Chadwick Paul, Hughes Stephanie, Russell Daphne, Russell Ian, Dagnan Dave
Institute of Psychiatry, King's College London, UK.
Behav Cogn Psychother. 2009 Jul;37(4):403-12. doi: 10.1017/S1352465809990166. Epub 2009 Jun 23.
The clinical literature cautions against use of meditation by people with psychosis. There is, however, evidence for acceptance-based therapy reducing relapse, and some evidence for clinical benefits of mindfulness groups for people with distressing psychosis, though no data on whether participants became more mindful.
To assess feasibility of randomized evaluation of group mindfulness therapy for psychosis, to replicate clinical gains observed in one small uncontrolled study, and to assess for changes in mindfulness.
Twenty-two participants with current distressing psychotic experiences were allocated at random between group-based mindfulness training and a waiting list for this therapy. Mindfulness training comprised twice-weekly sessions for 5 weeks, plus home practice (meditation CDs were supplied), followed by 5 weeks of home practice.
There were no significant differences between intervention and waiting-list participants. Secondary analyses combining both groups and comparing scores before and after mindfulness training revealed significant improvement in clinical functioning (p = .013) and mindfulness of distressing thoughts and images (p = .037).
Findings on feasibility are encouraging and secondary analyses replicated earlier clinical benefits and showed improved mindfulness of thoughts and images, but not voices.
临床文献警示精神病患者不宜使用冥想。然而，有证据表明基于接纳的疗法可减少复发，也有一些证据显示正念团体对患有痛苦性精神病的患者有临床益处，不过尚无关于参与者是否变得更具正念的数据。
评估对精神病患者进行团体正念疗法随机评估的可行性，复制一项小型非对照研究中观察到的临床获益，并评估正念的变化。
22名目前有痛苦性精神病体验的参与者被随机分配到基于团体的正念训练组和该疗法的等待名单组。正念训练包括为期5周、每周两次的课程，外加家庭练习（提供冥想CD），之后是5周的家庭练习。
干预组和等待名单组参与者之间无显著差异。将两组合并并比较正念训练前后分数的二次分析显示，临床功能（p = .013）以及对痛苦想法和意象的正念（p = .037）有显著改善。
关于可行性的研究结果令人鼓舞，二次分析复制了早期的临床益处，并显示出对想法和意象的正念有所改善，但对幻听没有效果。
