Programa baseado em mindfulness para redução do estresse em mulheres inférteis: ensaio clínico controlado e randomizado

Abstract

Background: Infertile women often experience chronic stress, which may have a negative impact on general well-being and increase the burden of infertility. Cortisol and brain-derived neurotrophic factor (BDNF) are involved in stress response. Mindfulness-based therapies develop abilities of self-awareness and may reduce stress symptoms and improve general well-being. However, no randomized trials have tested the effects of a mindfulness-based program (MBP) on stress measures in infertile women. Objective: To evaluate the effects of a MBP on stress symptoms, depressive symptoms, general well-being, hair cortisol and serum BDNF in infertile women. Methods: This was an open label randomized controlled trial. Infertile women aged 18-50 years (median 37 years) were randomly assigned to an eight-week MBP or no intervention. The primary outcome was stress intensity measured by the Lipp Stress Symptoms Inventory (ISSL). Secondary outcomes were depressive symptoms measured by the Beck Depression Inventory (BDI), general well-being assessed by the Psychological General Well Being Inventory (PGWBI), hair cortisol and serum BDNF levels. Data were analyzed by modified intent-to-treat principle, which included all cases available to follow-up regardless of adherence to the intervention (62 participants from the MBP group and 38 from the control group). Results: The median number of symptoms of chronic stress recorded in the past month decreased from 6 (interquartile range 2 to 9) before the MBP to 2 (interquartile range 1 to 4) after the intervention (p<0.001, repeated measures analysis of variance with time x group interaction). Depressive symptoms also decreased after MBP (BDI score 12.0 [6.3-17.0] before and 6.5 [1.5-10.8] after intervention, p=0.001), while general well-being improved (PGWBI score 82 [67-97] before and 97 [84-107] after intervention, p=0.003). Hair cortisol and serum BDNF did not change significantly between pre- and post-intervention. None of the outcomes changed significantly in the control group. Conclusion: MBP was effective in reducing stress and depressive symptoms as well as increasing general well-being in infertile women.