Abstract
Objective
Impairment of mental well-being (anxiety,
depression, stress) is common among people with
multiple sclerosis (PwMS). Treatment options are limited,
particularly for anxiety. The aim of this study was to
update our previous systematic review (2014) and
evaluate via meta-analysis the efficacy of mindfulnessbased interventions (MBIs) for improving mental wellbeing in PwMS.
Methods
Systematic searches for eligible randomised
controlled trials (RCTs) were carried out in seven major
databases (November 2017, July 2018), using medical
subject headings and key words. Studies were screened,
data extracted, quality appraised and analysed by two
independent reviewers, using predefined criteria. Study
quality was assessed using the Cochrane Collaboration
risk of bias tool. Mental well-being was the primary
outcome. Random effects model meta-analysis was
performed, with effect size reported as standardised
mean difference (SMD).
Results
Twelve RCTs including 744 PwMS were
eligible for inclusion in the systematic review, eight had
data extractable for meta-analysis; n=635. Ethnicity,
socioeconomic status, comorbidity and disability were
inconsistently reported. MBIs varied from manualised
to tailored versions, lasting 6–9 weeks, delivered
individually and via groups, both in person and online.
Overall SMD for mental well-being (eight studies)
was 0.40 (0.28–0.53), p<0.01, I2=28%; against
active comparators only (three studies) SMD was 0.17
(0.01–0.32), p<0.05, I2=0%. Only three adverse events
were reported.
Conclusions
MBIs are effective at improving mental
well-being in PwMS. More research is needed regarding
optimal delivery method, cost-effectiveness and
comparative-effectiveness
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Mindfulness 