Mindfulness- and Acceptance-based Interventions for Psychosis: A Systematic Review and Meta-analysis

Holger Cramer, Romy Lauche, Heidemarie Haller, Jost Langhorst, Gustav Dobos, Holger Cramer, Romy Lauche, Heidemarie Haller, Jost Langhorst, Gustav Dobos

Abstract

Background: Mindfulness- and acceptance-based interventions are increasingly studied as a potential treatment for a variety of mental conditions.

Objective: To assess the effects of mindfulness- and acceptance-based interventions on psychotic symptoms and hospitalization in patients with psychosis.

Methods: MEDLINE/PubMed, Embase, the Cochrane Library, and PsycINFO were screened from inception through April 2015. Randomized controlled trials (RCTs) were analyzed when they assessed psychotic symptoms or hospitalization in patients with psychosis; affect, acceptance, mindfulness, and safety were defined as secondary outcomes.

Results: Eight RCTs with a total of 434 patients comparing mindfulness-based (4 RCTs) or acceptance-based interventions (4 RCTs) to treatment as usual or attention control were included. Six RCTs had low risk of bias. Moderate evidence was found for short-term effects on total psychotic symptoms, positive symptoms, hospitalization rates, duration of hospitalization, and mindfulness and for long-term effects on total psychotic symptoms and duration of hospitalization. No evidence was found for effects on negative symptoms, affect, or acceptance. No serious adverse events were reported.

Conclusion: Mindfulness- and acceptance-based interventions can be recommended as an additional treatment for patients with psychosis.

Keywords: Psychosis; acceptance; meta-analysis; mindfulness; systematic review.

Figures

Figure 1
Figure 1
Flowchart of the results of the literature search.
Figure 2
Figure 2
Short-term effects of mindfulness- and acceptance-based interventions compared to treatment as usual on primary outcomes: total symptoms, positive symptoms, negative symptoms, and hospitalization.
Figure 2
Figure 2
Short-term effects of mindfulness- and acceptance-based interventions compared to treatment as usual on primary outcomes: total symptoms, positive symptoms, negative symptoms, and hospitalization.
Figure 3
Figure 3
Effects of mindfulness- and acceptance-based interventions compared to treatment as usual on secondary outcomes: affect, acceptance, and mindfulness.
Figure 4
Figure 4
Long-term effects of mindfulness- and acceptance-based interventions compared to treatment as usual on primary outcomes: total symptoms and hospitalization.

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Source: PubMed

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