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Abstract 


Context

Solid organ transplant patients require life-long immune suppression that can produce distressing side effects and complications.

Objective

To evaluate the potential of Mindfulness-Based Stress Reduction (MBSR) to reduce symptoms of depression, anxiety, and sleep disturbance and improve quality of life after solid organ transplantation.

Design

Longitudinal with evaluations at baseline, postcourse and 3-month follow-up.

Participants and setting

Kidney, lung, or pancreas transplant recipients (N = 20), aged 35 to 59 years, living in the community.

Intervention

An MBSR class (2.5 hours weekly, for 8 weeks), modeled after the program of Jon Kabat-Zinn. Home practice (goal: 45 minutes, 5 days weekly) was monitored.

Main outcome measures

Self-report scales for depression (CES-D), anxiety (STAI-Y1), and sleep dysfunction (PSQI).

Results

Nineteen participants completed the course. Findings suggest improvement from baseline symptom scores for depression (P = .006) and sleep (P = .011) at the completion of the MBSR program. At 3 months, improvement in sleep continued (P = .002), and a significant improvement in anxiety scores was seen (P = .043); scores for both symptoms demonstrated a linear trend and dose-response relationship with practice time. In contrast, depression scores showed a quadratic trend, and at 3 months were no longer different from baseline. A composite symptom measure was significantly improved at 3-month follow-up (P = .007). Global and health-related quality of life ratings were not improved. Effects of group support and instructor attention were not controlled, and sample size and follow-up time were limited. A randomized trial to overcome these shortcomings should be done, as symptom distress in transplant recipients appears responsive to MBSR.

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