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A Good Guffaw Could Help MS Patients Cope

— But pilot study of laughter therapy saw substantial dropout rate

MedpageToday

NASHVILLE -- Laughter is definitely not the best medicine for patients with multiple sclerosis (MS) -- that would be disease modifying treatments -- but laughter therapy did appear to have some benefit, according to researchers here.

In a pilot study of MS and other central nervous system (CNS) disorders, patients experienced some change in the mean score for depression from baseline to 8 weeks, reported Theodore Brown, MD, MPH, and Virginia Simnad, MD, both of the MS Center at EvergreenHealth in Kirkland, Washington.

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

However, the dropout rate was >50%, although most of the dropouts did so before attending their first laughter therapy session.

Laughter therapy has been used in the U.S. in and , but the small study is the first to examine the alternative treatment in a neurological setting. The authors reported their findings at the Consortium of Multiple Sclerosis Centers (CMSC) annual meeting.

The open label, 8-week trial originally included 24 patients with MS and other CNS disorders (Parkinson's, Alzheimer's) who were asked to attend eight weekly, 60-minute group sessions of laughter therapy.

The involved ≥10 activities involving laughter, including play-acting (asking participants to "evil laugh," for example) and combining simulated laughter with body movements. Activities were performed seated and they were interspersed with conversation.

"We weren't telling people jokes to make them laugh. That wasn't the idea," Brown told app. "It was more like a breathing exercise, only we were asking people to laugh for roughly 3 minutes periodically during a session. And for the people who were willing to go with it, there were some benefits in overall well-being."

The hypotheses were that laughter therapy would improve depression and anxiety as measured by the Patient Health Questionnaire-9 (PHQ-9) and 7-Item Generalized Anxiety Disorder Scale (GAD-7), and that the effects would be sustained for 8 weeks, the authors explained.

For the participants who completed the study protocol, the mean baseline and week-8 scores and mean change were as follows:

  • PHQ-9: 6.8, 5.2 (-1.6 reduction in score, indicated less depression)
  • GAD-7: 2.8, 2.9 (+0.1, indicated no change in anxiety level)

Among patients who attended the sessions, laughter therapy was well tolerated, Brown said.

Although the pilot study did not address this, Brown said laughter therapy may be most beneficial among MS and other neurological disorder patients with severe disabilities.

"Patients who can't walk, or might be severely limited in the types of exercises, they can do might find this useful," he said. "As long as patients can still breathe they can laugh. It's a universal thing."

CMSC CEO June Halper, MSN, said laughter therapy could be beneficial in MS since depression and fatigue are so common.

"The more depressed someone gets the more fatigued they are, and visa versa. It's a vicious circle," she told app. "It makes sense that laughter might help break the cycle."

Disclosures

Brown disclosed relevant relationships with Biogen, Astellas, Merck, Ibsen Pharmaceutical, Sanofi Genzyme, and Teva Neuroscience. Simnad disclosed relevant relationships with Biogen and Novartis.

Primary Source

Consortium of Multiple Sclerosis Centers

Brown TR and Simnad V "Pilot investigation of the effects of laughter therapy on mood, stress and self-efficacy in people with MS and other CNS disorders" CMSC 2018; Abstract CA04.