Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.
Schizophr Res. 2021 Feb;228:134-144. doi: 10.1016/j.schres.2020.12.008. Epub 2021 Jan 9.
A Growing body of literature indicates therapeutic effectiveness of mindfulness for mental disorders. Only few trials have been conducted with schizophrenia spectrum disorders (SSD), mostly in outpatient settings. Primary objective was to assess feasibility, acceptability, and preliminary outcomes of mindfulness-based group therapy (MBGT) for in-patients with SSD.
A pre-registered randomized controlled trial was conducted to assess feasibility and acceptability of the MBGT. The primary outcome was mindfulness measured with the Southampton Mindfulness Questionnaire (SMQ). Secondary outcomes were rater-blinded positive- and negative symptoms, depression, social functioning, and self-reported mindfulness, depression, anxiety, psychological flexibility, quality of life, and medication regime at baseline, post-intervention, and follow-up (Clinical Trails NCT03671005).
40 participants received either treatment-as-usual (TAU; n=19) or (MBGT+TAU; n = 21) for four weeks. At post-intervention, protocol adherence was 95.2%, and retention rate was 95%. ANCOVA revealed significant improvements in the MBGT+TAU for the primary outcome SMQ as well as negative symptoms at post-intervention between groups. In exploratory analyses, secondary outcomes showed medium-to-large pre-to-post-intervention effects on mindfulness, positive-, negative-, and depressive symptoms, psychological flexibility, quality of life, and social functioning for MBGT+TAU and small-to-moderate changes on positive symptoms and social functioning for TAU. No serious adverse effects were reported.
MBGT appears feasible and acceptable for in-patient settings, with high protocol adherence and retention rates. Preliminary findings highlight a proof of concept of MBGT and various improvements in clinical- and process dimensions. A fully powered trial is warranted to determine efficacy, cost-efficiency, and longitudinal changes based on these promising outcomes.
越来越多的文献表明正念疗法对精神障碍具有治疗效果。虽然已经有一些针对精神分裂症谱系障碍（SSD）的试验，但大多都是在门诊环境中进行的。本研究的主要目的是评估正念团体治疗（MBGT）对 SSD 住院患者的可行性、可接受性和初步疗效。
本研究采用前瞻性、随机对照试验来评估 MBGT 的可行性和可接受性。主要结局指标是使用南安普顿正念问卷（SMQ）测量的正念水平。次要结局指标包括评定者盲法评估的阳性和阴性症状、抑郁、社会功能以及基线时、干预结束时和随访时的自我报告的正念、抑郁、焦虑、心理灵活性、生活质量和药物治疗方案。
40 名参与者分别接受常规治疗（TAU；n=19）或（MBGT+TAU；n=21）治疗 4 周。在干预结束时，方案依从率为 95.2%，保留率为 95%。协方差分析显示，MBGT+TAU 组在干预后主要结局 SMQ 以及阳性和阴性症状均有显著改善。探索性分析显示，MBGT+TAU 组在正念、阳性、阴性和抑郁症状、心理灵活性、生活质量和社会功能方面的次要结局均有中到大的从基线到干预结束的改善，而 TAU 组在阳性症状和社会功能方面仅有小到中度的改善。没有报告严重的不良事件。
MBGT 似乎适用于住院环境，具有较高的方案依从性和保留率。初步研究结果突显了 MBGT 的概念验证以及临床和治疗过程的各个方面的改善。需要进一步开展充分的试验来确定 MBGT 的疗效、成本效益以及基于这些有前景的结果的纵向变化。
