Mindfulness-based stress reduction for people with multiple sclerosis – a feasibility randomised controlled trial

Simpson, R., Mair, F. S. and Mercer, S. W. (2017) Mindfulness-based stress reduction for people with multiple sclerosis – a feasibility randomised controlled trial. BMC Neurology, 17, 94. (doi: 10.1186/s12883-017-0880-8) (PMID:28511703) (PMCID:PMC5434553)

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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. Trial registration: ClinicalTrials.gov Identifier NCT02136485; trial registered 1st May 2014.

• Item Type: Articles
• Additional Information: This project was funded by the Scottish Homeopathic Research and Educational Trust (SC006557).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mercer, Professor Stewart and Mair, Professor Frances and Simpson, Dr Robert
• Authors: Simpson, R., Mair, F. S., and Mercer, S. W.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: BMC Neurology
• Publisher: BioMed Central
• ISSN: 1471-2377
• ISSN (Online): 1471-2377
• Copyright Holders: Copyright © 2017 The Authors
• First Published: First published in BMC Neurology 17:94
• Publisher Policy: Reproduced under a Creative Commons License