Effectiveness of mindfulness-integrated cognitive behavior therapy on anxiety, depression and hope in multiple sclerosis patients: a randomized clinical trial

Abstract Introduction Multiple sclerosis (MS) is a chronic medical condition that attracts particular attention because of the high risks associated with it. MS patients suffer from medical problems, depression, anxiety, and reduced hopefulness. These issues can increase the severity of the disease and treatment resistance and reduce patients’ individual and social efficacy. Mindfulness-integrated cognitive behavior therapy (MICBT) is a new approach that is being applied in chronic diseases and can be used in combination with existing treatments. Therefore, the present study investigated the efficacy of MICBT in terms of anxiety, depression, and hope in MS patients. Methods A sample of 20 patients with MS was randomly selected at Shafa Hospital in Kerman City, Iran. Patients were then assigned to one of two groups of 10 people using a random number table. The experimental group received MICBT. The control group also received the same therapy after study completion. The assessment tools used in this study included the Beck Depression Inventory-Second Edition (BDI-II), Beck Anxiety Inventory (BAI), and Miller Hope Scale (MHS). Measurements were conducted at three stages: pre-test, post-test, and follow-up. For data analysis, means and standard deviations were calculated and one-way analysis of covariance was conducted using SPSS 24. Results Compared with controls, MICBT was effective for reducing depression (P < 0.001, F = 72.55), anxiety (P < 0.001, F = 100.75). Additionally, MICBT was effective in improving hope (P < 0.001, F = 45.36). Changes were maintained in the follow-up phase. Conclusion The MICBT affects depression, anxiety and hope of MS patients. Therefore, mental health professionals can benefit from the results obtained in the present study to reduce depression and anxiety and increase hope in this group of patients. Clinical trial registration: Iranian Registry of Clinical Trials, IRCT201601030258N4.

摘要
引言 多发性硬化症（Multiple Sclerosis, MS）是一种慢性疾病，因其伴随极高的发病风险而受到学界广泛关注。MS患者常伴有躯体不适、抑郁、焦虑及希望水平降低等问题，上述状况会加重疾病严重程度与治疗抵抗性，并降低患者的个体与社会功能效能。正念整合认知行为疗法（Mindfulness-integrated Cognitive Behavior Therapy, MICBT）是一种新兴干预手段，已被应用于多种慢性疾病的治疗，且可与现有治疗方案联合使用。因此，本研究旨在探讨MICBT对MS患者焦虑、抑郁及希望水平的干预效果。

方法 本研究于伊朗克尔曼市舍法医院随机选取20名MS患者作为研究对象，通过随机数字表法将其分为两组，每组各10人。实验组接受MICBT干预，对照组则在本研究结束后接受相同治疗。本研究采用的评估工具包括贝克抑郁量表第二版（Beck Depression Inventory-Second Edition, BDI-II）、贝克焦虑量表（Beck Anxiety Inventory, BAI）以及米勒希望量表（Miller Hope Scale, MHS）。分别于干预前、干预后及随访三个阶段进行测评。数据分析采用均数与标准差进行描述，并使用SPSS 24统计软件开展单因素协方差分析。

结果 与对照组相比，MICBT可显著降低患者的抑郁评分（P < 0.001, F = 72.55）与焦虑评分（P < 0.001, F = 100.75），同时可显著提升患者的希望水平（P < 0.001, F = 45.36），且上述干预效果在随访阶段仍得以维持。

结论 MICBT可对MS患者的抑郁、焦虑及希望水平产生显著影响。因此，精神卫生从业者可参考本研究结果，以改善该类患者的抑郁与焦虑症状，并提升其希望水平。

临床试验注册：伊朗临床试验注册中心，IRCT201601030258N4。