A feasibility investigation of mindfulness-based cognitive therapy for people with Huntington's disease

Fiona J R Eccles, David Craufurd, Alistair Smith, Rhys Davies, Kristian Glenny, Max Homberger, Siofra Peeren, Dawn Rogers, Leona Rose, Zara Skitt, Rachael Theed, Jane Simpson, Fiona J R Eccles, David Craufurd, Alistair Smith, Rhys Davies, Kristian Glenny, Max Homberger, Siofra Peeren, Dawn Rogers, Leona Rose, Zara Skitt, Rachael Theed, Jane Simpson

Abstract

Background: Huntington's disease (HD) is an inherited neurodegenerative condition which affects movement, coordination and cognitive functioning. Psychological difficulties are commonly experienced; however, psychological interventions have been little researched with this population. We investigated the feasibility of conducting a randomised controlled trial (RCT) of mindfulness-based cognitive therapy (MBCT) with people with the HD genetic mutation, either pre-manifest (before onset of movement symptoms) or at an early disease stage. Specifically, we evaluated the willingness of participants to be recruited into and complete the intervention; the acceptability of the study measures in relation to completion; the feasibility of offering the standard MBCT course to people with HD; the acceptability of the intervention and the estimated effect sizes.

Methods: Participants were recruited from two UK HD centres and took part in an 8-week course of MBCT, with three reunions throughout the following year. Stress, depression, anxiety, and mindfulness were measured pre-, mid-, and post-course, at 3 months and at 1 year. Sleep, quality of life, positive affect and coping were measured pre- and post-course, at 3 months and at 1 year. Descriptive data and approximate effect sizes were calculated. Interviews were conducted post-course and at 1 year and data pertaining to the acceptability of the course were extracted.

Results: Twelve participants took part in two groups; all were pre-manifest. Levels of depression and anxiety were low pre-course leaving little room for improvement. Changes in stress and in some aspects of mindfulness were medium to large. The qualitative data suggested participants rated the course highly and found it helpful and no changes to the standard course were needed. Recruitment levels were below those anticipated. Most measures were found to be acceptable.

Conclusions: Although the course was acceptable to those who took part, given the difficulties in recruiting and the rarity of HD, conducting an RCT of MBCT teaching groups in person does not seem feasible. However, alternative modes of course delivery (e.g. online) would allow the recruitment of people from a greater geographical area and may make an RCT feasible; this revised focus would be suitable for future feasibility studies.

Trial registration: ClinicalTrials.gov identifier NCT02464293, registered 8 June 2015.

Keywords: Anxiety; Depression; Huntington’s disease; Mindfulness; Stress.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
Flow of participants throughout the research. Repeaters in cohort 2 had completed the intervention in cohort 1 and took part in the intervention a second time. Only data for the new completers in cohort 2 (not the repeaters) are included in the results section

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