Marouane Nassim1, Haley Park1,2, Elena Dikaios1, Angela Potes1, Sasha Elbaz1, Clare Mc Veigh3, Mark Lipman4,5, Marta Novak6, Emilie Trinh5,7, Ahsan Alam5,7, Rita S Suri5,8, Zoe Thomas1,2, Susana Torres-Platas1, Akshya Vasudev9, Neeti Sasi1, Maryse Gautier1, Istvan Mucsi7,10,11, Helen Noble3, Soham Rej1. 1. McGill Meditation and Mind-Body Medicine Research Clinic (MMMM-RC) and Geri-PARTy Research Group, Jewish General Hospital, Montreal, QC H3T 1E2, Canada. 2. Department of Psychiatry, McGill University, Montreal, QC H3A 0G4, Canada. 3. School of Nursing and Midwifery, Queen's University, Belfast BT7 1NN, UK. 4. Division of Nephrology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada. 5. Research Institute of the McGill University Health Center, McGill University, Montreal, QC H3A 0G4, Canada. 6. Department of Psychiatry, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada. 7. Division of Nephrology, McGill University Health Centre, Montreal, QC H3A 0G4, Canada. 8. Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC H2X 0A9, Canada. 9. Geriatric Mood Disorders Lab, Department of Psychiatry, Western University, London N6A 3K7, UK. 10. Transplant Inpatient Unit, Division of Nephrology, University Health Network, Toronto, ON M5G 2C4, Canada. 11. Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.
Abstract
BACKGROUND: Between 20-50% of patients undergoing maintenance dialysis for end-stage kidney disease experience symptoms of depression and/or anxiety, associated with increased mortality, greater health care utilization, and decreased quality of life. It is unknown whether mindfulness-based interventions can improve depression and anxiety symptoms in patients receiving this treatment. METHODS: We conducted an 8-week multicenter randomized controlled trial comparing a brief mindfulness intervention (BMI) vs. an active control (Health Enhancement Program [HEP]) in 55 patients receiving dialysis with symptoms of depression and/or anxiety. The primary outcome was change in Patient Health Questionnaire-9 (PHQ-9) depression scores, with a primary analysis in participants with baseline PHQ-9 ≥ 10, and a secondary analysis including all participants. The secondary outcome was change in Generalized Anxiety Disorder-7 (GAD-7) anxiety scores with corresponding primary and secondary analyses. RESULTS: Both BMI and HEP reduced depressive symptoms, with no difference between trial arms (PHQ-9 change = -7.0 vs. -6.1, p = 0.62). BMI was more effective than HEP in reducing anxiety (GAD-7 change = -8.7 vs. -1.4, p = 0.01). Secondary analyses revealed no differences between arms. CONCLUSIONS: For patientsundergoing dialysis, both BMI and HEP may be helpful interventions for depression symptoms, and BMI may be superior to HEP for anxiety symptoms. Mindfulness-based and other psychosocial interventions may be further evaluated in those undergoing dialysis as treatment options for symptoms of depression and anxiety.
RCT Entities:
BACKGROUND: Between 20-50% of patients undergoing maintenance dialysis for end-stage kidney disease experience symptoms of depression and/or anxiety, associated with increased mortality, greater health care utilization, and decreased quality of life. It is unknown whether mindfulness-based interventions can improve depression and anxiety symptoms in patients receiving this treatment. METHODS: We conducted an 8-week multicenter randomized controlled trial comparing a brief mindfulness intervention (BMI) vs. an active control (Health Enhancement Program [HEP]) in 55 patients receiving dialysis with symptoms of depression and/or anxiety. The primary outcome was change in Patient Health Questionnaire-9 (PHQ-9) depression scores, with a primary analysis in participants with baseline PHQ-9 ≥ 10, and a secondary analysis including all participants. The secondary outcome was change in Generalized Anxiety Disorder-7 (GAD-7) anxiety scores with corresponding primary and secondary analyses. RESULTS: Both BMI and HEP reduced depressive symptoms, with no difference between trial arms (PHQ-9 change = -7.0 vs. -6.1, p = 0.62). BMI was more effective than HEP in reducing anxiety (GAD-7 change = -8.7 vs. -1.4, p = 0.01). Secondary analyses revealed no differences between arms. CONCLUSIONS: For patients undergoing dialysis, both BMI and HEP may be helpful interventions for depression symptoms, and BMI may be superior to HEP for anxiety symptoms. Mindfulness-based and other psychosocial interventions may be further evaluated in those undergoing dialysis as treatment options for symptoms of depression and anxiety.
Authors: Christina Rigas; Haley Park; Marouane Nassim; Chien-Lin Su; Kyle Greenway; Mark Lipman; Clare McVeigh; Marta Novak; Emilie Trinh; Ahsan Alam; Rita S Suri; Istvan Mucsi; Susana G Torres-Platas; Helen Noble; Harmehr Sekhon; Soham Rej; Michael Lifshitz Journal: Can J Kidney Health Dis Date: 2022-03-04