A mindfulness-based program helped people with multiple sclerosis [MS] improve quality of life, depression and fatigue in a randomized controlled trial published in the journal Neurology (2010; 75, 1141–49). Researchers from University Hospital Basel and the University of Basel, Switzerland, undertook the study to determine whether mindfulness training could improve health-related quality of life in patients with MS. This is the most common nontraumatic neurological disease among young adults in both Europe and the United States, and current medical management programs generally do not address the aspects of well-being examined in this study.
Researchers randomized 150 subjects with mild to moderate MS into either a usual-care [UC] group or a mindfulness-based intervention [MBI] group. Four MBI subjects did not finish the study; seven UC participants also dropped out. Investigators assessed health-related quality of life, depression and fatigue at baseline, at the end of the intervention and 6 months later.
The mindfulness intervention closely followed the program developed by Jon Kabat-Zinn, PhD, with modifications for patients with MS. Components included a personal intake interview; eight weekly 21/2-hour mindfulness classes to teach subjects how to develop nonjudgmental awareness of the present moment; one 7-hour session at week 6; daily homework assignments, such as journaling; and a post-intervention interview. The UC group received the usual care provided by the hospital’s neurology department: a medical examination at baseline and another at the end of the program.
Data analysis revealed that MBI participants improved significantly across all categories, while UC subjects showed a slight decline on most measures. Improvements were strongest for those with depressive symptoms, who were able to reduce symptoms by more than 30%. At the 6-month follow-up, improvements persisted in all categories with some reduction, except in fatigue, which remained at the same level of improvement seen immediately after the 8-week MBI.
“Unfortunately, the treatments that help slow the disease process have little effect on people’s overall quality of life, fatigue or depression. So any complementary treatments that can quickly and directly improve quality of life are very welcome,” said lead study author Paul Grossman, PhD, of University Hospital Basel. Editorialists Jinny Tavee and Lael Stone from the American Academy of Neurology, which publishes Neurology, wrote, “The results of this solidly designed study underscore the importance of treatment directed at quality of life issues in patients with MS and provide level III evidence that mindfulness-based meditation is a helpful therapeutic option.”
Limitations of the study included the fact that components of the MBI program were not isolated, so it was not clear which aspect or whether all aspects of the integrated program led to the outcome. More research was recommended.