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基于正念的干预措施治疗精神障碍:系统评价和荟萃分析。

Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis.

机构信息

VA Puget Sound Health Care System, Seattle, WA, USA; Center for Healthy Minds, University of Wisconsin - Madison, Madison, WI, USA; Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA.

Department of Psychology, Louisiana State University, Baton Rouge, LA, USA.

出版信息

Clin Psychol Rev. 2018 Feb;59:52-60. doi: 10.1016/j.cpr.2017.10.011. Epub 2017 Nov 8.

Abstract

Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms. To address the question of relative efficacy, we coded the strength of the comparison group into five categories: no treatment, minimal treatment, non-specific active control, specific active control, and evidence-based treatment. A total of 142 non-overlapping samples and 12,005 participants were included. At post-treatment, mindfulness-based interventions were superior to no treatment (d=0.55), minimal treatment (d=0.37), non-specific active controls (d=0.35), and specific active controls (d=0.23). Mindfulness conditions did not differ from evidence-based treatments (d=-0.004). At follow-up, mindfulness-based interventions were superior to no treatment conditions (d=0.50), non-specific active controls (d=0.52), and specific active controls (d=0.29). Mindfulness conditions did not differ from minimal treatment conditions (d=0.38) and evidence-based treatments (d=0.09). Effects on specific disorder subgroups showed the most consistent evidence in support of mindfulness for depression, pain conditions, smoking, and addictive disorders. Results support the notion that mindfulness-based interventions hold promise as evidence-based treatments.

摘要

尽管基于正念的干预措施在科学和大众中广受欢迎,但这些治疗方法的实证状况仍存在疑问。我们旨在研究基于正念的干预措施对特定疾病症状的临床人群的疗效。为了解决相对疗效的问题,我们将对照组的强度分为五类:无治疗、最小治疗、非特异性活性对照、特异性活性对照和基于证据的治疗。共纳入了 142 个不重叠的样本和 12005 名参与者。在治疗后,基于正念的干预措施优于无治疗(d=0.55)、最小治疗(d=0.37)、非特异性活性对照(d=0.35)和特异性活性对照(d=0.23)。正念条件与基于证据的治疗无差异(d=-0.004)。在随访时,基于正念的干预措施优于无治疗条件(d=0.50)、非特异性活性对照(d=0.52)和特异性活性对照(d=0.29)。正念条件与最小治疗条件(d=0.38)和基于证据的治疗(d=0.09)无差异。在特定疾病亚组的影响方面,正念对抑郁症、疼痛状况、吸烟和成瘾障碍的支持证据最为一致。研究结果支持这样一种观点,即基于正念的干预措施有希望成为基于证据的治疗方法。

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