Long-term efficacy of Mindfulness Based Stress Reduction on Depression and Anxiety, Symptoms and Distress, Health Status, Coping Capacity and Immune Response in Breast Cancer Survivors: A longitudinal Randomized Controlled Trial

Abstract Purpose This 5-year longitudinal randomized controlled trial explored the long-term efficacy of a MBSR intervention for psychological and biological response in breast cancer survivors.

Methods: A total of 166 women were randomly assigned into one of 3 groups: MBSR, Active controls and non-MBSR. Data were collected at baseline, 3-months, 6-months and 1-year follow-up, thereafter yearly up to 5-year. The participants completed the Hospital Anxiety and Depression Scale, the Memorial Symptom Assessment Scale, SF-36, and Sense of Coherence. Blood samples were collected and analyzed for NK cells activity, lymphocytes and cytokine concentrations.

Results: The MBSR intervention demonstrated a strong effect in reducing depression (3-months: 0.015;d Cohen =0.5; 1-year: 0.013;d Cohen =0.5), anxiety (1-year: 0.023;d Cohen =0.4), and a strong effect in psychological symptoms (3-months: 0.019;d Cohen =0.4; 1-year: 0.005;d Cohen =0.6), global distress (3-months: 0.013;d Cohen =0.5; 1-year: 0.002;d Cohen =0.6), and total symptom burden (1-year: 0.046;d Cohen =0.4), a very strong effect on mental health (3-months: <0.001;d Cohen =0.7; 6-months: 0.008;d Cohen =0.5; 1-year: <0.001;d Cohen =0.8), vitality (1-year:0.007;d Cohen =0.5), and general health perceptions (1-year: 0.031;d Cohen =0.4). Coping capacity strongly over improved time (3-months: 0.028;d Cohen =0.4; 6-months: 0.044;d Cohen =0.4; 1-year: 0.006;d Cohen =0.6). A significant increase in NK-cell activity as well as for total number of lymphocytes was seen in all study groups with time. A moderate difference in CD3-16 + 56 + NKx10e9/l (3-months: 0.041;d Cohen =0.4), a moderate difference for cytokines IL-6 (6-months: 0.049;d Cohen =0.4) and IL-8 (1-year: 0.039;d Cohen =0.4) were seen.

Conclusions: This RTC showed long-term efficacy in reducing depression, anxiety, psychological symptoms, global distress and total symptom burden, improved coping capacity and health status up to 1-year post-intervention. MBSR also seemed to have some beneficial efficacy on immune status.