Summary
Health-related quality of life (HRQOL) is often much reduced among individuals with multiple sclerosis (MS), and incidences of depression, fatigue, and anxiety are high. Authors examined effects of a mindfulness-based intervention (MBI) compared to usual care (UC) upon HRQOL, depression, and fatigue among adults with relapsing-remitting or secondary progressive MS. P. Grossman P. Grossman, PhD, L. Kappos, MD, H. Gensicke, MD, M. D'Souza, MD, D.C. Mohr, PhD, I.K. Penner, PhD and C. Steiner, MS. Neurology. 2010;75:1141-1149
Details
The largest study of its kind shows that mindfulness-based
meditation significantly improved health-related quality of life,
depression, and fatigue in a study involving 150 people with
relapsing-remitting and secondary-progressive MS. This controlled
study provides important evidence on the value of an alternative
treatment for MS symptoms, and highlights the importance of
focusing on quality of life issues to improve well being.
Depression and fatigue are common symptoms of MS and can
interfere with quality of life. These and other psychosocial
impacts of MS can adversely affect what is known as
health-related quality of life (HRQOL) or sense of well-being,
and their intensity is often independent of the physical aspects
of any individual’s disease. Although the disease-modifying
therapies for MS can impact the disease course, they do not
usually cause significant improvement in an individual’s HRQOL.
For this study, investigators focused on whether a type of
meditation, called mindfulness-based intervention, could improve
well being in people with MS. This form of meditation is mental
training aimed at changing an individual’s perception, creating
awareness and acceptance of moment-to-moment experiences, with
the goal of reducing reactions that may worsen any pain or
emotional distress that occurs from health-related changes.
In this largest study of its kind in MS, a total of 150
participants with relapsing-remitting or
secondary-progressive MS were enrolled. Seventy-six were randomly
assigned to receive weekly 2½-hour group training sessions in
mindfulness-based intervention (MBI) for eight weeks, plus one
all-day session and practice homework. A control group of 74
people received regular medical care. Health-related quality of
life, depression, and fatigue were assessed using various
questionnaires before the study, after the eight weeks of
training, and after another six months. Secondary outcomes
included anxiety, personal goal attainment, and adherence to
homework.
After eight weeks, participants improved significantly more in
the MBI group than in the control group across all outcome
measures (except for perceived limb mobility). The benefits
remained significant at the six-month follow-up, but were less
than at the eight-week endpoint. In a subgroup of people who
scored worse on scales for depression, fatigue, and anxiety
before the study, this group showed an even greater degree of
improvement.