CONTEXT: Solid organ transplant patients require life-long immune suppression that can produce distressing side effects and complications. OBJECTIVE: To evaluate the potential of Mindfulness-Based Stress Reduction (MBSR) to reduce symptoms of depression, anxiety, and sleep disturbance and improve quality of life after solid organ transplantation. DESIGN: Longitudinal with evaluations at baseline, postcourse and 3-month follow-up. PARTICIPANTS AND SETTING: Kidney, lung, or pancreas transplant recipients (N=20), aged 35 to 59 years, living in the community. INTERVENTION: An MBSR class (2.5 hours weekly, for 8 weeks), modeled after the program of Jon Kabat-Zinn. Home practice (goal: 45 minutes, 5 days weekly) was monitored. MAIN OUTCOME MEASURES: Self-report scales for depression (CES-D), anxiety (STAI-Y1), and sleep dysfunction (PSQI). RESULTS: Nineteen participants completed the course. Findings suggest improvement from baseline symptom scores for depression (P=.006) and sleep (P=.011) at the completion of the MBSR program. At 3 months, improvement in sleep continued (P=.002), and a significant improvement in anxiety scores was seen (P=.043); scores for both symptoms demonstrated a linear trend and dose-response relationship with practice time. In contrast, depression scores showed a quadratic trend, and at 3 months were no longer different from baseline. A composite symptom measure was significantly improved at 3-month follow-up (P=.007). Global and health-related quality of life ratings were not improved. Effects of group support and instructor attention were not controlled, and sample size and follow-up time were limited. A randomized trial to overcome these shortcomings should be done, as symptom distress in transplant recipients appears responsive to MBSR.
CONTEXT: Solid organ transplant patients require life-long immune suppression that can produce distressing side effects and complications. OBJECTIVE: To evaluate the potential of Mindfulness-Based Stress Reduction (MBSR) to reduce symptoms of depression, anxiety, and sleep disturbance and improve quality of life after solid organ transplantation. DESIGN: Longitudinal with evaluations at baseline, postcourse and 3-month follow-up. PARTICIPANTS AND SETTING: Kidney, lung, or pancreas transplant recipients (N=20), aged 35 to 59 years, living in the community. INTERVENTION: An MBSR class (2.5 hours weekly, for 8 weeks), modeled after the program of Jon Kabat-Zinn. Home practice (goal: 45 minutes, 5 days weekly) was monitored. MAIN OUTCOME MEASURES: Self-report scales for depression (CES-D), anxiety (STAI-Y1), and sleep dysfunction (PSQI). RESULTS: Nineteen participants completed the course. Findings suggest improvement from baseline symptom scores for depression (P=.006) and sleep (P=.011) at the completion of the MBSR program. At 3 months, improvement in sleep continued (P=.002), and a significant improvement in anxiety scores was seen (P=.043); scores for both symptoms demonstrated a linear trend and dose-response relationship with practice time. In contrast, depression scores showed a quadratic trend, and at 3 months were no longer different from baseline. A composite symptom measure was significantly improved at 3-month follow-up (P=.007). Global and health-related quality of life ratings were not improved. Effects of group support and instructor attention were not controlled, and sample size and follow-up time were limited. A randomized trial to overcome these shortcomings should be done, as symptom distress in transplant recipients appears responsive to MBSR.
Authors: S Jedel; A Hoffman; P Merriman; B Swanson; R Voigt; K B Rajan; M Shaikh; H Li; A Keshavarzian Journal: Digestion Date: 2014-02-14 Impact factor: 3.216