van Son Jenny, Nyklíček Ivan, Pop Victor J, Blonk Marion C, Erdtsieck Ronald J, Pouwer François
Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
J Psychosom Res. 2014 Jul;77(1):81-4. doi: 10.1016/j.jpsychores.2014.03.013. Epub 2014 Mar 31.
The DiaMind trial showed beneficial immediate effects of mindfulness-based cognitive therapy (MBCT) on emotional distress, but not on diabetes distress and HbA1c. The aim of the present report was to examine if the effects would be sustained after six month follow-up.
In the DiaMind trial, 139 outpatients with diabetes (type-I or type-II) and a lowered level of emotional well-being were randomized into MBCT (n=70) or a waiting list with treatment as usual (TAU: n=69). Primary outcomes were perceived stress, anxiety and depressive symptoms, and diabetes distress. Secondary outcomes were, among others, health status, and glycemic control (HbA1c).
Compared to TAU, MBCT showed sustained reductions at follow-up in perceived stress (p<.001, d=.76), anxiety (p<.001, assessed by HADS d=.83; assessed by POMS d=.92), and HADS depressive symptoms (p=.004, d=.51), but not POMS depressive symptoms when using Bonferroni correction for multiple testing (p=.016, d=.48). No significant between-group effect was found on diabetes distress and HbA1c.
This study showed sustained benefits of MBCT six months after the intervention on emotional distress in people with diabetes and a lowered level of emotional well-being.
Dutch Trial Register NTR2145, http://www.trialregister.nl.
DiaMind试验显示，基于正念的认知疗法（MBCT）对情绪困扰有即时有益效果，但对糖尿病困扰和糖化血红蛋白（HbA1c）无此效果。本报告的目的是检验干预六个月后的随访中这些效果是否会持续。
在DiaMind试验中，139名患有糖尿病（I型或II型）且情绪幸福感较低的门诊患者被随机分为MBCT组（n = 70）或常规治疗等待组（TAU：n = 69）。主要结局指标为感知压力、焦虑和抑郁症状以及糖尿病困扰。次要结局指标包括健康状况和血糖控制（HbA1c）等。
与TAU组相比，MBCT组在随访时感知压力持续降低（p <.001，d =.76）、焦虑持续降低（p <.001，用医院焦虑抑郁量表（HADS）评估d =.83；用状态-特质焦虑问卷（POMS）评估d =.92）以及HADS抑郁症状持续降低（p =.004，d =.51），但在多重检验采用Bonferroni校正时，POMS抑郁症状无显著降低（p =.016，d =.48）。在糖尿病困扰和HbA1c方面未发现显著的组间效应。
本研究表明，干预六个月后，MBCT对糖尿病患者且情绪幸福感较低者的情绪困扰具有持续益处。
荷兰试验注册库NTR2145，http://www.trialregister.nl 。
