The Effectiveness of Mindfulness-Integrated Cognitive Behavior Therapy on Depression, Anxiety, and Stress in Females with Multiple Sclerosis: A Single Blind Randomized Controlled Trial

Background: Previous studies have shown the effectiveness of cognitive behavior therapy in improvement of psychological symptoms such as depression, anxiety, and stress. Recent studies suggest that mindfulness-based interventions (MBI) are effective in reducing these psychological symptoms in chronic diseases. The present study was the first study to examine the effects of mindfulness-integrated cognitive behavior therapy (MiCBT) on common comorbid psychological symptoms in patients with multiple sclerosis (MS). Objectives: The present study aimed at examining the effect of mindfulness-integrated cognitive behavior therapy on depression, anxiety, and stress in females with multiple sclerosis. Methods: This research was a quasi-experimental study conducted on female patients with MS who referred to Fars MS Society, Shiraz, Iran, in 2015. A total of 56 patients with MS were selected by convenience sampling method and randomly assigned into intervention and control groups. The intervention group received eight 2-hour sessions of MiCBT, while the control group was only given the usual treatment (TAU). The patients in both groups filled out a demographic questionnaire along with depression, anxiety and stress scales (DASS-21) in pre-and posttest. Results: In the current study, no statistically significant differences were found between the study groups in demographic variables (P > 0.05). Analysis of covariance revealed significant differences between the study groups in all the 3 variables in posttest compared to the pretest. The mean scores of depression, anxiety, and stress in the MiCBT group were significantly lower than the control group (P < 0.001). The mean score of depression was 16.69 +/- 7.1 in the experimental group before the intervention, which decreased to 6.17 +/- 5.7 after the intervention (P < 0.001). In addition, the mean score of anxiety was 13.2 +/- 7.25 in pre-intervention, which significantly reduced to 6.09 +/- 5.2 in post-intervention (P < 0.001). The mean score of stress also decreased from 22.09 +/- 6.07 to 10.87 +/- 6.3 compared to the pretest (P < 0.001). Conclusions: The results of the present study suggested that mindfulness-integrated cognitive behavior therapy is an effective and affordable treatment in reducing depression, anxiety, and stress for patients with MS.