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- Title
Mindfulness-based stress reduction for people with multiple sclerosis - a feasibility randomised controlled trial.
- Authors
Simpson, Robert; Mair, Frances S.; Mercer, Stewart W.
- Abstract
<bold>Background: </bold>Multiple sclerosis (MS) is a stressful condition. Mental health comorbidity is common. Stress can increase the risk of depression, reduce quality of life (QOL), and possibly exacerbate disease activity in MS. Mindfulness-Based Stress Reduction (MBSR) may help, but has been little studied in MS, particularly among more disabled individuals.<bold>Methods: </bold>The objective of this study was to test the feasibility and likely effectiveness of a standard MBSR course for people with MS. Participant eligibility included: age > 18, any type of MS, an Expanded Disability Status Scale (EDSS) </= 7.0. Participants received either MBSR or wait-list control. Outcome measures were collected at baseline, post-intervention, and three-months later. Primary outcomes were perceived stress and QOL. Secondary outcomes were common MS symptoms, mindfulness, and self-compassion.<bold>Results: </bold>Fifty participants were recruited and randomised (25 per group). Trial retention and outcome measure completion rates were 90% at post-intervention, and 88% at 3 months. Sixty percent of participants completed the course. Immediately post-MBSR, perceived stress improved with a large effect size (ES 0.93; p < 0.01), compared to very small beneficial effects on QOL (ES 0.17; p = 0.48). Depression (ES 1.35; p < 0.05), positive affect (ES 0.87; p = 0.13), anxiety (ES 0.85; p = 0.05), and self-compassion (ES 0.80; p < 0.01) also improved with large effect sizes. At three-months post-MBSR (study endpoint) improvements in perceived stress were diminished to a small effect size (ES 0.26; p = 0.39), were negligible for QOL (ES 0.08; p = 0.71), but were large for mindfulness (ES 1.13; p < 0.001), positive affect (ES 0.90; p = 0.54), self-compassion (ES 0.83; p < 0.05), anxiety (ES 0.82; p = 0.15), and prospective memory (ES 0.81; p < 0.05).<bold>Conclusions: </bold>Recruitment, retention, and data collection demonstrate that a RCT of MBSR is feasible for people with MS. Trends towards improved outcomes suggest that a larger definitive RCT may be warranted. However, optimisation changes may be required to render more stable the beneficial treatment effects on stress and depression.<bold>Trial Registration: </bold>ClinicalTrials.gov Identifier NCT02136485 ; trial registered 1st May 2014.
- Subjects
MINDFULNESS-based cognitive therapy; PREVENTION of psychological stress; MULTIPLE sclerosis; QUALITY of life; RANDOMIZED controlled trials; COMORBIDITY; PATIENTS; ANXIETY treatment; TREATMENT of psychological stress; ANXIETY; MENTAL depression; EXPERIMENTAL design; MENTAL health; HEALTH outcome assessment; PEOPLE with disabilities; PSYCHOLOGICAL stress; ANXIETY disorders; MINDFULNESS; DISEASE complications
- Publication
BMC Neurology, 2017, Vol 17, p1
- ISSN
1471-2377
- Publication type
journal article
- DOI
10.1186/s12883-017-0880-8