Ires Ghielen

100 Chapter 6 Besides CBT, mindfulness-based treatments (MBTs) receive increasing attention in clinical practice. Mindfulness involves ‘paying attention in a particular way: on purpose, in the present moment, and non-judgmentally’ [15]. MBTs include mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation, and acceptance and commitment therapy. MBTs have been proven to be effective in reducing anxiety and depressive symptoms in patients with anxiety and depressive disorders [16], and patients with chronic pain [17]. Also, small to moderate effect sizes in improving mental health were found in populations with different chronic somatic diseases [18, 19], and medium effect sizes were found in MBTs for MS patients [20]. To reduce psychological distress in patients with progressive neurological disorders, CBTs and MBTs might thus be of potential benefit. Since these interventions are considered treatment options, it is warranted to investigate their effectiveness. In order to establish the efficacy of CBTs and MBTs on reducing psychological distress in PD, HD, and MS patients, we performed a meta-analysis on randomized controlled trials. Method Selection of studies A comprehensive literature search was conducted in PubMed, PsycINFO, the Cochrane library and EMBASE through March 2018. In addition, ClinicalTrials.gov was searched for completed but unpublished studies. The following keywords were used: “Parkinson”, “Huntington”, “Multiple Sclerosis”, “psychological distress”, “stress reduction”, “distress”, “depressive symptoms”, “anxiety symptoms” (see the supplementary material for the complete search string). Besides the database searches, recent meta-analyses [21-23] were read to find additional studies. Two researchers (IG, SR) independently selected the studies for inclusion and when they disagreed a consensus was made. Inclusion criteria for the meta-analyses were: • Patients: a study population of MS, PD, or HD patients. • Intervention: the examination of a CBT- or MBT-based intervention. • Comparison: the intervention was compared with a waitlist or treatment- as-usual (TAU) condition, or with another active form of therapy. Only randomized controlled trials (RCTs) were included in this meta-analysis.