Introduction
Medical students present a high prevalence of stress, related to factors such as academic overload, limited time for self-care, and early exposure to emotionally demanding situations. When persistent, this stress may impair academic performance, mental health, and future professional practice. Mindfulness, defined as the self-regulation of attention with non-judgmental awareness of the present moment, has demonstrated recognized therapeutic potential. Evidence suggests that strategies such as Mindfulness-Based Stress Reduction (MBSR), when practiced regularly, can reduce stress, anxiety, and depressive symptoms while promoting emotional regulation and empathy. This study evaluated the effects of an adapted MBSR protocol, specifically designed for medical students, on perceived stress and inflammatory marker modulation.
Methods
A prospective, longitudinal, controlled study was conducted with 26 medical students from Faculdade de Medicina do ABC (13 in the intervention group; 13 in the control group). The intervention involved six weekly 1.5-hour sessions of mindfulness-based practices. Assessments were conducted before and after the intervention. Subjective outcomes included the Perceived Stress Scale (PSS-10), the Cognitive and Affective Mindfulness Scale–Revised (CAMS-R), and the Philadelphia Mindfulness Scale (PHLMS). Biological outcomes included serum levels of cortisol, TNF-α, IL-6, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Participants who missed more than one session, failed to provide lab samples, or did not complete the questionnaires were excluded.
Results and Discussion
Twelve participants completed the study (six per group), resulting in a dropout rate of 53.9%. Attrition was likely related to emotional discomfort during mindfulness practices and overlap with final exams, which may also have influenced outcomes. Still, significant and literature-aligned differences were observed.
In the intervention group, perceived stress decreased by 53.35%, while it increased by 6.29% in controls. CAMS-R scores showed a progressive increase in mindfulness traits (+45.16% intervention vs. +21.18% control). On the PHLMS, notable increases were observed in acceptance (+21.12% intervention vs. +2.55% control) and awareness (+20% intervention vs. −16.82% control), suggesting enhanced emotional stability and mental presence among mindfulness practitioners, even under academic pressure.
Regarding biological outcomes, CRP levels dropped markedly in the intervention group (−53.37%) but rose in controls (+20%), indicating favorable inflammatory modulation. ESR rose slightly in the intervention group (+3.95%) but sharply in controls (+65.09%). IL-6 increased in both groups, though less in the intervention group (+31.88% vs. +117.32%). Interestingly, TNF-α rose sharply in the intervention group (+527.36%), possibly reflecting acute inflammatory responses to emotional release during practices. Cortisol levels decreased similarly in both groups (~6.5%).
Conclusions
Despite the small sample size and high dropout rate, regular engagement in the protocol's activities proved to be an effective and accessible strategy for reducing perceived stress, enhancing mindfulness, and modulating inflammatory markers in medical students. Although more robust studies are needed, the findings support the inclusion of mindfulness as a complementary tool in mental health promotion. Moreover, the adapted protocol shows potential for standardization and integration into university extension programs. Its implementation may contribute to the development of emotionally intelligent, resilient, and compassionate physicians, with a positive impact on patient care and professional sustainability.
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