Background: Alongside experiencing physical symptoms with no identifiable
organic cause, patients with MUS commonly experience comorbid anxiety and
depression. They also have high health utilisation costs, which has implications for
the health service. Interventions which target these symptoms in a cost effective way
need to be developed and evaluated.
Objective: To develop and evaluate a self-help mindfulness-based stress reduction
(MBSR) intervention for patients with medically unexplained symptoms (MUS).
Methods: A systematic review of the literature was carried out to evaluate the
effectiveness of MBSR for reducing psychological distress in people with MUS.
Study 1 developed and evaluated a self-help MBSR intervention in a clinical setting.
Fifteen participants were recruited from eight practice, however only five completed
post-intervention measures. A combination of t-tests and descriptive statistics were
used to compare changes in levels of psychological distress, quality of life,
symptoms and mindfulness at post-intervention. Pearson‘s correlations were used to
identify relationships between improvements in mindfulness and improvements in
outcomes. Study 2, exploring the reasons for the difficulties recruiting participants to
Study 1, was then carried out through questionnaires to GPs.
Results: Though more evidence is needed, the systematic review found MBSR to
have moderate effects on psychological distress, which are largely maintained or
improved at follow-up. Study 1 found symptom frequency and levels of acceptance
to have improved at post-intervention. Study 2 found that the main reasons for GPs
not recruiting participants was that they were busy and found it difficult to prioritise
given other demands.
Conclusions: Evidence to date suggests that MBSR is an effective intervention for
patients with MUS. Future studies may benefit from recruiting participants from
relevant organisations or using alternative methods such as database searches. No
firm conclusions can be made about the self-help MBSR intervention‘s efficacy due
to the study‘s limitations, however changes seen in the completer group suggest that
further research would be warranted