Dataset Information

Mindfulness based interventions in multiple sclerosis--a systematic review.

ABSTRACT:

Background

Multiple sclerosis (MS) is a stressful condition; depression, anxiety, pain and fatigue are all common problems. Mindfulness based interventions (MBIs) mitigate stress and prevent relapse in depression and are increasingly being used in healthcare. However, there are currently no systematic reviews of MBIs in people with MS. This review aims to evaluate the effectiveness of MBIs in people with MS.

Methods

Systematic searches were carried out in seven major databases, using both subject headings and key words. Papers were screened, data extracted, quality appraised, and analysed by two reviewers independently, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Perceived stress was the primary outcome. Secondary outcomes include mental health, physical health, quality of life, and health service utilisation. Statistical meta-analysis was not possible. Disagreements were adjudicated by a third party reviewer.

Results

Three studies (n = 183 participants) were included in the final analysis. The studies were undertaken in Wales (n = 16, randomised controlled trial - (RCT)), Switzerland (n = 150, RCT), and the United States (n = 17, controlled trial). 146 (80%) participants were female; mean age (SD) was 48.6 (9.4) years. Relapsing remitting MS was the main diagnostic category (n = 123, 67%); 43 (26%) had secondary progressive disease; and the remainder were unspecified. MBIs lasted 6-8 weeks; attrition rates were variable (5-43%); all employed pre- post- measures; two had longer follow up; one at 3, and one at 6 months. Socio-economic status of participants was not made explicit; health service utilisation and costs were not reported. No study reported on perceived stress. All studies reported quality of life (QOL), mental health (anxiety and depression), physical (fatigue, standing balance, pain), and psychosocial measures. Statistically significant beneficial effects relating to QOL, mental health, and selected physical health measures were sustained at 3- and 6- month follow up.

Conclusion

From the limited data available, MBIs may benefit some MS patients in terms of QOL, mental health, and some physical health measures. Further studies are needed to clarify how MBIs might best serve the MS population.

SUBMITTER: Simpson R

PROVIDER: S-EPMC3900731 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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Publications

Mindfulness based interventions in multiple sclerosis--a systematic review.

Simpson Robert R Booth Jo J Lawrence Maggie M Byrne Sharon S Mair Frances F Mercer Stewart S

BMC neurology 20140117

<h4>Background</h4>Multiple sclerosis (MS) is a stressful condition; depression, anxiety, pain and fatigue are all common problems. Mindfulness based interventions (MBIs) mitigate stress and prevent relapse in depression and are increasingly being used in healthcare. However, there are currently no systematic reviews of MBIs in people with MS. This review aims to evaluate the effectiveness of MBIs in people with MS.<h4>Methods</h4>Systematic searches were carried out in seven major databases, us ...[more]

PMID: 24438384

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Project description:BackgroundMindfulness-based interventions (MBIs) are becoming increasingly popular for helping people with physical health conditions. Expanding from traditional face-to-face program delivery, there is growing interest in Web-based application of MBIs, though Web-based MBIs for people with physical health conditions specifically have not been thoroughly reviewed to date.ObjectiveThe objective of this paper was to review Web-based MBIs for people with physical health conditions and to examine all outcomes reported (eg, efficacy or effectiveness for physical changes or psychological changes; feasibility).MethodsDatabases PubMed, PsycINFO, Science Direct, CINAHL Plus, and Web of Science were searched. Full-text English papers that described any Web-based MBI, examining any outcome, for people with chronic physical health conditions were included. Randomized, nonrandomized, controlled, and uncontrolled trials were all included. Extracted data included intervention characteristics, population characteristics, outcomes, and quality indicators. Intervention characteristics (eg, synchronicity and guidance) were examined as potential factors related to study outcomes.ResultsOf 435 publications screened, 19 published papers describing 16 studies were included. They examined Web-based MBIs for people with cancer, chronic pain or fibromyalgia, irritable bowel syndrome (IBS), epilepsy, heart disease, tinnitus, and acquired brain injury. Overall, most studies reported positive effects of Web-based MBIs compared with usual care on a variety of outcomes including pain acceptance, coping measures, and depressive symptoms. There were mixed results regarding the effectiveness of Web-based MBIs compared with active control treatment conditions such as cognitive behavioral therapy. Condition-specific symptoms (eg, cancer-related fatigue and IBS symptoms) targeted by treatment had the largest effect size improvements following MBIs. Results are inconclusive regarding physical variables.ConclusionsPreliminary evidence suggests that Web-based MBIs may be helpful in alleviating symptom burden that those with physical health conditions can experience, particularly when interventions are tailored for specific symptoms. There was no evidence of differences between synchronous versus asynchronous or facilitated versus self-directed Web-based MBIs. Future investigations of Web-based MBIs should evaluate the effects of program adherence, effects on mindfulness levels, and whether synchronous or asynchronous, or facilitated or self-directed interventions elicit greater improvements.

Project description:Objectives: With this systematic review we aim to provide an overview of the evidence of the effect of Mindfulness Based Interventions (MBIs) on (1) tinnitus distress and (2) anxiety and/or depression in tinnitus patients. Methods: We conducted a systematic search in PubMed Medline, EMBASE and PsycInfo combining the terms and synonyms of "Tinnitus" and "Mindfulness." The most recent search was performed on December 4th 2018. We wrote this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two independent authors identified studies, assessed the risk of bias and extracted data. Studies were considered eligible if they included adults with tinnitus, performed a protocolled MBI and measured tinnitus distress with validated questionnaires. Studies were appraised with either the Cochrane Risk of Bias tool or the MINORS criteria, depending on their design. Results: The systematic search yielded seven articles (425 patients). Three randomized controlled trials (RCTs), three cohort studies and one comparative controlled trial. Different types of MBIs, including MBCT and MBSR, were assessed with various questionnaires. Two of three RCTs showed a statistically significant decrease in tinnitus distress scores directly after treatment in the mindfulness group compared to the control group. Six of seven studies showed statistically significant decrease in tinnitus distress scores directly after mindfulness therapy. One of three RCTs showed a statistically significant improvement of depression questionnaire scores after MBI compared to the control group directly post treatment. Conclusions: A decrease of tinnitus distress scores in MBIs can be observed directly post-therapy based on moderate to high quality studies. This was found regardless of the heterogeneity of patients, study design, type of MBI and outcome assessment. Two out of three RCTs found clinically relevant decreases in tinnitus distress scores. No effect of MBIs was observed for depression and anxiety in tinnitus patients. Long term effects remain uncertain. Mindfulness may have a place in tinnitus therapy, although the long term effects need to be studied.

Dataset Information

Mindfulness based interventions in multiple sclerosis--a systematic review.

Background

Methods

Results

Conclusion

Publications

Mindfulness based interventions in multiple sclerosis--a systematic review.

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