Mindfulness - Based Stress Reduction and the Relationship on Inflammation in Autoimmune Hepatitis
Mindfulness - Based Stress Reduction and the Relationship on Inflammation in Autoimmune Hepatitis
The study is a 'pilot study' to assess the effect of a mindfulness-based stress reduction
 (MBSR) intervention on patients with autoimmune liver disease specifically autoimmune
 hepatitis type I. MBSR is a standardized intervention that has shown benefit in addiction
 disorders and other psychiatric disorders. There has been no study evaluating or showing the
 benefit of the use of MBSR in autoimmune liver disease. With published data showing the
 evidence of an association of stress and relapse in autoimmune hepatitis, it is hypothesized
 that such an intervention such as MBSR may have therapeutic effect in patients with
 autoimmune liver disease.
With the understanding that autoimmune hepatitis has a relationship with psychological
 stress, the use of a strategy such as mindfulness stress based reduction (MBSR) may similarly
 have a substantial impact as seen in other disease conditions. The proposed hypothesis is
 that undergoing MBSR has potential to benefit patients with autoimmune hepatitis in relation
 to decreased relapse rate and ultimately improved quality of life.

 The focus of this study is surrounding the possibility of psychosocial stress for relapse in
 AIH. The investigators, however, would like to also understand the role of serological
 testing at the time of these relapses and during states of psychosocial stress to demonstrate
 if the association can be found. During active disease activity or relapses of autoimmune
 hepatitis, there is an expected rise in alanine aminotransferase (ALT) and immunoglobulin G
 (IgG) levels. Demonstrating the correlation of ALT and IgG with disease status and possible
 improvement with stress modifications is also key for this proposed study.
Inclusion Criteria:

 -  Between ages 18-80 years

 -  Diagnosis of Autoimmune Hepatitis Type I

 Exclusion Criteria:

 Medical

 -  Hospitalization in the last 30 days

 -  New immunosuppression agent started <6 weeks prior to study

 -  Patients with concurrent viral hepatitis and/or alcoholic liver disease

 -  Patients with decompensated cirrhosis (defined as ascites, encephalopathy, variceal
 hemorrhage)

 -  Patients with hepatocellular carcinoma

 -  Patients post-liver transplantation Psychological

 -  Any psychotic disorder or current psychiatric symptoms

 Attitudinal

 -  Inability to commit to program schedule and attendance of classes

 Physical

 -  Inability to physically attend classes; disability or physical impairment not included
 as an exclusion criteria Other

 -  Inadequate English proficiency

 -  Inability to read and/or write