A dyadic Mbsr intervention for Parkinson’s disease patients/caregivers: Effects on distress, cortisol, and inflammation

Abstract

As Parkinson’s disease (PD) progresses, stressors increase among PD patients and their caregivers, often impacting psychological and physical health. Mindfulness-based stress reduction (MBSR) programs have been widely disseminated among clinical and healthy populations, demonstrating improvements in psychological and physical well-being. The present RCT examined pre-to-post changes in psychological and physiological outcomes of PD patients and their caregivers in an MBSR intervention compared to patients and caregivers in wait-list control. Repeated-measures ANOVA analyses comparing PD patients across conditions revealed an unexpected increase in psychological distress for PD patients in MBSR (p = 0.032), driven by a significant increase in intrusive thoughts (p = 0.015). However, as hypothesized, PD patients in MBSR demonstrated a significant decrease in nighttime cortisol (p = 0.021) and a significant decrease in IL-1β (p = 0.004), suggesting improvement in HPA functioning and inflammation stress markers, respectively. Repeated-measures ANOVA analyses comparing caregivers across conditions also revealed a significant decrease in diurnal cortisol slope (p = 0.044) for MBSR caregivers. Findings suggest that the effects of MBSR may increase psychological distress in the form of increased awareness of thoughts. However, MBSR appears to improve patients’ response to stress at the biological level – impacting both HPA functioning and inflammatory response. The effects of MBSR also demonstrated physiological benefit for PD caregivers in regard to their own internal stress response, suggesting clinical implications for the use of MBSR within the family system experiencing illness.