基于正念的干预措施治疗非情感性精神病:全面的系统评价和荟萃分析。

Mindfulness-based interventions for non-affective psychosis: a comprehensive systematic review and meta-analysis.

机构信息

School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, UK.

出版信息

Ann Med. 2022 Dec;54(1):2340-2353. doi: 10.1080/07853890.2022.2108551.

Abstract

AIM

Although mindfulness-based interventions (MBIs) are routinely used in clinical practice, a comprehensive synthesis of the effectiveness of MBIs for non-affective psychosis has yet to be conducted. The aim of the present review and meta-analysis was to investigate the effectiveness of MBIs including those with mindfulness as an active treatment component for alleviating symptoms of psychosis to inform future clinical practice.

METHODS

A systematic review of studies published in journals or in dissertations in CINAHL, PubMed, EMBASE, PsycINFO, CENTRAL, ISRCTN, or CNKI from January 1990 until December 2020. A total of 31 eligible studies ( = 2146) were included.

RESULTS

Effect-size estimates suggested that 22 independent samples ( = 1632) produced a statistically significant small effect for psychotic symptoms ( = -0.48), and with a clinically significant reduction of 50% from baseline (pooled OR: 1.84). Separate meta-analyses demonstrated small effects for affective symptoms ( = -0.44) and smallto-large positive effects for quality of life ( = 0.38), mindfulness skills ( = 0.45), and insight into illness/treatment ( = 1.35). The heterogeneity was high across the studies.

CONCLUSION

Results suggest that short-term MBIs can be beneficial for non-affective psychosis. Future research is needed to test the efficacy and safety of dedicated MBIs for this population group over a longer term. KEY MESSAGESSchizophrenia spectrum and other psychotic disorders, also known as non-affective psychosis, is the most chronic and debilitating type of psychosis, seriously affecting every aspect of a person's life, including social, occupational, or general functioning.The aim of the current systematic review and meta-analysis was to investigate formerly unexamined questions regarding the clinical significance of MBIs including yoga as an increasingly utilized, conceptualized psychological intervention on overall psychotic symptoms for people with non-affective psychosis.No serious adverse events were reported in the studies, suggesting that MBIs may be safe interventions, while there is robust evidence to support the view that MBIs are beneficial to young people in particular.

摘要

目的

虽然基于正念的干预措施(MBIs)已在临床实践中常规应用,但尚未综合评估 MBIs 对非情感性精神病的有效性。本综述和荟萃分析旨在调查包括正念作为主动治疗成分的 MBIs 对缓解精神病症状的有效性,以为未来的临床实践提供信息。

方法

对 1990 年 1 月至 2020 年 12 月期间在 CINAHL、PubMed、EMBASE、PsycINFO、CENTRAL、ISRCTN 和 CNKI 杂志上发表的研究或论文进行系统综述。共纳入 31 项符合条件的研究( = 2146)。

结果

效应量估计表明,22 个独立样本( = 1632)的精神病症状存在统计学上显著的小效应( = -0.48),与基线相比,有 50%的临床显著降低(合并 OR:1.84)。单独的荟萃分析表明,情感症状有较小的效应( = -0.44),生活质量( = 0.38)、正念技能( = 0.45)和对疾病/治疗的洞察力( = 1.35)有小到中等的积极效应。研究之间的异质性很高。

结论

结果表明,短期 MBIs 对非情感性精神病可能有益。需要进一步研究,以测试针对该人群的专门 MBIs 在更长时间内的疗效和安全性。

关键信息

精神分裂症谱系和其他精神病性障碍,也称为非情感性精神病,是最慢性和致残性的精神病类型,严重影响一个人的生活的方方面面,包括社会、职业或一般功能。本系统综述和荟萃分析的目的是调查以前未研究过的问题,即包括瑜伽在内的日益被应用的概念化心理干预措施对非情感性精神病患者的整体精神病症状的 MBIs 的临床意义。

研究中未报告严重不良事件,这表明 MBIs 可能是安全的干预措施,同时有强有力的证据支持 MBIs 对年轻人特别有益的观点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8784/9423825/128686590919/IANN_A_2108551_F0001_B.jpg

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