Publications

Featured Publications

David Spiegel
Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • Tranceformation: Digital dissemination of hypnosis. Neuron Spiegel, D. 2024

    Abstract

    Hypnosis is an underutilized tool despite evidence of efficacy from randomized clinical trials. In this NeuroView, I discuss potential mechanisms in the context of brain networks and propose the use of app-based instruction in self-hypnosis.

    View details for DOI 10.1016/j.neuron.2023.12.010

    View details for PubMedID 38262415

  • Stanford Hypnosis Integrated with Functional Connectivity-targeted Transcranial Stimulation (SHIFT): a preregistered randomized controlled trial NATURE MENTAL HEALTH Faerman, A., Bishop, J. H., Stimpson, K. H., Phillips, A., Gulser, M., Amin, H., Nejad, R., Desouza, D. D., Geoly, A. D., Kallioniemi, E., Jo, B., Williams, N. R., Spiegel, D. 2024; 2 (1)

    View details for DOI 10.1038/s44220-023-00184-z

    View details for Web of Science ID 001390103900003

  • Emotion regulation and choice of bilateral mastectomy for the treatment of unilateral breast cancer. Cancer medicine Zhang, J. X., Kurian, A. W., Jo, B., Nouriani, B., Neri, E., Gross, J. J., Spiegel, D. 2023

    Abstract

    There has been steadily increasing use of bilateral mastectomy (BMX) in the treatment of primary breast cancer (BC). In this study, we utilized functional magnetic resonance imaging (fMRI) to examine the influence of emotion regulation on the decision of newly diagnosed BC patients to choose BMX rather than non-BMX treatments.We recruited 123 women with unilateral BC, 61 of whom received BMX and 62 of whom received non-BMX treatments, and 39 healthy controls. While participants were in the fMRI scanner, we showed them BC-related and non-BC-negative images. In one condition, they were instructed to watch the images naturally. In another, they were instructed to regulate their negative emotion. We compared the fMRI signal during these conditions throughout the brain.With non-BC-negative images as the baseline, BC patients showed greater self-reported reactivity and neural reactivity to BC-related images in brain regions associated with self-reflection than did controls. Among the BC patients, the BMX group showed weaker activation in prefrontal emotion regulation brain regions during emotion regulation than did the non-BMX group.BC patients are understandably emotionally hyper-reactive to BC-related stimuli and those who ultimately received BMX experience more difficulty in regulating BC-related negative emotion than non-BMX BC patients. These findings offer neuropsychological evidence that difficulty in managing anxiety related to the possibility of cancer recurrence is a factor in surgical treatment decision-making and may be an intervention target with the goal of strengthening the management of cancer-related anxiety by nonsurgical means.NCT03050463.

    View details for DOI 10.1002/cam4.5963

    View details for PubMedID 37083300

  • Point of care testing of enzyme polymorphisms for predicting hypnotizability and postoperative pain. The Journal of molecular diagnostics : JMD Cortade, D. L., Markovits, J., Spiegel, D., Wang, S. X. 2023

    Abstract

    Hypnotizability is a stable trait that moderates the benefit of hypnosis for treating pain, but limited availability of hypnotizability testing deters widespread use of hypnosis. Inexpensive genotyping of 4 single nucleotide polymorphisms in the catechol-o-methyltransferase (COMT) gene was performed using giant magnetoresistive biosensors to determine if hypnotizable individuals can be identified for targeted hypnosis referrals. For individuals with the proposed 'optimal' COMT diplotypes, 89.5% score highly on the Hypnotic Induction Profile (OR = 6.12, 95%CI = 1.26-28.75), which identified 40.5% of the treatable population. Mean hypnotizability scores of the optimal group were significantly higher than the total population (p = 0.015 effect size = 0.60), an effect that was present in females (p = 0.0015, effect size = 0.83), but not in males (p = 0.28). In an exploratory cohort, optimal individuals also reported significantly higher postoperative pain scores (p = 0.00030, effect size = 1.93), indicating a greater need for treatment.

    View details for DOI 10.1016/j.jmoldx.2023.01.002

    View details for PubMedID 36702396

  • Brief structured respiration practices enhance mood and reduce physiological arousal. Cell reports. Medicine Balban, M. Y., Neri, E., Kogon, M. M., Weed, L., Nouriani, B., Jo, B., Holl, G., Zeitzer, J. M., Spiegel, D., Huberman, A. D. 2023: 100895

    Abstract

    Controlled breathwork practices have emerged as potential tools for stress management and well-being. Here, we report a remote, randomized, controlled study (NCT05304000) of three different daily 5-min breathwork exercises compared with an equivalent period of mindfulness meditation over 1 month. The breathing conditions are (1) cyclic sighing, which emphasizes prolonged exhalations; (2) box breathing, which is equal duration of inhalations, breath retentions, and exhalations; and (3) cyclic hyperventilation with retention, with longer inhalations and shorter exhalations. The primary endpoints are improvement in mood and anxiety as well as reduced physiological arousal (respiratory rate, heart rate, and heart rate variability). Using a mixed-effects model, we show that breathwork, especially the exhale-focused cyclic sighing, produces greater improvement in mood (p < 0.05) and reduction in respiratory rate (p < 0.05) compared with mindfulness meditation. Daily 5-min cyclic sighing has promise as an effective stress management exercise.

    View details for DOI 10.1016/j.xcrm.2022.100895

    View details for PubMedID 36630953

  • Marital status and survival in cancer patients: A systematic review and meta-analysis. Cancer medicine Krajc, K., Mirosevic, S., Sajovic, J., Klemenc Ketis, Z., Spiegel, D., Drevensek, G., Drevensek, M. 2022

    Abstract

    BACKGROUND: In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival.METHODS: The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT).RESULTS: Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p<0.001), thus confirming results from the previous meta-analysis.CONCLUSIONS: Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.

    View details for DOI 10.1002/cam4.5003

    View details for PubMedID 35789072

  • Effects of hypnosis versus enhanced standard of care on postoperative opioid use after total knee arthroplasty: the HYPNO-TKA randomized clinical trial. Regional anesthesia and pain medicine Markovits, J., Blaha, O., Zhao, E., Spiegel, D. 2022

    Abstract

    BACKGROUND: Hypnosis decreases perioperative pain and has opioid-sparing potential but has not been rigorously studied in knee arthroplasty. This trial investigates the impact of perioperative hypnosis on inpatient opioid use following total knee arthroplasty.METHODS: This prospective randomized controlled trial was conducted at a single academic medical center. The hypnosis arm underwent a scripted 10min hypnosis session prior to surgery and had access to the recorded script. The control arm received hypnosis education only. The primary outcome was opioid use in milligram oral morphine equivalents per 24 hours during hospital admission. A secondary analysis was performed for patients taking opioids preoperatively.RESULTS: 64 primary knee arthroplasty patients were randomized 1:1 to hypnosis (n=31) versus control (n=33) and included in the intent-to-treat analysis. The mean (SD) postoperative opioid use in oral morphine equivalents per 24 hours was 70.5 (48.4) in the hypnosis versus 90.7 (74.4) in the control arm, a difference that was not statistically significant (difference -20.1; 95% CI -51.8 to 11.4; p=0.20). In the subgroup analysis of the opioid-experienced patients, there was a 54% daily reduction in opioid use in the hypnosis group (82.4 (56.2) vs 179.1 (74.5) difference of -96.7; 95% CI -164.4 to -29.0; p=<0.01), equivalent to sparing 65mg of oxycodone per day.CONCLUSION: Perioperative hypnosis significantly reduced inpatient opioid use among opioid-experienced patients only. A larger study examining these findings is warranted.TRIAL REGISTRATION NUMBER: NCT03308071.

    View details for DOI 10.1136/rapm-2022-103493

    View details for PubMedID 35715013

  • Shared cognitive mechanisms of hypnotizability with executive functioning and information salience. Scientific reports Faerman, A., Spiegel, D. 2021; 11 (1): 5704

    Abstract

    In recent years, evidence linked hypnotizability to the executive control and information salience networks, brain structures that play a role in cognitive conflict resolution and perseveration (insisting on applying a previously learned logical rule on a new set). Despite the growing body of neuroimaging evidence, the cognitive phenotype of hypnotizability is not well understood. We hypothesized that higher hypnotizability would correspond to lower perseveration and set-shifting. Seventy-two healthy adults were tested for hypnotizability and executive functions (perseveration and set-shifting). Multiple regression analyses were performed to test the relationship between hypnotizability and perseveration and set-shifting. Higher hypnotizability was associated with lower perseveration after accounting for age and education. Hypnotizability significantly predicted perseveration but not set-shifting. Our results indicate an inverse relationship between trait hypnotizability and perseveration, an executive function that utilizes regions of both the executive control and the salience systems. This suggests that hypnotizability may share a common cognitive mechanism with error evaluation and implementation of logical rules.

    View details for DOI 10.1038/s41598-021-84954-8

    View details for PubMedID 33707531

  • Testing Hypnotizability by Phone: Development and Validation of the Remote Hypnotic Induction Profile (rHIP). The International journal of clinical and experimental hypnosis Kittle, J., Zhao, E., Stimpson, K., Weng, Y., Spiegel, D. 2021; 69 (1): 94–111

    Abstract

    Standard hypnotizability scales require physical contact or direct observation by tester and participant. The authors addressed this limitation by developing and testing the remote Hypnotic Induction Profile (rHIP), a hypnotizability test derived from the Hypnotic Induction Profile that is completed by telephone. To assess the validity of the rHIP, 56 volunteers naive to hypnotizability testing completed both the HIP and the rHIP, with order of testing randomized. Results indicate a strong correlation between HIP and rHIP scores, r s=.71(0.53-0.84), p <.0001, and good concordance, difference=.03(-0.53, 0.59), p =.91, independent of testing order. The rHIP had few complications. Possible advantages of using the rHIP include improving patient expectancy prior to scheduling a hypnosis session, increasing access to hypnotizability testing for remote interventions, and obviating resource-intensive in-person hypnotizability screening for trials that exclude subjects with certain scores.

    View details for DOI 10.1080/00207144.2021.1827937

    View details for PubMedID 33513064

  • When Physicians Engage in Practices That Threaten the Nation's Health. JAMA Pizzo, P. A., Spiegel, D. n., Mello, M. M. 2021

    View details for DOI 10.1001/jama.2021.0122

    View details for PubMedID 33538765

Journal Articles

David Spiegel
Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • Incidence of Depression and Anxiety in Kidney Cancer Survivors: A Nationwide Population-Based Cohort Study. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology Jung, M., Li, M., Choo, E., Lee, S., Spiegel, D., Baiocchi, M., Deng, Z., Li, J., Langston, M. E., Bondy, M. L., Chung, B. I. 2025: OF1-OF9

    Abstract

    Depression and anxiety have a high prevalence among kidney cancer survivors. We aimed to evaluate their cumulative incidence trajectories and associations between kidney cancer diagnosis and incidence of these conditions.This population-based cohort study used the Korean Nationwide Health Insurance and Medical Checkup Linkage Database. We included adults (≥20 years) diagnosed with kidney cancer (2010-2020; i.e., cancer survivors), along with age- and sex-matched noncancer comparators. We quantified the empirical risk trajectory of depression and anxiety for up to 5 years following diagnosis and conducted weighted Cox regressions to estimate time-dependent HRs with 95% confidence intervals (CI) within three time intervals: 0 to 1, 1 to 3, and 3 to 5 years.For the empirical risks, survivors (n = 24,310) had higher risks of depression (2.8% vs. 2.2%) and anxiety (3.3% vs. 2.6%) compared with comparators (n = 173,471). For the associations, survivors (n = 16,049) had an increased hazard of depression (HR = 1.92; 95% CI, 1.52-2.42) and anxiety (HR = 1.63; 95% CI, 1.31-2.02) compared with comparators (n = 100,782) in the first year. During the subsequent 1 to 3 years, survivors experienced an increased hazard of anxiety (HR = 1.32; 95% CI, 1.07-1.62). Trends of decreasing HRs for both disorders were observed across successive time intervals.Kidney cancer survivors had a higher rate of depression and anxiety, especially during the early phase following diagnosis, compared with the noncancer population.Our findings emphasize the need for early identification and treatment of psychiatric disorders, highlighting the integration of mental health care into oncology settings. They also inform future research on prevention and treatment strategies, focusing on timing and high-risk groups.

    View details for DOI 10.1158/1055-9965.EPI-24-1879

    View details for PubMedID 40287950

  • Maladaptive daydreaming should be included as a dissociative disorder in psychiatric manuals: position paper. The British journal of psychiatry : the journal of mental science Soffer-Dudek, N., Somer, E., Spiegel, D., Chefetz, R., O'Neil, J., Dorahy, M. J., Cardeña, E., Mamah, D., Schimmenti, A., Musetti, A., Boon, S., van Dijke, A., Ross, C., Nijenhuis, E., Krause-Utz, A., Dell, P., Gold, S. N., Pietkiewicz, I., Silberg, J., Steele, K., Moskowitz, A., Draijer, N., Thomson, P., Barach, P., Kinsler, P., Maves, P., Şar, V., Krüger, C., Middleton, W. 2025: 1-5

    Abstract

    Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one's life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one's hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.

    View details for DOI 10.1192/bjp.2024.279

    View details for PubMedID 40094484

  • The association between the circadian misalignment of serum cortisol acrophase and sleep end time with chemotherapy-induced peripheral neuropathy. Chronobiology international Shin, J. S., Jung, S., Won, G. H., Lee, S. H., Kim, J., Jung, S., Yeom, C. W., Lee, K. M., Son, K. L., Kim, J. I., Jeon, S. Y., Lee, H. B., Spiegel, D., Hahm, B. J. 2025: 1-11

    Abstract

    Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of chemotherapy. The objective of this prospective observational study was to examine the association between circadian misalignment (CM), as measured by phase angle difference (PAD) of biological and behavioral rhythms and CIPN. The PAD of cortisol acrophase and actigraphy-based sleep end time in breast cancer patients was measured and categorized into low PAD (n = 11) and high PAD (n = 12) groups based on median value. CIPN was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN20 (CIPN20). The assessment of CM revealed that the sleep end time of the low PAD group was more delayed in relation to cortisol acrophase compared to the high PAD group. The low PAD group demonstrated significantly higher CIPN20 global and sensory scale scores compared to the high-PAD group at one month post-chemotherapy, with an estimated group difference of 17.63 ± 4.75 and 27.07 ± 6.70 (p = 0.001 and p < 0.001, respectively). The present findings indicate that the low PAD group, which exhibited a relatively delayed behavioral rhythm with respect to its biological rhythm, displayed an increased susceptibility to CIPN. Further large-sample research is necessary to attain a comprehensive understanding of the mechanisms through which CM affects CIPN.

    View details for DOI 10.1080/07420528.2025.2460643

    View details for PubMedID 39899884

  • A dyadic stress induction tool for experimental investigation of adult patients with cancer and their family caregivers. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine Kim, Y., Carver, C. S., Tsai, T. C., Ting, A., Spiegel, D. 2025; 59 (1)

    Abstract

    Medical illnesses are major stressors not only for the patients but also for their family caregivers, yet existing tools are inadequate to assess mechanistic response patterns to such stressors.We sought to validate a stress induction task that pertains to close relationships and health-related concerns with adult patients with cancer and their family caregivers.Patients newly diagnosed with colorectal cancer (n = 123, 56 years old, 34% female, 60% Hispanic, 6.5 months post-diagnosis) and their family caregivers (55 years old, 66% female, 59% Hispanic) underwent an experimental session during which both individuals imagined a scenario where one person is hit by a car (patient) and the partner (caregiver) has no means to provide or seek out help for the victim. The session consisted of 6 phases: baseline, scenario provision, speech preparation, speech by caregiver, speech by patient, and recovery.Results of general linear modeling with repeated measures revealed that the task induced significant affective, stress, and cardiovascular responses in both patients and caregivers. Stress reactivity and recovery patterns, however, varied by patients versus caregivers, stress induction phases, and the types of assessment.Findings suggest the newly developed stress task as an acceptable tool for studying stress regulation in medical and family contexts. With further validation, this tool may help identify psychological and physiological pathways to improve the stress coping outcomes of adult patients with cancer and their family caregivers.

    View details for DOI 10.1093/abm/kaaf005

    View details for PubMedID 39921341

    View details for PubMedCentralID PMC11805928

  • Emotional Reactivity and Regulation Relate to Surgical Treatment Decision Making Among Newly Diagnosed Women With Breast Cancer. Cancer medicine Benedict, C., Nouriani, B., Neri, E., Miller, K., Kurian, A. W., Gross, J. J., Spiegel, D. 2024; 13 (23): e70357

    Abstract

    Despite bilateral mastectomy (BLM) for early-stage breast cancer (BC) showing no survival benefit and increased risk compared to breast conserving surgery, some patients still choose this treatment. This study examined whether emotion reactivity and regulation influence treatment decision making among newly diagnosed women with breast cancer.Cross-sectional survey data were analyzed as part of a larger study. Measures included the Contralateral Prophylactic Mastectomy (CPM) survey, PROMIS Anxiety scale, and Emotion Regulation Questionnaire (ERQ) Cognitive Reappraisal and Emotional Suppression subscales. Primary analysis included a logistic regression model predicting treatment choice (BLM vs. non-BLM).Participants (N = 137) with unilateral BC (Stages 0-III) were divided between BLM (n = 66) versus breast conserving surgery (i.e., non-BLM, n = 71) treatment groups. Compared to the non-BLM group, the BLM group was younger, more likely to be partnered, and had a higher household income. Women with high levels of BC-specific worry were 3.6 times more likely to choose BLM compared to women with low levels of worry (OR = 3.09, 95% CI: 1.07-0.8.93). Those who used cognitive reappraisal were 10% less likely to choose BLM compared to women who did not use cognitive reappraisal (OR = 0.90, 95% CI: 0.82-0.99). There were no group differences in levels of generalized anxiety (OR = 0.93, 95% CI: 0.87-0.99) or emotional suppression (OR = 1.02, 95% CI: 0.90-1.16).Findings suggest the choice of BLM may be due, in part, to negative emotional experiences after a BC diagnosis and lesser use of reappraisal to reframe cancer-related fears. These may be important targets of intervention to support women making BC treatment decisions.

    View details for DOI 10.1002/cam4.70357

    View details for PubMedID 39653041

  • Hypnosis for Antineoplastic-Related Taste Disturbance in a Patient With Metastatic Breast Cancer. Psycho-oncology Saperia, C., Tran, N., Zewde, N., Spiegel, D. 2024; 33 (12): e70052

    Abstract

    Taste disturbances are prominent side effects of antineoplastic medications and contribute to morbidity and quality-of-life impairment. Few treatment options are available for antineoplastic-related taste disorders. Hypnosis has been found to be effective for a variety of symptoms in the cancer setting, including insomnia, pain, mood disorders and anxiety. Numerous somatosensory perceptual changes have been observed with hypnosis, including perception of tactile stimuli and color. Here, we report a case of a 74-year-old woman with recurrent metastatic breast cancer presenting with an 18-month history of antineoplastic-related hypogeusia. She was treated with hypnosis and reported resolution of taste symptoms after 10 days of daily practice. Her improvement seems to be related to hypnotic changes in somatosensory perception, which may be associated with functional alterations in salience, executive control and default mode networks during hypnosis. Further investigation of hypnosis for antineoplastic-related taste disturbances is indicated.

    View details for DOI 10.1002/pon.70052

    View details for PubMedID 39694869

  • Management of Insomnia NEW ENGLAND JOURNAL OF MEDICINE Palesh, O., Innominato, P., Spiegel, D. 2024; 391 (13): 1260-1261

    View details for DOI 10.1056/NEJMc2410241

    View details for Web of Science ID 001329232900003

  • The associations of spirituality and Hispanic ethnicity with neuroendocrine biomarkers among patients with colorectal cancer. Journal of psychosomatic research Cruz, E., Mendez, A., Ting, A., Spiegel, D., Tsai, T. C., Carver, C. S., Kim, Y. 2024; 185: 111865

    Abstract

    Dealing with cancer evokes not only physical and emotional distress, but may also promote resilience through spirituality. Patients with cancer are vulnerable to neuroendocrine dysregulation. This longitudinal observational study examined the degree to which spirituality was associated with neuroendocrine biomarkers and the moderating role of Hispanic ethnicity.Participants were adults who were recently diagnosed with colorectal cancer (n = 81, 55 years old, 66% male, 63% Hispanic, 72% advanced cancer, 7 months post-diagnosis). The domains of spirituality (faith, meaning, and peace) and ethnicity (Hispanic vs. non-Hispanic) were self-reported. Cortisol and alpha amylase (sAA) were assayed from saliva samples collected at waking and bedtime on seven consecutive days. Mean levels at waking and bedtime, and diurnal slopes over seven days were calculated. Age and cancer stage were covariates.Overall, patients reported moderate to high levels of spirituality. General linear modeling revealed that greater faith was associated with higher levels of sAA at waking and bedtime as well as more blunted diurnal pattern of sAA only among Hispanic patients (p ≤ .045). Greater peace was associated with steeper diurnal pattern of sAA, regardless of ethnicity (B = 0.021, p = .005). Meaning and cortisol were not significantly associated with study variables.Findings indicate that presence of peace facing a cancer diagnosis associated with neuroendocrine regulation, whereas drawing on one's faith, particularly among Hispanic patients, associated with neuroendocrine dysregulation during the first months after the diagnosis. Further investigations of psychobiobehavioral moderators and mediators for healthy neuroendocrine functioning among patients with cancer are warranted.

    View details for DOI 10.1016/j.jpsychores.2024.111865

    View details for PubMedID 39116686

  • Hypnosis facilitates psychosomatic improvement in a patient with treatment-resistant idiopathic tinnitus. The American journal of clinical hypnosis Tran, N., Zewde, N., Spiegel, D. 2024: 1-6

    Abstract

    Chronic tinnitus, also known as phantom sound perception, is a pervasive and often debilitating condition, affecting 15 to 20% of the population. Due to its idiopathic and persistent nature, chronic tinnitus is frequently associated with co-occurring psychiatric disorders as well as decreased sleep and quality of life. Additionally, heterogeneous presentations of tinnitus create challenges for treatment. In this paper, we present a case study of a 70-year-old female patient who presented with severe bilateral tinnitus over a period of 5years. After failing multiple treatment trials such as transtympanic electric stimulation, acupuncture, Eye Movement Desensitization and Reprocessing, and medication, the patient found relief only through hypnotherapy. Results may be explained by alterations in interoceptive processing, increased cognitive flexibility, or somatosensory changes, with corresponding changes in functional neural structures. Given the results of this case study, we recommend hypnosis as an alternative or adjunct to current treatment modalities for tinnitus and further investigation in this area.

    View details for DOI 10.1080/00029157.2024.2379284

    View details for PubMedID 39051968

  • Differential effects of desvenlafaxine on hot flashes in women with breast cancer taking tamoxifen: a randomized controlled trial. NPJ breast cancer Kim, Y., Yeom, C. W., Lee, H. J., Kim, J. H., Lee, K. M., Kim, T. Y., Lee, H. B., Kim, H., Im, S. A., Lee, K. H., Kim, M., Han, W., Moon, H. G., Spiegel, D., Hahm, B. J., Son, K. L. 2024; 10 (1): 59

    Abstract

    Hot flashes (HF) are a common adverse event of prolonged tamoxifen use in women with estrogen receptor-positive breast cancer, impacting psychiatric health and quality of life. While desvenlafaxine does not interact with tamoxifen, its efficacy and safety in breast cancer patients remain unstudied. This phase 3, four-week, multi-center, three-arm, parallel-group, randomized, double-blind, placebo-controlled trial investigated the efficacy and safety of desvenlafaxine for treating HF in women with breast cancer taking tamoxifen, assessing potential differential effects in patients with psychiatric and inflammatory conditions. Between December 2017 and February 2019, 57 women aged 19 or older, regularly taking tamoxifen as adjuvant therapy, experiencing moderate-to-severe HFs for more than a month, were randomized to receive desvenlafaxine 50 mg/day (D-50), desvenlafaxine 100 mg/day (D-100), or placebo for four weeks. The primary endpoint was the change rate in HF scores over four weeks, with adverse events as a secondary endpoint. Both desvenlafaxine arms demonstrated greater HF score reductions compared to placebo: D-50 (2.20 points/week, 95% CI: 0.71, 3.68) and D-100 (2.34 points/week, 95% CI: 0.92, 3.76). Notably, D-50 arm showed significantly greater efficacy in patients with depression or elevated inflammation. Desvenlafaxine offers an effective and safe treatment regimen for HF in women with breast cancer taking tamoxifen. The presence of depression and inflammation may guide optimal desvenlafaxine dosing. (Trial Registration: ClinicalTrials.gov Identifier: NCT02819921).

    View details for DOI 10.1038/s41523-024-00668-w

    View details for PubMedID 39019875

    View details for PubMedCentralID 4603551

Conference Proceedings

David Spiegel
Jack, Lulu and Sam Willson Professor of Medicine

Publications

  • DYADIC INVESTIGATION OF POST-TRAUMATIC STRESS SYMPTOMS AND DAILY SLEEP HEALTH IN PATIENTS WITH CANCER AND THEIR CAREGIVERS Tsai, T., Mitchell, H., Zeitzer, J., Ting, A., Laurenceau, J., Spiegel, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2024: A182

    View details for Web of Science ID 001290655500443

  • Association of childhood trauma with choice of bilateral mastectomy for the treatment of unilateral breast cancer. Jagielo, A. D., Benedict, C., Zewde, N., Neri, E., Nouriani, B., Spiegel, D. LIPPINCOTT WILLIAMS & WILKINS. 2024

    View details for Web of Science ID 001275557405869

  • THE EFFECTS OF DYADIC STRESS REGULATION ON DAILY SLEEP HEALTH AMONG ADULT PATIENTS WITH CANCER AND THEIR SLEEP-PARTNER CAREGIVERS Kim, Y., Tsai, T., Moulder, R., Ting, A., Gonzalez, A., Spiegel, D. LIPPINCOTT WILLIAMS & WILKINS. 2024: A153

    View details for Web of Science ID 001290655500374

  • DYADIC ASSOCIATIONS OF SELF-REGULATION WITH CARDIOVASCULAR STRESS RESPONSES AMONG PATIENTS WITH CANCER AND THEIR CAREGIVERS Tsai, T., Hurwitz, B., Spiegel, D., Ortega, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2024: A141

    View details for Web of Science ID 001290655500345

  • ROADMAP TO PARENTHOOD' DECISION AID AND PLANNING TOOL FOR FAMILY BUILDING AFTER CANCER: RESULTS OF A SINGLE-ARM PILOT STUDY Benedict, C., Ford, J. S., Schapira, L., Davis, A. M., Simon, P., Spiegel, D., Diefenbach, M. A. OXFORD UNIV PRESS INC. 2024: S153

    View details for Web of Science ID 001271352800306

  • POSTER SESSION D: PILOT STUDY OF 'ROADMAP TO PARENTHOOD' DECISION AID AND PLANNING TOOL FOR FAMILY BUILDING AFTER CANCER Benedict, C., Simon, P., Spiegel, D., Kurian, A. W., Alvero, R., Berek, J. S., Philip, E. J., Schapira, L. OXFORD UNIV PRESS INC. 2023: S533

    View details for Web of Science ID 001042977901464

  • Changing Cancer Mindsets: A Randomized Controlled Feasibility and Efficacy Trial Zion, S., Schapira, L., Berek, J., Spiegel, D., Dweck, C., Crum, A. WILEY. 2023: 17

    View details for Web of Science ID 000947888900033

  • CARDIOVASCULAR COREGULATION TO A SERIES OF ACUTE INTERPERSONAL STRESSORS: INNOVATIVE METHODOLOGICAL APPROACH TO STUDYING REGULATION TO A CHRONIC ILLNESS IN THE FAMILY Moulder, R., Tsai, T. C., Hurwitz, B., Spiegel, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2022: A38

    View details for Web of Science ID 000804854700122

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