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A mindfulness-based group intervention to reduce psychological distress and fatigue in patients with inflammatory rheumatic joint diseases: a randomised controlled trial
  1. Heidi A Zangi1,
  2. Petter Mowinckel1,
  3. Arnstein Finset2,
  4. Liv R Eriksson3,
  5. Turid Ø Høystad4,
  6. Anne Kristine Lunde5,
  7. Kåre B Hagen1
  1. 1National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2Department of Behavioural Science in Medicine, University of Oslo, Oslo, Norway
  3. 3Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  4. 4Department of Rheumatology, Innlandet Hospital, Kongsvinger, Norway
  5. 5Department of Rheumatology, Betanien Hospital, Skien, Norway
  1. Correspondence to Heidi A Zangi, National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, PO Box 23 Vinderen, NO-0319 Oslo, Norway; heidi.zangi{at}


Objective To evaluate the effects of a mindfulness-based group intervention, the Vitality Training Programme (VTP), in adults with inflammatory rheumatic joint diseases.

Methods In a randomised controlled trial, the VTP—a 10-session mindfulness-based group intervention including a booster session after 6 months—was compared with a control group that received routine care plus a CD for voluntary use with mindfulness-based home exercises. The primary outcome was psychological distress measured by the General Health Questionnaire-20. Self-efficacy (pain and symptoms) and emotion-focused coping (emotional processing and expression) were used as co-primary outcomes. Secondary outcomes included pain, fatigue, patient global disease activity, self-care ability and well-being. Effects were estimated by mixed models repeated measures post-intervention and at 12-month follow-up.

Results Of 73 participants randomised, 68 completed assessments post-intervention and 67 at 12 months. Significant treatment effects in favour of the VTP group were found post-treatment and maintained at 12 months in psychological distress (adjusted mean between-group difference −3.7, 95% CI −6.3 to −1.1), self-efficacy pain (9.1, 95% CI 3.4 to 14.8) and symptoms (13.1, 95% CI 6.7 to 19.3), emotional processing (0.3, 95% CI 0.02 to 0.5), fatigue (−1.1, 95% CI −1.8 to −0.4), self-care ability (1.0, 95% CI 0.5 to 1.6) and overall well-being (0.6, 95% CI 0.1 to 1.2). No significant group differences were found in emotional expression, pain or disease activity.

Conclusion The VTP improved most primary and secondary outcomes compared with individual use of CD exercises. Improvements were maintained at 12 months, suggesting that the VTP is a beneficial complement to existing treatments for patients with inflammatory rheumatic joint diseases.

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  • Funding The study was supported by Diakonhjemmet Hospital.

  • Competing interests None.

  • Ethical approval The study protocol was approved by the Regional Committee for Medical Research Ethics and the Data Inspectorate.

  • Provenance and peer review Not commissioned; externally peer reviewed.