Effect of Mindfulness-based Metacognitive Skills Training on Depression, Anxiety, Stress, and Well-being in Patients with Systemic Lupus Erythematosus

Background and purpose: Patients with systemic lupus erythematosus (SLE) suffer from a variety of psychological problems, including depression, anxiety, and stress. This study aimed to examine the effect of mindfulness-based metacognitive skills training on depression, anxiety, stress, and sense of well-being in patients with SLE. Materials and methods: This randomized clinical trial with pre-test/post-test design was carried out in 60 patients with SLE attending Babol Shahid Beheshti Nephrology Clinic, 2018. They were randomly divided into two groups (n=30 per group). The experimental group received weekly sessions of mindfulness-based metacognitive skills training (1 hr/ 8 weeks), while the control group did not receive any intervention. The patients’ socio-demographic information was recorded and Depression Anxiety and Stress Scale (DASS-21) and Psychological Well-Being Scale (PWB) were administered. Descriptive and inferential statistical methods including generalized estimator equations with autoregressive correlation structure were applied in SPSS V24. Results: In experimental group, the mean scores for depression, anxiety, and stress significantly changed after the intervention (P=0.001). In this group, the post-intervention mean score for well-being also significantly improved (P=0.006). Compared with the experimental group, the control group was not found with any significant changes in depression, anxiety, stress, and well-being. Conclusion: Mindfulness-based metacognitive skills may improve depression, anxiety, stress, and sense of well-being in patients with systemic lupus erythematosus.   (Clinical Trials Registry Number: IRCT20171203037723N2)