title: MS quality of life, depression, and fatigue improve after mindfulness training: a randomized trial.
abstract: OBJECTIVE
  Health-related quality of life (HRQOL) is often much reduced among individuals with multiple sclerosis (MS), and incidences of depression, fatigue, and anxiety are high. We examined effects of a mindfulness-based intervention (MBI) compared to usual care (UC) upon HRQOL, depression, and fatigue among adults with relapsing-remitting or secondary progressive MS.
  
  
  METHODS
  A total of 150 patients were randomly assigned to the intervention (n = 76) or to UC (n = 74). MBI consisted of a structured 8-week program of mindfulness training. Assessments were made at baseline, postintervention, and 6 months follow-up. Primary outcomes included disease-specific and disease-aspecific HRQOL, depression, and fatigue. Anxiety, personal goal attainment, and adherence to homework were secondary outcomes.
  
  
  RESULTS
  Attrition was low in the intervention group (5%) and attendance rate high (92%). Employing intention-to-treat analysis, MBI, compared with UC, improved nonphysical dimensions of primary outcomes at postintervention and follow-up (p < 0.002); effect sizes, 0.4-0.9 posttreatment and 0.3-0.5 at follow-up. When analyses were repeated among subgroups with clinically relevant levels of preintervention depression, fatigue, or anxiety, postintervention and follow-up effects remained significant and effect sizes were larger than for the total sample.
  
  
  CONCLUSIONS
  In addition to evidence of improved HRQOL and well-being, these findings demonstrate broad feasibility and acceptance of, as well as satisfaction and adherence with, a program of mindfulness training for patients with MS. The results may also have treatment implications for other chronic disorders that diminish HRQOL.
  
  
  METHODS
  This trial provides Class III evidence that MBI compared with UC improved HRQOL, fatigue, and depression up to 6 months postintervention.
authors.affiliation: Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Hebelstrasse 2, Basel, Switzerland. PGrossman@uhbs.ch
authors.forename: P
authors.initials: P
authors.lastname: Grossman
authors.forename: L
authors.initials: L
authors.lastname: Kappos
authors.forename: H
authors.initials: H
authors.lastname: Gensicke
authors.forename: M
authors.initials: M
authors.lastname: D'Souza
authors.forename: D C
authors.initials: DC
authors.lastname: Mohr
authors.forename: I K
authors.initials: IK
authors.lastname: Penner
authors.forename: C
authors.initials: C
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003863:Depression / Q000209:etiology / Q000534:rehabilitation*; D004185:Disability Evaluation; D004311:Double-Blind Method; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026441:Mind-Body Therapies / Q000379:methods*; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology / Q000534:rehabilitation; D009483:Neuropsychological Tests; D011788:Quality of Life; D016896:Treatment Outcome