Please select the eligibility criteria that correspond to the clinical trial below.
Title: Mindfulness Training to Improve Mental Health, Stress and Performance In Physicians
Brief Summary: Background:

Burnout and overwhelming stress are growing issues among surgeons and are associated with mental illness, attrition and diminished patient care. Among surgical trainees, burnout and distress are alarmingly prevalent but high inherent mindfulness has been shown to decrease the risk of depression, suicidal ideation, burnout and overwhelming stress by more than 75%. In other high-stress populations formal mindfulness training has been shown to improve mental health and buffer overwhelming stress and yet this approach has not been tried in surgery.

The aim of this study is to evaluate feasibility and acceptability of modified mindfulness-based stress reduction (MBSR) training among PGY-1 surgery residents and to obtain initial evidence of efficacy in regard to well-being and performance.

Design: A pilot randomized clinical trial of modified MBSR versus an active control.

Setting: Residency training program, tertiary academic medical center.

Participants: PGY-1 surgery residents.

Intervention:

Weekly two-hour modified MBSR classes (compared to an active control) and 20 minutes of suggested daily home practice over an eight-week period.

Main Outcomes and Measures:

Primary outcome is feasibility, assessed along six domains (demand, implementation, practicality, acceptability, adaptation and integration), using focus groups, interviews, surveys, attendance, daily practice time and subjective self-report of experience.

Secondary outcomes include perceived stress, mindfulness and executive function (specifically working memory capacity), followed by psychosocial well-being (burnout, depression, resilience), performance (motor skills testing) and functional brain scans focused on areas associated with reappraisal as a surrogate for emotional control.

This study seeks to demonstrate the feasibility of mindfulness training in surgery PGY-1s while simultaneously providing preliminary quantitative data on the effects of mindfulness training in a randomized, controlled setting. Data will inform modifications to the MBSR curriculum that enhance feasibility and inform sample size calculations for subsequent, adequately-powered RCTs which will likely need to be multi-center trials.

Results could potentially impact formal medical training, the mental health of providers at every level, and the overall quality of patient care.


Options:
A: Inclusion Criteria:

* UCSF surgical interns entering training. Do not meet exclusion criteria.

Exclusion Criteria:

* Current personal mindfulness practice, medications with CNS effects, lifetime history of a mental disorder, acute or chronic immune or inflammatory disorders, pregnancy, breast-feeding or implanted MRI-incompatible metal.
B: Inclusion Criteria:

* age ≥ 18 years
* DSM-IV-TR diagnoses of BPD and PTSD
* legal competence
* none or stable medication
* illegal drug abstinence for at least the last 6 months
* capacity to consent and contract

Exclusion Criteria:

* other severe mental disorders (e.g., bipolar disorder, acute psychosis)
* simultaneous consumption of drugs
* simultaneous participation in other treatment-studies
* pregnancy or breastfeeding
* lack of capability to negotiate a no-suicide agreement
* suicide attempt or attempts during the 8 weeks prior to start of treatment
* perpetrator-contact
* Body Mass Index (BMI) \< 16
C: Inclusion Criteria:

* Being enrolled in fourth or fifth year medical study
* Having signed the informed consent
* Being able to attend all scheduled visits and comply with all trial procedures

Exclusion Criteria:

* Suffering from a current depressive episode according to DSM-5 criteria
* Suffering from a current panic disorder according to DSM-5 criteria
* Pregnancy
* Exclusion period in relation to another protocol
* Not being affiliated to the French National Social Security System
* Having reached 4500 € annual compensation for participation in clinical trials
* Protection by law (guardianship or curatorship)
* Deprivation of liberty (by judicial or administrative decision)
* Planned longer stay outside the region that prevents compliance with the visit plan
* For Paris students : participation in the optional teaching "Pleine conscience et médecine" (organized by Cloé Brami)
* For Tours students : participation in the optional teaching on meditation organized by the faculty of medicine
* For Strasbourg students : participation in the optional teaching on meditation (organized by Pr Bloch)
D: Inclusion Criteria:

* Meet a minimum of 4 DSM-5 BPD criteria
* Have parent's or parent substitute's commitment and ability to participate in the MBT-Parents program.
* Score 67\< BPFS-C

Exclusion Criteria:

* Comorbid diagnosis of pervasive developmental disorder, learning disability (75 \< IQ), anorexia, current psychosis, diagnosis of schizophrenia or schizotypal personality disorder, antisocial personality disorder as well as any other axis-I or axis-II psychopathology considered to be the primary diagnosis.
* Current psychiatric inpatient treatment
* Current (past two months) substance dependence (but not substance misuse)
* Participation in concurrent psychotherapeutic treatment outside the MBT program
* Not able to speak Danish
* Lack of informed consent

Answer: A