The Effects of a Mindfulness-Based Intervention on Emotional Distress, Quality-of-Life, and HbA1c in Outpatients With Diabetes (DiaMind)
A randomized controlled trial
- Jenny van Son, MSC1,
- Ivan Nyklíček, PHD1⇓,
- Victor J. Pop, MD, PHD1,
- Marion C. Blonk, MD, PHD2,
- Ronald J. Erdtsieck, MD, PHD3,
- Pieter F. Spooren, MD, PHD4,
- Arno W. Toorians, MD, PHD5 and
- François Pouwer, PHD1
- 1Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
- 2Department of Internal Medicine, Catharina Hospital, Eindhoven, the Netherlands
- 3Department of Internal Medicine, Máxima Medical Center, Eindhoven, the Netherlands
- 4Department of Internal Medicine, TweeSteden Hospital, Tilburg, the Netherlands
- 5Department of Internal Medicine, St. Anna Hospital, Geldrop, the Netherlands
- Corresponding author: Ivan Nyklíček, .
OBJECTIVE Emotional distress is common in outpatients with diabetes, affecting ∼20–40% of the patients. The aim of this study was to determine the effectiveness of group therapy with Mindfulness-Based Cognitive Therapy (MBCT), relative to usual care, for patients with diabetes with regard to reducing emotional distress and improving health-related quality-of-life and glycemic control.
RESEARCH DESIGN AND METHODS In the present randomized controlled trial, 139 outpatients with diabetes (type 1 or type 2) and low levels of emotional well-being were randomized to MBCT (n = 70) or a waiting list group (n = 69). Primary outcomes were perceived stress (Perceived Stress Scale), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), mood (Profiles of Mood States), and diabetes-specific distress (Problem Areas In Diabetes). Secondary outcomes were health-related quality-of-life (12-Item Short-Form Health Survey), and glycemic control (HbA1c). Assessments were conducted at baseline and at 4 and 8 weeks of follow-up.
RESULTS Compared with control, MBCT was more effective in reducing stress (P < 0.001, Cohen d = 0.70), depressive symptoms (P = 0.006, d = 0.59), and anxiety (P = 0.019, d = 0.44). In addition, MBCT was more effective in improving quality-of-life (mental: P = 0.003, d = 0.55; physical: P = 0.032, d = 0.40). We found no significant effect on HbA1c or diabetes-specific distress, although patients with elevated diabetes distress in the MBCT group tended to show a decrease in diabetes distress (P = 0.07, d = 0.70) compared with the control group.
CONCLUSIONS Compared with usual care, MBCT resulted in a reduction of emotional distress and an increase in health-related quality-of-life in diabetic patients who had lower levels of emotional well-being.
- Received July 24, 2012.
- Accepted September 14, 2012.
- © 2013 by the American Diabetes Association.
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