Efficacy of Mindfulness-based Stress Reduction in Hemodialysis Patients with Anxiety and Depression: a randomized, double-blind, parallel-group trial

A randomized clinical trial tested whether an eight-session mindfulness-based stress reduction (MBSR) program, added to standard health education, could reduce anxiety and depression in fifty hemodialysis patients in Iran. Depression and anxiety scores decreased significantly more in the MBSR group than in the control group, which received only health education. The authors suggest that MBSR may help manage these psychiatric symptoms in people undergoing hemodialysis for chronic kidney disease.

Study at a glance

Abstract

Background: Diseases with a chronic and debilitating nature, such as chronic kidney disease, are frequently associated with psychiatric disorders like anxiety and depression. Objective: To assess the efficacy of mindfulness-based stress reduction (MBSR) on anxiety and depression in hemodialysis patients. Methods: In this randomized clinical trial, fifty hemodialysis patients were selected from two dialysis centers of Kashan city in Iran in 2016. The patients had desired cognitive status based on MMSE (Mini Mental Status Examination) and clinical interview, and were randomly allocated into the intervention and control groups. The intervention group (n=25) received a Mindfulness-Based Stress Reduction (MBSR) program in addition to the health education program in eight sessions, whereas the control group (n=25) received only the health education program. To measure the anxiety and depression score before and after study, the Hospital Anxiety and Depression Scale were used. Data were analyzed by SPSS version 11.5, using Analysis of Covariance (ANCOVA), t-test, Chi-square, Mann-Whitney U, and Fisher exact test. Results: The mean age of intervention and control groups were 46.86±11.66 and 46.26±11.71 respectively. The mean duration of illness was 2.47±1.78 and 2.62±1.32 in intervention and control groups respectively. There were no significant differences between the two groups regarding age, sex, education level and job. Depression and anxiety were reduced in the intervention group compared with the control group (p=0.0001). Conclusions: The MBSR program may reduce anxiety and depression in hemodialysis patients. Funding: This study was financially supported by the Deputy of Research, Kashan University of Medical Sciences, Kashan, Iran (Ref: 9436). Clinical Trial Registration: The protocol of study was registered at the Iranian Registry of Clinical Trials (IRCT) with ID number of IRCT2015081723652N1.