Mindfulness-based cognitive therapy for severely fatigued multiple sclerosis patients: A waiting list controlled study

Abstract

Background: Fatigue is the most common symptom in multiple sclerosis. Evidence-based treatment options are scarce. Objective: To study the feasibility and potential effectiveness of mindfulness-based cognitive therapy in severely fatigued multiple sclerosis patients. Methods: Non-randomized pilot study with a wai-ting list control period including 59 multiple sclerosis patients with severe fatigue. Primary outcome measure: fatigue severity subscale of the Checklist Individual Strength-20. Secondary measures: Hospital Anxiety and Depression Scale, Life Satisfaction Questionnaire, subscale sleep of the Symptom Checklist-90, Cognitive Failure Questionnaire, Fatigue Catastrophizing Scale, Coping Inventory of Stressful Situations, and Five Facet Mindfulness Questionnaire-Short Form. Measurements were taken before treatment (double baseline), after treatment, and at follow-up (3 months). Results: Adherence rate was 71%. Eight out of 10 participants who completed the intervention were satisfied with the intervention. Significant time effects were found for 7 out of 11 outcome measures (p=0.006 to<0.001). The effect size was moderate for all outcome measures that were significant post-treatment and/or at follow-up (Ƞ²=0.10-0.17). Improvements were maintained at follow-up. Of the completers, 46% showed a clinically relevant change regarding fatigue. Conclusion: Mindfulness-based cognitive therapy is feasible in severely fatigued multiple sclerosis patients and has positive results in the reduction of severe fatigue and several psychological factors.