Volume 7 • Issue 2 • 1000547 Open Access Research Article J AIDS Clin Res ISSN: 2155-6113 JAR an open access journal Schadé et al., J AIDS Clin Res 2016, 7:2 DOI: 10.4172/2155-6113.1000547 Mindfulness Based Cognitive Therapy (MBCT) as An Addition to Psychiatric Care as Usual for HIV-infected Patients with Mental Health Symptoms Annemiek Schadé*, Gerard van Grootheest and Johannes H Smit GGZ inGeest and Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands *Corresponding author: Annemiek Schadé, Expert and Treatment Center on HIV and Mental Health, GGZ inGeest, VU University Medical Center, Amstelveenseweg 5891081 JC Amsterdam, The Netherlands, Tel: 00-31-20-7885000, E-mail: a.schade@ggzingeest.nl Received January 25, 2016; Accepted February 15, 2016; Published February 23, 2016 Citation: Schadé A, van Grootheest G, Smit JH (2016) Mindfulness Based Cognitive Therapy (MBCT) as An Addition to Psychiatric Care as Usual for HIV-infected Patients with Mental Health Symptoms. J AIDS Clin Res 7: 547. doi:10.4172/2155- 6113.1000547 Copyright: © 2016 Schadé A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Anxiety; Depressive symptoms; Fatigue; HIV; Mental health; Mindfulness based cognitive therapy (MBCT); Suicidal thoughts Introduction HIV-infected patients have an increased risk of mental health symptoms like depression, anxiety disorders, abuse of alcohol and drugs and personality disorders and there is a high prevalence of psychopathology in those patients [1-3]. In addition, suicidal ideations occur frequently and the risk of suicide and suicide attempts is high among HIV-infected patients, compared to the general population and compared to patients with other chronic somatic diseases [4]. Many HIV-infected patients sufer from pain and physical symptoms and there is a strong association between these symptoms and mental health symptoms [5]. HIV-related fatigue has a high prevalence and is strongly associated with psychological factors such as depression and anxiety [6]. Physical and mental health symptoms have a major negative infuence on the quality of life and on the treatability, adherence, and prognosis of the HIV infection [2,7,8]. Both psychotherapy and medication have proven to be efective treatment for mental health problems in HIV-infected patients, especially with regard to depressive symptoms [9]. Terefore, it is important that treatments are developed that take both physical and mental aspects into account. In the 1980s, such a combination program for chronically ill patients was developed by John Kabat-Zinn. He developed the Mindfulness Based Stress Reduction (MBSR) programme for patients with chronic pain and stress-symptoms based on meditation techniques and an alternative way of focussing attention [10]. Segal, Williams and Teasdale added elements of cognitive therapy and developed the Mindfulness Based Cognitive Terapy (henceforth MBCT) [11]. MBCT is a short, easy to realize 8-week therapy, consisting of 8 sessions with trained therapists. Patients are expected to do exercises and meditation at home for at least one hour per day. Although the reported positive results have met with criticism [12], a meta-analysis showed that MBCT had small efects on depression, anxiety and psychological distress in people with chronic somatic diseases [13]. Randomized clinical trials (RCTs) have shown that combining MBCT with regular treatment signifcantly reduces the relapse risk in depressive symptoms or extends the time until relapse, compared with regular treatment alone [11,14,15]. Another study showed that MBCT reduced depressive symptoms and pain intensity and increased energy levels for patients with a traumatic brain injury and a clinically diagnosed depression [16]. Abstract Objectives: HIV-infected patients suffer from both physical and mental health symptoms and treatment of both symptoms is important. The 8-week Mindfulness Based Cognitive Therapy (henceforth MBCT) was originally developed for both mental and physical symptoms and is easy to implement. It is unknown, however, whether the addition of MBCT to psychiatric care as usual is effective in the long term and feasible for this group of patients. We measured depressive and anxiety symptoms, suicidal thoughts and fatigue in HIV-infected patients receiving psychiatric care as usual with or without MBCT, at intake and after one year. Methods: The study was conducted at the outpatient clinic for HIV and Mental Health at GGZ inGeest in Amsterdam, the Netherlands, between March 2006 and September 2009. MBCT was offered as a group therapy in addition to individual care as usual to all (N=208) patients in their frst year of psychiatric treatment. Results: In the research period, 58 patients opted for the MBCT and 150 did not. Twenty patients did not complete the MBCT and questionnaires of both time points were available from 22 patients with and from 60 patients without MBCT. During their frst year of psychiatric care, patients in both treatment groups showed signifcant improvement on depressive and anxiety symptoms, suicidal thoughts and fatigue. Conclusion: Measured after one year, the addition of MBCT to psychiatric care as usual for HIV-infected patients had no measurable added effect on the treatment of depressive and anxiety symptoms, suicidal thoughts and fatigue. The present study was an explorative study to investigate the role of additional MBCT to psychiatric care as usual. It seems that general addition of MBCT is not feasible in this group of patients. However, further research, for example in a randomized controlled trial (RCT) is necessary to confrm the results. J o u r n a l o f A I D S & C li n i c a l R e s e a r c h ISSN: 2155-6113 Journal of AIDS & Clinical Research