The Relationship Between Mindfulness, Depression, Anxiety, and Quality of Life in Individuals With Schizophrenia Spectrum Disorders

Abstract

Background: Schizophrenia spectrum disorders (SSD) are frequently accompanied by comorbid depressive and anxiety symptoms, as well as impaired quality of life (QoL). A growing body of evidence has demonstrated the relevance of mindfulness for SSD in recent years. The study examined the association between mindfulness, depression, anxiety, and QoL.Materials and Methods: A total of 83 participants with SSD were recruited at the in- and outpatient psychiatric hospital care. Participants completed the Southampton Mindfulness Questionnaire, Comprehensive Inventory for Mindful Experiences, and Freiburger Mindfulness Inventory, the Depression, Anxiety, Stress Scale to assess depression and anxiety, and the WHO-QoL Questionnaire. Multiple regression analyses examined the relationship between mindfulness and QoL and the mediating role of depression and anxiety.Results: Mindfulness had a significant statistical positive effect on QoL domains physical health, psychological, and environmental QoL in patients with SSD. Depression was identified as a significant mediator of this relationship.Conclusion: This study provides novel insight into mindfulness’ mechanisms and paves the way for a process-oriented approach to treat SSD. The results provide first evidence for the process-based value of mindfulness for SSD; future studies can focus on the role of mindfulness for central therapeutic processes of change by employing longitudinal designs.

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

“…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. 51 These results showed that increased DM was associated with improved emotions and psychotic symptoms in people with SSDs. Rumination is highly associated with negative emotions and psychotic symptoms and has been supported as a buffer between DM and psychiatric symptoms in clinical populations and SSDs.…”

“…The findings were consistent with previous studies and a recent mediation analysis that found acting with awareness and nonjudging to be significant predictors of depression and anxiety, while describing and observing were found to be unable to predict depression and anxiety in the general population and people with SSDs. 51,76,77 Acting with awareness and nonjudging were suggested to have a substantial role in the prediction of rumination and mental health outcomes, particularly depressive symptoms and quality of life. 51,76,77 Individuals who were judgemental and lacked awareness were found to have higher levels of depression and anxiety and were more inclined to self-criticise and ruminate on negative feelings rather than responding with awareness and self-acceptance, potentially exacerbating and maintaining psychopathological symptoms.…”

“…51,76,77 Acting with awareness and nonjudging were suggested to have a substantial role in the prediction of rumination and mental health outcomes, particularly depressive symptoms and quality of life. 51,76,77 Individuals who were judgemental and lacked awareness were found to have higher levels of depression and anxiety and were more inclined to self-criticise and ruminate on negative feelings rather than responding with awareness and self-acceptance, potentially exacerbating and maintaining psychopathological symptoms. [77][78][79] The study results showed that the influence of DM on hallucination was completely mediated by rumination and negative emotions and significantly mediated by the specific pathway from rumination to negative emotional status.…”

“…Transdiagnostic mediators such as rumination and negative emotion are suggested to amplify or buffer the psychopathological process. 51 DM and mindfulness practice may help to uncouple these transdiagnostic processes implicated in the comorbidities of SSDs. 51,80 Our findings shed light on the contribution of changes in transdiagnostic mediators underlying the therapeutic effects of mindfulness training.…”

“…51 DM and mindfulness practice may help to uncouple these transdiagnostic processes implicated in the comorbidities of SSDs. 51,80 Our findings shed light on the contribution of changes in transdiagnostic mediators underlying the therapeutic effects of mindfulness training. However, further research is needed to confirm the mediating role of rumination, negative emotions and other transdiagnostic factors in the relationship between DM and psychotic symptoms in SSDs.…”