Simpson, Jane and Craufurd, David and Smith, Douglas Alistair and Eccles, Fiona Juliet Rosalind and Peeren, Siofra and Rogers, Dawn and Skitt, Zara and Theed, Rachael (2016) A pilot evaluation of mindfulness based cognitive therapy for Huntington's disease. Journal of Neurology, Neurosurgery and Psychiatry, 87 (Suppl.): M16. A107. ISSN 0022-3050
Abstract
Background Many people with the Huntington’s disease (HD) gene, both pre-manifest and manifest, experience low mood, anxiety and other psychological difficulties. Medication can alleviate these difficulties to some extent, but it is not effective for everyone, and is not always the preferred option. Psychological interventions may provide an alternative or additional way of alleviating distress. Aims To see if a particular type of psychological therapy, mindfulness-based cognitive therapy (MBCT), is an acceptable and useful way of alleviating psychological distress for people with the HD gene who are pre-manifest or at an early disease stage. Methods To date 10 pre-manifest HD gene carriers have completed an 8 week course of MBCT led by an experienced mindfulness teacher. The course consisted of weekly 2 hour sessions and up to an hour of home practice every day. Quantitative measures of anxiety, depression, stress and mindfulness were administered pre- and post-course. Qualitative data about participants’ experiences were gathered via semi-structured interview. We are currently recruiting for a second course and aim to run this in Autumn 2016. Results Mean depression levels were low pre-course and thus, unsurprisingly, little change was observed in mean depression post course. However, large effect sizes were seen for mean changes in anxiety and stress and in five aspects of mindfulness (describing, non-judging, non-reacting, observing and acting with awareness). The interview data (and participants’ regular attendance) also suggested that participants found the course acceptable. Furthermore they reported that they thought it beneficial for their wellbeing now and also that the skills they had learnt would be useful in the future. Conclusions MBCT appears to be an acceptable psychological approach for some pre-manifest individuals with the HD gene. Early results indicate that learning mindfulness is possible and can be beneficial. Further research is needed with larger samples to show if it can significantly reduce psychological distress and would benefit from including more individuals with raised depression at baseline to enable changes in depression to be detected. Some recruitment difficulties were encountered and these and the possible implications for future courses will be presented.