Effectiveness of group cognitive behavioral therapy with mindfulness in end-stage renal disease hemodialysis patients

BACKGROUND: Many patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience depression. Depression influences patient quality of life (QOL), dialysis compliance, and medical comorbidity. We developed and applied a group cognitive behavioral therapy (CBT) program including mindfulness meditation for ESRD patients undergoing HD, and measured changes in QOL, mood, anxiety, perceived stress, and biochemical markers. METHODS: We conducted group CBT over a 12-week period with seven ESRD patients undergoing HD and suffering from depression. QOL, mood, anxiety, and perceived stress were measured at baseline and at weeks 8 and 12 using the World Health Organization Quality of Life scale, abbreviated version (WHOQOL-BREF), the Beck Depression Inventory II (BDI-II), the Hamilton Rating Scale for Depression (HAM-D), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS). Biochemical markers were measured at baseline and after 12 weeks. The Temperament and Character Inventory was performed to assess patient characteristics before starting group CBT. RESULTS: The seven patients showed significant improvement in QOL, mood, anxiety, and perceived stress after 12 weeks of group CBT. WHOQOL-BREF and the self-rating scales, BDI-II and BAI, showed continuous improvement across the 12-week period. HAM-D scores showed significant improvement by week 8; PSS showed significant improvement after week 8. Serum creatinine levels also improved significantly following the 12 week period. CONCLUSION: In this pilot study, a CBT program which included mindfulness meditation enhanced overall mental health and biochemical marker levels in ESRD patients undergoing HD.

The Effectiveness of Free and Cued Selective Reminding Test Using Pattern Cue

OBJECTIVE: Memory Impairment has been proposed as the first sign in preclinical and early Alzheimer's disease (AD). This study aims to assess the utility of a new memory test based on Free and Cued Selective Reminding Test using pattern cue that seems useful for detecting memory impairments associated with AD. METHODS: Twenty-six patients with mild cognitive impairment, 24 AD patients at a mild stage, 35 normal controls and 8 Lewybody dementia (LBD) patients at a mild stage took part in the study. A newly devised Pattern Cued Recall Test (PCRT) was compared with established memory test, the word list recall from the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). To assess the ability of the PCRT subtests and CERAD-K to screen dementia, receiver operating characteristic curves were plotted. RESULTS: The distinctive feature of the PCRT was that encoding specificity was increased by adding an immediate cued recall stage at the encoding phase. PCRT was confirmed as having sufficient validity to diagnose dementias. Compared to CERAD-K, the PCRT had similar accuracy of discriminating AD. But the analysis showed better diagnostic validity of PCRT than CERAD-K in LBD. Therefore, this test appears to be, especially, well suited for the diagnosis of mild LBD. CONCLUSION: This study showed that a memory test based on controlled encoding and retrieval condition and especially using pattern cue could be effective methodology for mild AD and LBD from normal control. PCRT could be an alternative to diagnose LBD by testing visual impairments, which is a hallmark symptom of LBD. Therefore, a further clinical study should be promising.