A mindful group intervention in people newly diagnosed with multiple sclerosis: a pilot study
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Mult Scler Relat Disord. May 8, 2021; 52: 103016. doi: 10.1016 / j.msard.2021.103016. Online before printing.
BACKGROUND: Recurrent MS (RMS) is a lifelong disease with no cure, usually diagnosed between the ages of 20 and 40. Being newly diagnosed with RMS is a very stressful event due to the unpredictable course of the disease after diagnosis. It is therefore imperative that people with MS have the skills and support to cope with the negative physical and emotional effects of the disease. The aim of this study was to assess whether a mindfulness-based intervention (MBI) would improve coping skills and thereby reduce the negative consequences of stress due to a new diagnosis of RMS.
METHODS: This was a prospective, randomized, single-blind (evaluator) study of 10-week MBI compared to usual standard of care in people newly diagnosed (within one year) with RMS, recruited from a tertiary MS clinic in London (ON), Canada. The MBI was administered in groups with a trained MBI facilitator. Primary outcomes included the Brief COPE measure and the Hospital Anxiety and Depression Scale (HADS) subscales. Secondary outcomes included measures of perceived stress, cognitive function, fatigue, and quality of life. Exploratory (tertiary) findings included serum markers of inflammation and stress. Subjects were assessed at baseline, after surgery (or equivalent) and 6 months later. Multivariate repeated measures analysis of covariance (MANCOVA) was used, with baseline scores used as covariates and test scores, to compare longitudinal changes immediately after MBI sessions and 6 months later.
RESULTS: Twenty-five subjects were recruited (16 MBI, 9 controls) for two MBI interventions (fall and spring) over 1.5 years. All controls completed the study, while 4 MBI participants did not, leaving 21 subjects in the analysis. Most were female (17, 81%), with a mean age of 37.1 ± 9.4 years. Two-thirds had already started DMT at the time of consent; the median EDSS was 2.0 (0.0-4.0). The groups were well matched on baseline characteristics except for months since diagnosis (MBI 6.4 ± 6.5 vs. control 3.6 ± 2.8, p = 0.023). All controls completed the study, while 4 MBI participants did not. The MBI group improved significantly on the COPE measure compared to the control group (p = 0.024) before and after the intervention; the MBI group also improved significantly on the HADS depression subscale (p = 0.007). There was no significant difference over time on the HADS anxiety subscale (p = 0.179). The size of the effect on COPE was 0.56 and 0.40 on HADS-D. On the secondary outcomes, there was a significant improvement on the perceived stress scale (p = 0.015). The exploratory results were not significantly different. None of the results were significant at the six-month follow-up.
Conclusion: This pilot study demonstrates that an MBI can improve coping, depression, and perceived stress in people newly diagnosed (within one year) with short-term RMS. Future research to confirm these results, as well as to investigate further steps to extend benefit beyond immediate intervention.