Effects on immune mediated illness need substantiation in independent studies

Recently JAMA published a trial of a “get it off your chest” writing exercise.1 Seventy one patients with asthma or rheumatoid arthritis were randomised to write about the most stressful experience they had ever had or about their plans for the day for three separate 20 minute periods over a few days and then to drop their completed essay into a sealed box. The study apparently showed a significant improvement in standard measures of disease severity in both conditions four months later. An accompanying editorial exhorted readers to abandon the Cartesian split between mind and body, and acknowledge the growing evidence in support of behavioural interventions that reduce emotional stress as therapies for diseases that are mediated in part by the immune system.2 Do these results stand up, and is it therefore time to heed this call?

Therapeutic writing is a hot topic on both sides of the Atlantic. In the United Kingdom the focus tends to be on descriptive accounts and somewhat speculative psychodynamic explanations for subjective improvements in health status. A recent book provides moving case studies of patients who came to terms with physical or psychological illness through creative writing and …