Effect of Mindfulness-Based Stress Reduction in rheumatoid arthritis patients.
OBJECTIVE
To assess the effect of a meditation training program, Mindfulness-Based Stress Reduction (MBSR), on depressive symptoms, psychological status, and disease activity in patients with rheumatoid arthritis (RA) through a randomized, waitlist-controlled pilot study.


METHODS
Participants were randomized to either an MBSR group, where they attended an 8-week course and 4-month maintenance program, or to a waitlist control group, where they attended all assessment visits and received MBSR free of charge after study end. Participants received usual care from their rheumatologists throughout the trial. Self-report questionnaires were used to evaluate depressive symptoms, psychological distress, well-being, and mindfulness. Evaluation of RA disease activity (by Disease Activity Score in 28 joints) included examination by a physician masked to treatment status. Adjusted means and mean changes in outcomes were estimated in mixed model repeated measures analyses.


RESULTS
Sixty-three participants were randomized: 31 to MBSR and 32 to control. At 2 months, there were no statistically significant differences between groups in any outcomes. At 6 months, there was significant improvement in psychological distress and well-being (P = 0.04 and P = 0.03, respectively), and marginally significant improvement in depressive symptoms and mindfulness (P = 0.08 and P = 0.09, respectively). There was a 35% reduction in psychological distress among those treated. The intervention had no impact on RA disease activity.


CONCLUSIONS
An 8-week MBSR class was not associated with change in depressive symptoms or other outcomes at 2-month followup. Significant improvements in psychological distress and well-being were observed following MBSR plus a 4-month program of continued reinforcement. Mindfulness meditation may complement medical disease management by improving psychological distress and strengthening well-being in patients with RA.
Pradhan
Elizabeth K
EK
The University of Maryland School of Medicine, Baltimore, MD, USA. epradhan@compmed.umm.edu
Baumgarten
Mona
M
Langenberg
Patricia
P
Handwerger
Barry
B
Gilpin
Adele Kaplan
AK
Magyari
Trish
T
Hochberg
Marc C
MC
Berman
Brian M
BM
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D019122:Meditation; D013315:Stress, Psychological / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome