Improve the Symptoms of Psychosis with Mindfulness
By John M. de Castro, Ph.D.
“There is increasing evidence that specially adapted mindfulness techniques can be used safely and effectively in the management and treatment of severe mental health problems, such as psychosis.” – Carly Samson
Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments.
Mindfulness training has been shown to be beneficial for patients with psychosis. Implementing interventions early in the disease progression may maximize the benefits. This training improves a number of different facets of mindfulness. These include describing, observing, acting with awareness, non-judging, and nor-reacting facets. It has not been established which of these facets is critical for symptom improvement
In today’s Research News article “The Role of Five Facets of Mindfulness in a Mindfulness-Based Psychoeducation Intervention for People With Recent-Onset Psychosis on Mental and Psychosocial Health Outcomes.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078358/), Chien and colleagues recruited patients in the early stages of psychosis (< 5 years since onset) including schizophrenia, schizophreniform/schizoaffective disorders or other psychotic disorders. They were randomly assigned to receive either mindfulness-based psychoeducation, conventional psychoeducation, or treatment-as-usual. The mindfulness-based psychoeducation program was a Mindfulness-Based Stress Reduction (MBSR) modified for psychotic patients and consisted of one session every other week for 24 weeks along with daily practice of 20 minutes. They were measured before and after the program and 6 and 18 months later for positive and negative psychotic symptoms, process of recovery, insight, treatment attitude, level of functioning, and mindfulness.
They found that in comparison to baseline and the control groups the patients who received mindfulness-based psychoeducation had significantly greater increases in mindfulness that persisted at the 18-month follow-up. They also found that greater the increases in mindfulness the greater the improvements in positive and negative psychotic symptoms, process of recovery, insight, treatment attitude, and level of functioning. Psychosocial functioning was the most highly related symptom while psychotic symptoms were less associated. Of the facets of mindfulness, only the observing and acting with awareness facets were significantly associated with the symptom improvements.
These results are interesting and suggest that mindfulness can be improved in psychotic patients with training and that these improvements are related to improvements in symptoms. It appears that training that improves the patient’s ability to observe what is occurring in the present moment and to act with awareness in response to what is occurring are the most important aspects of mindfulness for symptom improvement. It would make sense that these abilities would be particularly useful for psychosocial functioning. Psychotic symptoms are extremely difficult to treat. So, these results suggest that mindfulness training may be a helpful program for psychotic patients in the early stages of the disease.
So, improve the symptoms of psychosis with mindfulness.
“There is emerging evidence that mindfulness for psychosis – when used in an adapted form – is safe and therapeutic.” – Paul Chadwick
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Chien, W. T., Chow, K. M., Chong, Y. Y., Bressington, D., Choi, K. C., & Chan, C. (2020). The Role of Five Facets of Mindfulness in a Mindfulness-Based Psychoeducation Intervention for People With Recent-Onset Psychosis on Mental and Psychosocial Health Outcomes. Frontiers in psychiatry, 11, 177. https://doi.org/10.3389/fpsyt.2020.00177
Abstract
Objective: This study aimed to examine how five facets of mindfulness may be associated with the changes in psychotic patients’ health outcomes after participating in a mindfulness-based psychoeducation group (MBPEG) program.
Methods: Longitudinal follow-up data from two pragmatic randomized controlled trials of MBPEG for psychotic patients were used for this study. A total of 124 patients who completed the MBPEG program were included in this analysis. Patient outcomes (psychotic symptoms, functioning, insight into illness/treatment, subjective recovery) and five facets of mindfulness were assessed at baseline and six, 12 and 24 months post-intervention. Areas under the curve of individual outcomes in repeated-measures were computed using trapezoidal method, rescaled to the original possible range of the underlying variable and used for correlation and regression analyses.
Results: All mean scores of the five facets increased across time and were significantly correlated with the improvements in all patient outcomes (p-values ranged from <0.001 to <0.05), except “non-judging” facet and symptom severity. Regression analyses revealed that only “observing” and “acting with awareness” were significantly associated with positive changes across all outcomes (increase in adjusted R2 ranged from 5.9% to 24.2%, p < 0.001).
Conclusions: Two facets of mindfulness, “observing” and “acting with awareness,” were related to positive outcomes of psychotic patients after participating in the MBPEG. More efforts in addressing these two facets of mindfulness can be considered to increase the efficacy of mindfulness-based interventions in psychosis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078358/