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Does Mindfulness-Based Cognitive Therapy benefit all people with diabetes and comorbid emotional complaints equally? Moderators in the DiaMind trial.

Journal of psychosomatic research
December 1, 2016
Ivan Nyklíček et al. (5 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to identify which factors (demographic, personality, and baseline mindfulness skills) moderate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in reducing emotional distress in patients with diabetes.

Results Summary

MBCT was effective in reducing anxiety, depressive symptoms, and perceived stress, with larger effects in women and those with lower extraversion. Men and highly extraverted individuals showed smaller improvements, with high extraverts also experiencing higher dropout rates.

Population

Outpatients with diabetes (type 1 or type 2) and elevated emotional distress.

Effective Dosage

Not specified

Duration

6-month follow-up (intervention duration not explicitly stated)

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Mindfulness-Based Cognitive Therapy (MBCT)
decrease
symptoms of anxiety, depression, and perceived stress
patients with diabetes
-
seems to be effective to decrease
#1
Mindfulness-Based Cognitive Therapy (MBCT)
decrease
anxiety and depression
women in the MBCT group
large effects
showed larger decreases
#2
Mindfulness-Based Cognitive Therapy (MBCT)
decrease
anxiety and depression
men in the MBCT group
medium to small effects
showed
#3
Mindfulness-Based Cognitive Therapy (MBCT)
decrease
symptoms
the three lowest quartiles of extraversion in the MBCT group
large
exhibited large decreases
#4
Mindfulness-Based Cognitive Therapy (MBCT)
decrease
perceived stress and depression
the high extraversion group in the MBCT group
medium (perceived stress) to small (depression)
showed medium to small decreases
#5
Abstract

OBJECTIVES: Research has shown the effectiveness of mindfulness-based interventions for a variety of emotional problems in different samples, but it is unknown which factors influence this effectiveness. Therefore, the aim of the current study was: which factors (demographic, personality, and baseline levels of mindfulness skills) moderate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT)? METHODS: Outpatients with diabetes (type 1 or type 2; N=139) and an elevated level of emotional distress participated in the Diabetes and Mindfulness (DiaMind) trial. They were randomized into MBCT (N=70) or a control group (N=69) that received treatment as usual and that was offered the intervention 6months later. Primary outcomes were anxiety, depressive symptoms, and perceived stress at post-intervention and at 6-month follow-up. RESULTS: Mixed models analyses showed that sex, extraversion, and baseline acting with awareness were significant moderators of effectiveness. In the MBCT group, women showed larger decreases in anxiety and depression across time (large effects) compared to men (medium to small effects). For extraversion divided into quartiles, the three lowest quartiles generally exhibited large decreases in symptoms, whereas the high extraversion group showed medium (perceived stress) to small (depression) decreases. CONCLUSION: MBCT seems to be effective to decrease symptoms of anxiety, depression, and perceived stress for a broad range of person characteristics in patients with diabetes. However, men and those high in extraversion showed considerably lower effectiveness compared to the other groups. The small effect in high extraverts may be due to the large dropout in this subgroup.

Medical Subject Headings (MeSH)
AdultAgedAnxiety DisordersAwarenessCognitive Behavioral TherapyComorbidityDepressive DisorderDiabetes MellitusExtraversion, PsychologicalFemaleHumansMaleMiddle AgedMindfulnessNetherlandsStatistics as TopicStress, PsychologicalTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations11
Citations/Year1.2
Relative Citation Ratio0.61
NIH Percentile32.7%
Research Impact Scores
APT Score0.50
Weight Score1.85
Normalized Score0.67
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