Kidney Res Clin Pract.  2018 Mar;37(1):77-84. 10.23876/j.krcp.2018.37.1.77.

Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients

Affiliations
  • 1Department of Psychiatry, Sanggye Paik Hospital, Seoul, Korea.
  • 2Department of Psychiatry, Inje University College of Medicine, Busan, Korea.
  • 3Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea. cslimjy@snu.ac.kr
  • 4Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 5Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea.
  • 6Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea.
  • 7Police Trauma Center, Seoul, Korea.
  • 8Department of Critical Care Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.
  • 9Choi Hee-Jeong Internal Medicine Clinic, Seoul, Korea.
  • 10Department of Psychiatry, Kangdong Sacred Heart Hospital, Seoul, Korea.
  • 11Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Korea.

Abstract

BACKGROUND
Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers.
METHODS
We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF), the Beck Depression Inventory II (BDI-II), the Hamilton Rating Scale for Depression (HAM-D), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT.
RESULTS
The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period.
CONCLUSION
In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.

Keyword

Cognitive behavioral therapy; Depression; Mindfulness; Quality of life; Renal dialysis

MeSH Terms

Anxiety
Biomarkers
Cognitive Therapy*
Comorbidity
Compliance
Creatinine
Depression
Dialysis
Humans
Kidney Failure, Chronic*
Meditation
Mental Health
Mindfulness*
Pilot Projects
Quality of Life
Renal Dialysis*
Temperament
Weights and Measures
World Health Organization
Biomarkers
Creatinine
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