Effect of Mindfulness‐Based stress reduction in rheumatoid arthritis patients

An eight-week Mindfulness-Based Stress Reduction (MBSR) program, combined with a four-month maintenance period, improved psychological distress and well-being in people with rheumatoid arthritis (RA) at six months, but did not affect RA disease activity. At two months, no differences were observed between the MBSR group and the waitlist control group. At six months, psychological distress decreased by 35% in the MBSR group, and improvements in well-being were significant. Changes in depressive symptoms and mindfulness were marginally significant. The intervention had no impact on RA disease activity as measured by the Disease Activity Score in 28 joints.

Study at a glance

Abstract

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. CONCLUSION: 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.