Hypnosis/Hypnotherapy

Hypnosis/Hypnotherapy

PEP Topic 
Hot Flashes
Description 

Hypnosis is a state between wakefulness and sleep; a state of heightened focal concentration and receptivity; an altered state of consciousness or a state of focused attention that results in suspension of peripheral cues. The effect of a hypnotic state results in alteration in perception and attention. Hypnosis has been tested for effect in pain, anxiety, depression, CINV, hot flashes, and fatigue in patients with cancer. Hypnosis has been delivered in various formats, including individual in-person sessions, use of a CD program for induction, and training in self-hypnosis.

Effectiveness Not Established

Research Evidence Summaries

Elkins, G., Marcus, J., Stearns, V., Perfect, M., Rajab, M.H., Ruud, C., … Keith, T. (2008). Randomized trial of a hypnosis intervention for treatment of hot flashes among breast cancer survivors. Journal of Clinical Oncology, 26, 5022–5026.

doi:10.1200/JCO.2008.16.6389
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Study Purpose:

Researchers compared a hypnosis intervention (five weekly sessions) or no treatment.

Sample Characteristics:

Sixty female breast cancer survivors with hot flashes were enrolled.  Eligible patients had to have a history of primary breast cancer without evidence of detectable disease and 14 or more weekly hot flashes for at least one month.

Study Design:

Participants were randomly assigned to treatment with hypnosis or no treatment.

Measurement Instruments/Methods:

The instrument was the Hot Flash Related Daily Interference Scale.

Results:

Fifty-one randomly assigned women completed the study. By the end of the treatment period, hot flash scores (frequency and average severity) decreased 68% from baseline to end point in the hypnosis arm (p ≤ 001). Significant improvements in self-reported anxiety, depression, interference of hot flashes on daily activities, and sleep were observed for patients who received the hypnosis intervention (p ≤ .005) in comparison to the no treatment control group.

Limitations:

Study limitations included:

  • Five weeks duration
  • No physiologic monitoring of hot flashes
  • No long-term follow-up

Elkins, G., Marcus, J., Stearns, V., & Rajab, M.H. (2007). Pilot evaluation of hypnosis for the treatment of hot flashes in breast cancer survivors. Psycho-Oncology, 16, 487–492.

doi:10.1002/pon.1096
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Study Purpose:

The study looked at the effectiveness of hypnosis in treating hot flashes in breast cancer survivors.

Intervention Characteristics/Basic Study Process:

Each participant received four weekly sessions of hypnosis using a standardized transcript and was instructed in self-hypnosis.

Sample Characteristics:

Sixteen breast cancer survivors were enrolled.

Study Design:

This was a pilot study.

Measurement Instruments/Methods:

Participants kept daily diaries of the frequency and severity of their hot flashes. They also completed baseline and post-treatment ratings of the degree to which hot flashes interfered with daily activities and QOL using the Hot Flash-Related Daily Interference Scale.

Results:

Results indicated a 59% decrease in total daily hot flashes and a 70% decrease in weekly hot flash scores from the baselines. Participants experienced a significant decrease in the degree to which hot flashes interfered with daily activities for all measures including work, social activities, leisure activities, sleep, mood, concentration, relations with others, sexuality, enjoyment of life, and overall QOL.

Limitations:

This study was limited by its small sample size and the limitations inherent in single group study design. All of the participants expressed interest in hypnosis, which may indicate some selection bias. Because no comparable control group was used, identifying the exact efficacy of hypnosis as a treatment for hot flashes is not possible.

Younus, J., Simpson, I., Collins, A., & Wang, X. (2003). Mind control of menopause. Women’s Health Issues, 13, 74–78.

doi:10.1016/S1049-3867(02)00196-2
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Study Purpose:

The primary purpose was to observe the effect of hypnosis on hot flashes and overall QOL in symptomatic patients. A secondary objective was to observe the effect of hypnosis on fatigue.

Intervention Characteristics/Basic Study Process:

Each participant had four, one-hour per week sessions of hypnosis. The same physician, with the help of a nurse, conducted every session.

Sample Characteristics:

Ten healthy volunteers and four patients with breast cancer (total 14 patients) with hot flashes were enrolled.

Measurement Instruments/Methods:

All participants recorded frequency, duration, and severity of hot flashes in a hot flash diary.

Results:

The frequency (p < 0.0001), duration (p < 0.0001), and severity (p < 0.0001) of hot flashes were significantly reduced. The overall QOL was also improved (p < 0.05). The participants enjoyed better sleep and had less insomnia (p < 0.012). There was a significant improvement on current fatigue level (p = 0.017), but reduction in the total fatigue level was not statistically significant.

Limitations:

Study limitations included pilot study nature with a very small sample size; mixed healthy participants and people with breast cancer.


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