Effectiveness of mindfulness‐based intervention on psychotic symptoms for patients with schizophrenia: A meta‐analysis of randomized controlled trials

Abstract

Aims To evaluate the effects of mindfulness‐based intervention on psychotic symptoms, positive symptoms, negative symptoms, depressive symptoms, anxiety, and rehospitalization. Design A meta‐analysis of randomized controlled trials. Data Sources Medline, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, National Digital Library of Theses and Dissertations in Taiwan, and Airiti Library were searched from their earliest available date up to April 2019. Review Methods The guidelines of the Cochrane Collaboration were followed to report this systematic review. Two authors conducted this meta‐analysis independently. Results Nine randomized controlled trials were included. Meta‐analysis showed that mindfulness‐based intervention significantly decreased psychotic symptoms, positive symptoms, negative symptoms, depressive symptoms, and duration of rehospitalization among patients with schizophrenia, and that the reduction in negative symptoms lasted through short‐term follow‐up. The moderation analysis showed that significantly decreased positive symptoms occurred in the nurse‐led intervention group, while no significant impact was found in the psychologist‐led intervention group. Conclusion The psychotic symptoms of the patients with schizophrenia are improved after mindfulness‐based intervention and the effects on the negative symptoms can be maintained for at least 3 to 6 months. Mindfulness‐based intervention provided by nurses produces more improvements in positive symptoms than intervention provided by psychologists. Impact A growing number of mindfulness‐based interventions have been implemented for patients with schizophrenia, although the effectiveness had not previously been established by meta‐analysis. Mindfulness‐based interventions appear to reduce the symptom severity of schizophrenia patients. Further suggestions for healthcare providers and researchers are provided and discussed.

Effects of Mindfulness-Based Stress Reduction (MBSR) on Stress, Heart Rate Variability, Affect, and Wellbeing among People with Schizophrenia

“…This result is similar to those of previous studies that observed changes in negative affect in adults through meditation [51,52]. In addition, the results of this study are aligned with previous meta-analyses [24,25], which found that MBIs were effective for the negative symptoms of people with schizophrenia. An explanation for this result could be that the MBSR program allowed participants to choose an adaptive direction of cognition, departing from dysfunctional aspects through training to become aware of their thoughts and emotions [53].…”

“…Recent systematic reviews and meta-analyses of randomized controlled trials have found that MBIs reduced psychotic symptoms, positive symptoms, negative symptoms, depressive symptoms, and duration of rehospitalization among people with schizophrenia, as well as improving their level of function and awareness of illness [24,25]. In the last few decades, MBIs have rapidly become more popular, and extensive research has explored their efficacy as treatments for various psychological disorders [26].…”

Promoting resilience in persons with serious mental health conditions during the Coronavirus pandemic.

“…Some recent reviews and meta-analyses highlight the value of mindfulness-based interventions, which for persons with serious mental health conditions, promote resilience and such recovery principles as self-determination (Davis & Kurzban, 2012; Khoury et al, 2013; Potes et al, 2018). Mindfulness interventions with the target population yield positive outcomes in terms of ameliorating psychotic symptoms as well as depressive symptoms and cognitions that may be exacerbated by pandemic-related stressors; reducing the need for psychiatric hospitalization; improving people’s sense of self-efficacy; and bolstering people’s psychosocial and vocational functioning (Hodann-Caudevilla et al, 2020; Jansen et al, 2020; Liu et al, 2021). During the COVID-19 pandemic, mindfulness interventions with this population, which can be done in the context of the therapy and/or via the use of mHealth or eHealth interventions, should be geared to support adaptive and flexible functioning in the context of long-term uncertainty and profound social changes (Antonova et al, 2021).…”

Dispositional Mindfulness and Psychotic Symptoms in Schizophrenia Spectrum Disorders: The Mediating Roles of Rumination and Negative Emotion

“…[41][42][43][44] Recent randomised control studies and metaanalyses showed that mindfulness-based interventions significantly improved DM, negative emotions, positive symptoms and negative symptoms compared with control groups. [43][44][45][46][47][48][49] A 2-year longitudinal follow-up study of the relationships between changes in the five facets of mindfulness (observing, describing, acting with awareness, nonjudging and nonreactivity) and the clinical outcomes of psychotic patients who received mindfulness training revealed that all facets of mindfulness significantly increased over time and that two facets (observing and acting with awareness) were significantly associated with improvements in positive and negative symptoms. 50 A recent mediation analysis also suggested that negative emotion might mediate the relationship between DM and clinical outcomes, such as quality of life, in people with SSDs.…”