Mindfulness-based stress reduction for solid organ transplant recipients: a randomized controlled trial.
BACKGROUND
Patients who have received solid organ transplants continue to experience a myriad of complex symptoms related to their underlying disease and to chronic immunosuppression that reduce the quality of life. Beneficial nonpharmacologic therapies to address these symptoms have not been established in the transplant population.


OBJECTIVE
Assess the efficacy of mindfulness-based stress reduction (MBSR) in reducing symptoms of anxiety, depression, and poor sleep in transplant patients.


METHODS
Controlled trial with a two-staged randomization. Recipients of kidney, kidney/pancreas, liver, heart, or lung transplants were randomized to MBSR (n=72) or health education (n=66) initially or after serving in a waitlist. Mean age was 54 years (range 21-75); 55% were men, and 91% were white.


METHODS
MBSR, a mindfulness meditation training program consisting of eight weekly 2.5-hour classes; health education, a peer-led active control.


METHODS
Anxiety (State-Trait Anxiety Inventory), depression (Center for Epidemiologic Studies Depression Scale), and sleep quality (Pittsburgh Sleep Quality Index) scales assessed by self-report at baseline, 8 weeks, 6 months, and 1 year.


RESULTS
Benefits of MBSR were above and beyond those afforded by the active control. MBSR reduced anxiety and sleep symptoms (P < .02), with medium treatment effects (.51 and .56) at 1 year compared to health education in intention-to-treat analyses. Within the MBSR group, anxiety, depression, and sleep symptoms decreased and quality-of-life measures improved by 8 weeks (P < .01, all), and benefits were retained at 1 year (P < .05, all). Initial symptom reductions in the health education group were smaller and not sustained. Comparisons to the waitlist confirmed the impact of MBSR on both symptoms and quality of life, whereas health education improvements were limited to quality-of-life ratings.


CONCLUSIONS
MBSR reduced distressing symptoms of anxiety, depression, and poor sleep and improved quality of life. Benefits were sustained over 1 year. A health education program provided fewer benefits, and effects were not as durable. MBSR is a relatively inexpensive, safe, and effective community-based intervention.
Gross
Cynthia R
CR
College of Pharmacy, University of Minnesota, Minneapolis, USA. gross002@umn.edu
Kreitzer
Mary Jo
MJ
Thomas
William
W
Reilly-Spong
Maryanne
M
Cramer-Bornemann
Michel
M
Nyman
John A
JA
Frazier
Patricia
P
Ibrahim
Hassan N
HN
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000628:therapy; D003863:Depression / Q000628:therapy; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D019122:Meditation / Q000379:methods*; D008875:Middle Aged; D019222:Mind-Body Relations, Metaphysical; D016377:Organ Transplantation / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012803:Sick Role; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult