Wednesday, December 29, 2010

MS Quality of Life, Depression, and Fatigue Improve After Mindfulness Training: A Randomized Trial

There's a new study looking at a mindfulness-based treatment in a medical setting. A group of researchers in Switzerland recently published a study in Neurology assessing a mindfulness-based intervention for people with multiple sclerosis (MS). MS is a neurological disease. According to the article, people with MS have high rates of depression, anxiety, fatigue, and what they call health-related quality of life. 

Dr. Paul Grossman and colleagues randomized 164 people with MS in a neurology clinic at the University Hospital Basel to one of two conditions: 1.) an 8-week mindfulness-based intervention; 2.) usual care, in which they continued to receive medical care but had no behavioral intervention.

According the researchers, the mindfulness-based intervention was based on Mindfulness-Based Stress Reduction (MBSR). I'm not clear how their intervention differs from MBSR. From the description, the intervention seemed at have the major elements of MBSR. Outcomes were assessment prior to the intervention, after the 8-week mindfulness-based intervention, and at 6-month follow-up. The usual care group was offered the mindfulness-based intervention after the 6-month follow-up.

In addition to assessing anxiety, depression, and health-related quality of life, the researchers also conducted a neurological assessment. People with MS in the mindfulness-based intervention exhibited significant reductions in depression, anxiety, and fatigue. The improvements remained significant at the 6-month follow-up; however, there was some loss in the gains or "slippage" for health-related quality of life and depressive symptoms between the end of the intervention and the follow-up. The authors suggest that booster sessions may be necessary in order to maintain treatment gains. People appeared to respond favorably to the mindfulness-based intervention; attrition rates were low and people reported high goal satisfaction.

Although cognitive behavioral interventions have been shown to improve depression, anxiety, and fatigue in people with MS, these interventions were delivered individually. As it is a group intervention, the mindfulness-based intervention may be more cost effective than the existing cognitive behavioral treatments.

As the authors note, however, because the mindfulness-based intervention wasn't compared against another intervention, it remains uncertain if factors non-specific to the treatment (e.g., placebo, social support) may be responsible for the improvements more than the treatment itself. Nonetheless, this study adds to the growing literature suggesting mindfulness-based, group-administered treatments may be helpful for people with difficult medical conditions.

To download a copy of the article, click on the citation below:

Grossman, P., Kappos, L., Gensicke, H., D'Souza, Mohr, D.C., et al. (2010). MS Quality of Life, Depression, and Fatigue Improve After Mindfulness Training: A Randomized Trial. Neurology, 75, 1141-1149.

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.