involved in organizations that promote and sell the products and services about which they wrote. Despite this, they submitted a signed financial disclosure form with their manuscript indicating that they had no such affiliations.

The statement, which all authors of articles accepted by JAMA must sign before publication, says: "I certify that any affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript (eg, employment, consultancies, stock ownership, honoraria, expert testimony) are listed below. Otherwise, my signature indicates that I have no such financial interest. "The authors of the "Letter from New Delhi" listed no involvements or affiliations. Upon learning otherwise, THE JOURNAL immediately requested a full accounting from the authors, which was published as a financial disclosure correction (JAMA.1991;266:798). 

Although the confusing list apparently holds the record in terms of length for corrections published in THE JOURNAL, it still is incomplete. In addition to being the medical director of TM's premiere health facility, the Maharishi Ayurveda Health Center for Stress Management and Behavioral Medicine, in Lancaster, Mass, and a former consultant and board member for Maharishi Ayur-Veda Products International (MAPI) Inc, also in Lancaster (the sole distributor of Maharishi Ayur-Veda TM products, an extensive line of herbs, teas, oils, food supplements, incense, and devices said to prevent or treat disease and reverse aging), Chopra performs many of the unproven and expensive Maharishi Ayur-Veda services throughout the country. Indeed, he claims to have treated more than 10 000 patients with these remedies between 1985 and 1990 (Perfect Health: The Complete Mind/Body Guide.New York, NY: Harmony Books; 1990:6).