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The Mindfulness Intervention as Myocardial Infarction Rehabilitation Additive (MIMIRA) study aimed at studying the feasibility and acceptability of Mindfulness Based Stress Reduction - an 8 week course in meditation and yoga - in patients with a recent coronary artery event and elevated depressive symptoms. To address these questions patients with elevated scores on a depression scale were invited to participate in MBSR, and there evaluation of the course as well as a panel of psychological risk factors and resources was measured.
Depressive symptomatology in patients with coronary artery disease (CAD) has prognostic importance. Yet, psychological interventions in clinical practice are scarce. Here, we explored the feasibility and acceptability of mindfulness-based stress reduction (MBSR) in patients with depressive symptoms after a recent coronary event. A second aim was to investigate psychological risk factors and resources among participants.
To address the research questions, depressive symptoms were first measured in a reference population, at 1 and 12 months after a coronary event (myocardial infarction or unstable angina pectoris), and a cut-off for elevated depressive symptoms were obtained from the median in this group. Thereafter, similar CAD patients with elevated depressive symptoms (above median in the reference group), from the same outpatient clinic, were consecutively invited to an 8-week MBSR program. Serious physical or psychiatric illness that would be an obstacle to participation were exclusion criteria.
Patients who completed the MBSR-course were asked to evaluate its various facets, and completion rate and attendance were feasibility outcomes. Psychological variables were measured before, after the course as well as 12 months later.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| MBSR participation | Experimental | Participation in the 8 week Mindfulness Based Stress Reduction (MBSR) course. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mindfulness Based Stress Reduction (MBSR) | Behavioral | An 8-week course in mindfulness meditation, yoga training and weekly group support in the form of weekly 2,5 hour meetings at the hospital. |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility | Patient evaluation questionnaire | Immediately after the 8-week intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Depressive Symptoms | Centre for Epidemiological Studies Scale Depression (CES-D) questionnaire (Radloff) | Before, immediately after and 12 months post intervention. |
| Anxiety | Generalized Anxiety Disorder Scale - 7 (GAD-7) questionnaire (Spitzer) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lena LJ Jonasson, M.D. Ph.D. | Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Linköping University | Linköping | 581 83 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34585329 | Derived | Lundgren O, Garvin P, Nilsson L, Tornerefelt V, Andersson G, Kristenson M, Jonasson L. Mindfulness-Based Stress Reduction for Coronary Artery Disease Patients: Potential Improvements in Mastery and Depressive Symptoms. J Clin Psychol Med Settings. 2022 Sep;29(3):489-497. doi: 10.1007/s10880-021-09822-z. Epub 2021 Sep 28. | |
| 30213276 |
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Individual participant data will be available on reasonable request.
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D003863 | Depression |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D000099024 | Mindfulness-Based Stress Reduction |
| ID | Term |
|---|---|
| D064866 | Mindfulness |
| D015928 | Cognitive Behavioral Therapy |
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
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Pilot and feasibility study of one cohort.
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| Before, immediately after and 12 months post intervention. |
| Mindfulness | Five Facets of Mindfulness Questionnaire (FFMQ) (Baer) | Before, immediately after and 12 months post intervention. |
| Acceptance | Acceptance and Action Questionnaire II (AAQII) (Block) | Before, immediately after and 12 months post intervention. |
| Mastery | Mastery questionnaire (Pearlin & Shooler) | Before, immediately after and 12 months post intervention. |
| Self-esteem | Self-esteem questionnaire (Rosenberg) | Before, immediately after and 12 months post intervention. |
| Patients experiences of mindfulness training | Written journal entries (linguistic content) | Continuously during the 8 week course. |
| Lundgren O, Garvin P, Kristenson M, Jonasson L, Thylen I. A journey through chaos and calmness: experiences of mindfulness training in patients with depressive symptoms after a recent coronary event - a qualitative diary content analysis. BMC Psychol. 2018 Sep 13;6(1):46. doi: 10.1186/s40359-018-0252-1. |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D004191 |
| Behavioral Disciplines and Activities |