Psychological stress and emotional well-being are important targets for multiple sclerosis (MS) research and clinical care. Mood disorders can adversely impact functioning, quality of life, and treatment adherence, and increase the risk of suicide.
Patients with multiple sclerosis (MS) are more prone to mood disorders, which can adversely impact functioning, quality of life, and treatment adherence, and increase the risk of suicide. These outcomes mean psychological stress and emotional well-being are important targets for MS research and clinical care.
A new study in the Multiple Sclerosis Journal analyzed the feasibility and efficacy of mindfulness-based stress reduction (MBSR) for people with MS as a therapeutic intervention to manage stress and enhance emotional well-being.
“Mindfulness-based interventions have shown benefit for a variety of symptoms associated with MS (anxiety, depression, pain, fatigue, physical function), but their use with MS populations has been limited,” the authors noted.
A total of 67 patients were included in the study. To be eligible, patients had to be at least 18 years old, have an Expanded Disability Status Scale score of £8, be stable on medication for 3 months, have a score of at least 10 on the Perceived Stress Scale, and be able to read and write English.
The patients were randomized to either the MBSR group (n = 33) or the control group (n = 34). Both groups attended 8 weekly 2-hour classes and a 6-hour retreat during week 6. The MBSR participants learned how to bring mindfulness into their daily practice and received instruction that included a variety of techniques, such as gentle yoga, breath work, and body scans.
The control for the study was the MS Education protocol. This group had classes structured around pamphlets with information that included medication and supplements, fatigue, pain, cognition and mood, and connecting with resources.
Assessments were conducted at baseline, after 4 weeks of class, and after 8 weeks of class, as well as 4, 8, and 12 months after the intervention ended. The primary and secondary end points were 8 weeks and 12 months, respectively.
Overall, 59 participants completed the 8-week assessment and 56 patients completed the 12-month assessment. The primary outcome of the study was to assess feasibility. The study met the goal of enrolling 60 patients within a 10-month period, as well as the goals of having more than 85% of patients attending at least 6 classes and at least 70% of patients completing the 12-month assessment. In the MBSR arm, 30 patients turned in practice logs that indicated they had practiced outside of classes.
Participants in the MBSR arm showed greater improvement in the secondary outcomes, which were clinical measures related to MS, but the differences in scores between the 2 groups were not statistically significant. Both groups showed improvements in perceived stress, anxiety, depression, fatigue, and resilience scores at 8 weeks and 12 months compared with baseline.
“Spontaneous improvement cannot be ruled out as an explanation for improvement with either intervention, and larger studies to determine efficacy that simultaneously compare mindfulness training to both active and passive controls appear to be warranted,” the authors concluded.
Senders A, Hanes D, Bourdette D, Carson K, Marshall LM, Shinto L. Impact of mindfulness-based stress reduction for people with multiple sclerosis at 8 weeks and 12 months: a randomized clinical trial [published July 9, 2018]. Mult Scler. 2018. doi: 10.1177/1352458518786650.