The effects of cognitive behavioral and mindfulness-based therapies on psychological distress in patients with multiple sclerosis, Parkinson's disease and Huntington's disease: Two meta-analyses
Open accessAbstract
Objective Psychological distress has a high impact on quality of life in patients with multiple sclerosis (MS), Parkinson's disease (PD), and Huntington's disease (HD). Studies have shown that cognitive behavioral therapy (CBT) and mindfulness-based therapies (MBTs) are successful in reducing psychological distress in patients with anxiety, depressive, and chronic somatic disorders. We aimed to investigate the effectiveness of these therapies in MS, PD, and HD patients.Methods We performed a comprehensive literature search in PubMed, PsycINFO, Embase and the Cochrane Central Register of Controlled Trials up to March 2018. Randomized controlled trials (RCTs) investigating a CBT or MBT and reporting psychological outcome measures were included. Two separate meta-analyses were performed; one on studies comparing psychological therapy with a treatment as usual or waitlist condition and one on studies with active treatment control conditions.Results The first meta-analysis (N = 12 studies, 8 in MS and 4 in PD populations) showed a significant effect size of g = 0.51 in reducing psychological distress. The second meta-analysis (N = 7 studies, in MS populations) showed a mean effect size of g = 0.36. No RCTs were found in HD populations. The overall quality of the included studies was low and considerable heterogeneity was found. No evidence was found for publication bias.Conclusion CBT and MBTs have a small to moderate effect on reducing psychological distress in patients with PD and MS. However, more research with better methodological quality and larger study samples is warranted, especially in HD patient populations.
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A recent meta-analysis found mindfulness-based interventions have small to moderate effect sizes in reducing psychological distress in people with Parkinson's disease.
“A recent meta-analysis found MBIs to have small to moderate effect sizes in reducing psychological distress in people with PD (Ghielen et al., 2019).”
From Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study (2022) · cites this paper as Ghielen et al., 2019
The Conclusion (section 4.2; page unavailable) says CBT and mindfulness-based therapies together have small-to-moderate effects in patients with Parkinson’s disease and multiple sclerosis. It does not establish that mindfulness-based interventions alone have those effects in Parkinson’s disease: the study table lists only one Parkinson’s intervention of that type (ACT+PT), with an effect size of g = -0.45, while the separate mindfulness-therapy analysis in section 3.3 covers multiple sclerosis patients only. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn neurological conditions like multiple sclerosis, mindfulness-based interventions have shown improvements in anxiety, depression, fatigue, and stress.
“MBIs have also been studied in neurological diseases such as multiple sclerosis, demonstrating improvement in anxiety, depression, fatigue, and stress levels (Ghielen et al., 2019; Hoogerwerf et al., 2017; Simpson et al., 2019).”
From Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study (2022) · cites this paper as Ghielen et al., 2019
The Introduction (page unavailable) reports improved mental health with mindfulness-based treatments in MS, and the Conclusion (page unavailable) reports reduced psychological distress across CBT and mindfulness-based treatments in MS and Parkinson’s disease. The paper does not establish improvements in all four named outcomes from mindfulness-based interventions in MS: fatigue appears in a cited study’s title, while the reported analyses do not establish an improvement in stress. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe magnitude of the observed effects is consistent with several smaller disorder-specific meta-analyses in Parkinson's disease, multiple sclerosis, and epilepsy, as well as in adults with long-term physical health conditions.
“The magnitude of these effects are consistent with several smaller disorder-specific meta-analyses in PD (Ghielen et al., 2019), MS (Hind et al., 2014), and epilepsy (Li et al., 2023), as well as in adults with long-term physical health conditions (Scott et al., 2023).”
From Cognitive behavioral interventions for depression and anxiety in adults with neurological disorders: a systematic review and meta-analysis (2024) · cites this paper as Ghielen et al., 2019
Reviews report mixed results for CBT and mindfulness approaches, in particular for anxiety and depression.
“with a number of reviews reporting mixed results for cognitive behavioural therapy (CBT) and approaches focused on mindfulness, in particular for anxiety and depression (Armento et al., 2012; Berardelli et al., 2015; Ghielen et al., 2019; Xie et al., 2015; Zečević, 2020).”
From Psychological interventions for people with Parkinson's disease in the early 2020s: Where do we stand? (2021) · cites this paper as Ghielen et al., 2019
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References 55 · Cited by 74
Research works printed but not linked: 1
- [28]28. M. Borenstein, Larry V. Hedges, Julian P.T. Higgins, et al., Introduction to MetaAnalysis, Wiley, Chichester, United Kingdom, 2009.
- Authors
- Ghielen, I., Rutten, S., Boeschoten, R. E., Houniet-de Gier, M., van Wegen, E. E. H., van den Heuvel, O. A., & Cuijpers, P.
- Affiliations
- Amsterdam Neuroscience (NL)
- Amsterdam Public Health (NL)
- Corresponding author
- Ghielen, Ires
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2019-07
- Volume
- 122
- Pages
- 43-51
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2944884729
- Cited by
- 74
- References
- 55
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 15 · 2023: 13 · 2022: 11 · 2021: 12 · 2020: 11 · 2019: 1
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Universiteit van Amsterdam
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy, mindfulness-based interventions, psychological distress, multiple sclerosis, Parkinson's disease, Huntington's disease, neuropsychiatric disorders, anxiety, depression, quality of life
- MeSH terms
- Humans, Huntington Disease, Multiple Sclerosis, Parkinson Disease, Psychotherapy, Quality of Life, Cognitive Behavioral Therapy, Mindfulness
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