Social Mindfulness is Reduced in Patients with Psychosis

Social Mindfulness is Reduced in Patients with Psychosis

 

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. Individuals with psychosis almost always have difficulties with social functioning. It is reasonable then to investigate the social mindfulness of patients having their first psychotic episode. In today’s Research News article “). Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381043/ ), Lemmers-Jansen and colleagues recruited patients having their first psychotic episode aged 16 to 22 years, individuals at high clinical risk for developing psychosis, and healthy control participants..

 

The participants were measured for social mindfulness, intelligence, and positive and negative symptoms of psychosis. In the social mindfulness task, the participants made a choice that would either enhance (socially mindful) or decrease (socially unmindful) choices for another unseen participant. They performed the task initially without instruction and again after being instructed “to keep the other’s best interest in mind.” The participants performed the social mindfulness task while undergoing functional Magnetic Resonance Scans (f-MRI) of their brains.

 

They found that the patients with their first psychotic episode tended to make less socially mindful choices both before and after instruction than either the individuals at high clinical risk for developing psychosis, and healthy control participants. In addition, the patients with psychosis showed less activation of the caudate during mindful choices and less activation of the medial and dorsal prefrontal cortex and the cingulate cortex during unmindful choices that the other groups.

 

The neural findings suggest that the psychotic patients used less higher-level thinking when making socially unmindful choices (prefrontal cortex) and received less reward for making socially mindful choices (caudate). This suggests that the psychotic patients are less mindful because they’re responding with less thought and with less reinforcement for making socially mindful choices. Regardless, it is clear that a laboratory test confirms what is reported in the patients that they respond less well to social situations.

 

Fears about meditation triggering psychosis were holding back progress in this area, despite growing evidence that a specially adapted form of mindfulness training could prove safe and very beneficial for these patients.” – Plastic Brain

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lemmers-Jansen, I., Fett, A. J., Van Doesum, N. J., Van Lange, P., Veltman, D. J., & Krabbendam, L. (2019). Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk. Frontiers in human neuroscience, 13, 47. doi:10.3389/fnhum.2019.00047

 

Abstract

Background: Psychosis is characterized by problems in social functioning and trust, the assumed glue to positive social relations. But what helps building trust? A prime candidate could be social mindfulness: the ability and willingness to see and consider another person’s needs and wishes during social decision making. We investigated whether first-episode psychosis patients (FEP) and patients at clinical high-risk (CHR) show reduced social mindfulness, and examined the underlying neural mechanisms.

Methods: Twenty FEP, 17 CHR and 46 healthy controls, aged 16–31, performed the social mindfulness task (SoMi) during fMRI scanning, spontaneously and after the instruction “to keep the other’s best interest in mind.” As first of two people, participants had to choose one out of four products, of which three were identical and one was unique, differing in a single aspect (e.g., color).

Results: FEP tended to choose the unique item (unmindful choice) more often than controls. After instruction, all groups significantly increased the number of mindful choices compared to the spontaneous condition. FEP showed reduced activation of the caudate and medial prefrontal cortex (mPFC) during mindful, and of the anterior cingulate cortex (ACC), mPFC, and left dorsolateral prefrontal cortex (dlPFC) during unmindful decisions. CHR showed reduced activation of the ACC compared to controls.

Discussion: FEP showed a trend toward more unmindful choices. A similar increase of mindful choices after instruction indicated the ability for social mindfulness when prompted. Results suggested reduced sensitivity to the rewarding aspects of social mindfulness in FEP, and reduced consideration for the other player. FEP (and CHR to a lesser extent) might perceive unmindful choices as less incongruent with the automatic mindful responses than controls. Reduced socially mindful behavior in FEP may hinder the building of trust and cooperative interactions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381043/

 

Improve Severe Mental Illness with Yoga and Mindfulness

Improve Severe Mental Illness with Yoga and Mindfulness

 

By John M. de Castro, Ph.D.

 

“yoga does in fact have positive effects on mild depression and sleep problems, and it improves the symptoms of psychiatric disorders like schizophrenia and ADHD among patients using medication.” – Alexandra Sifferin

 

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. Psychoses are very difficult to treat with psychotherapy and are usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Hence, there is a need for safe and effective alternative treatments for psychosis.

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time.

 

Clearly, there is a need for treatment alternatives that can be effective alone or in combination with drugs. Both mindfulness and yoga training has been shown to be beneficial for patients with psychosis and with major depression. It is important at this point to step back and review the published studies of the application of mindfulness and yoga practices for the treatment of severe mental illnesses, In today’s Research News article “Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/ ), Sathyanarayanan and colleagues review and summarize 49 published research studies on the effectiveness of mindfulness and yoga practices for the treatment of severe mental illnesses.

 

They report that the research finds that both mindfulness practices and yoga practice in combination with antipsychotic medications significantly reduces both the positive and negative symptoms of schizophrenia and other psychotic disorders, improves the patient’s ability to effectively engage in everyday activities and also improves higher level thought processes, cognition. With Bipolar Disorder they report that there are only a very small number of studies that suggest improvements but more research is needed. With Major Depressive Disorders both mindfulness and yoga practices have been shown to produce significant reductions in depression alone or in combination with anti-depressive medications.

 

Hence, they find that the current published research supports the use of either mindfulness or yoga practices for the treatment of severe mental illnesses. There is clearly a need for more research, but the studies to date are very encouraging. They suggest that these practices are safe and effective whether used alone or in combination with drugs and may then be a needed alternative treatment to drugs.

 

So, improve severe mental illness with yoga and mindfulness.

 

“Yoga can be an incredible tool for self-growth, empowerment, healing, and health for those with mental disorders.” – Zoie Kanakis

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sathyanarayanan, G., Vengadavaradan, A., & Bharadwaj, B. (2019). Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review. International journal of yoga, 12(1), 3-28.

 

Abstract

Background:

Yoga has its origin from the ancient times. It is an integration of mind, body, and soul. Besides, mindfulness emphasizes focused awareness and accepting the internal experiences without being judgemental. These techniques offer a trending new dimension of treatment in various psychiatric disorders.

Aims:

We aimed to review the studies on the efficacy of yoga and mindfulness as a treatment modality in severe mental illnesses (SMIs). SMI includes schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD).

Methods:

We conducted a literature search using PubMed, Google Scholar, and Cochrane Library with the search terms “yoga,” “meditation,” “breathing exercises,” “mindfulness,” “schizophrenia spectrum and other psychotic disorders,” “depressive disorder,” and “bipolar disorder” for the last 10-year period. We also included relevant articles from the cross-references.

Results:

We found that asanas and pranayama are the most commonly studied forms of yoga for schizophrenia. These studies found a reduction in general psychopathology ratings and an improvement in cognition and functioning. Some studies also found modest benefits in negative and positive symptoms. Mindfulness has not been extensively tried, but the available evidence has shown benefits in improving psychotic symptoms, improving level of functioning, and affect regulation. In MDD, both yoga and mindfulness have demonstrated significant benefit in reducing the severity of depressive symptoms. There is very sparse data with respect to BD.

Conclusion:

Both yoga and mindfulness interventions appear to be useful as an adjunct in the treatment of SMI. Studies have shown improvement in the psychopathology, anxiety, cognition, and functioning of patients with schizophrenia. Similarly, both the techniques have been established as an effective adjuvant in MDD. However, more rigorously designed and larger trials may be necessary, specifically for BD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329226/

 

Improve Schizophrenia Symptoms with Yoga

Improve Schizophrenia Symptoms with Yoga

 

By John M. de Castro, Ph.D.

 

Using a combination of asanas (poses and stretches) and pranayama (systematic breathing practices), yoga can help you achieve a state of focus and relaxation that makes it easier to shine a lens on the nature of your thoughts. Understanding this nature and how it affects and distorts your reality is a key part of treating schizophrenia and helping you realize just how much it’s affecting your life and the relationships that you have with others.” – Tyler Dabel

 

Schizophrenia is the most common form of psychosis. Its effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. Yoga is a mindfulness practice that has been shown to improve the symptoms of schizophrenia. Hence it is important to further investigate the effectiveness of yoga practice for the treatment of schizophrenia.

 

In today’s Research News article “Add-on Yoga Therapy for Social Cognition in Schizophrenia: A Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134743/ ), Govindaraj and colleagues performed an uncontrolled pilot study of yoga practice for the treatment of schizophrenia. They recruited schizophrenia patients who were stabilized on antipsychotic medications and provided for them 20, 1-hour, yoga sessions over 6 weeks. The practice consisted of poses, breathing practices, and chanting. They were measured before and after treatment for positive and negative symptoms of schizophrenia, social disability, and social cognition.

 

They found that after the 6 weeks of yoga practice there were significant reductions in both positive and negative symptoms of schizophrenia and in social disability, and significant increases in social cognition. This was an uncontrolled pilot study, so conclusions must be tempered, But the results are encouraging and support the potential application of yoga practice for the treatment of the symptoms of schizophrenia. They provide the support needed to launch a large randomized controlled trial to firmly establish whether yoga practice may be a beneficial add-on treatment for schizophrenia.

 

So, improve schizophrenia symptoms with yoga.

 

“yoga has significant benefits to those diagnosed with schizophrenia. The effects of yoga therapy are multifaceted, including reduction of psychotic symptoms and depression, improving cognition, increasing quality of life, and producing neurobiological changes, such as increased oxytocin levels.” – Namita Nayyar

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Govindaraj, R., Naik, S., Manjunath, N. K., Mehta, U. M., Gangadhar, B. N., & Varambally, S. (2018). Add-on Yoga Therapy for Social Cognition in Schizophrenia: A Pilot Study. International journal of yoga, 11(3), 242-244.

 

Abstract

Background:

Yoga as a mind–body therapy is useful in lifestyle-related disorders including neuropsychiatric disorders. In schizophrenia patients, yoga has been shown to significantly improve negative symptoms, functioning, and plasma oxytocin level.

Aim:

The aim of the study was to study the effect of add-on yoga therapy on social cognition in schizophrenia patients.

Materials and Methods:

In a single pre-post, study design, 15 schizophrenia patients stabilized on antipsychotic medication for 6 weeks were assessed for social cognition (theory of mind, facial emotion recognition, and social perception [SP]) and clinical symptoms (negative and positive symptoms and social disability) before and after twenty sessions of add-on yoga therapy.

Results:

There was a significant improvement in the social cognition composite score after 20 sessions of yoga (t[13] = −5.37, P ≤ 0.001). Clinical symptoms also reduced significantly after twenty sessions of yoga.

Conclusion:

Results are promising to integrate yoga in clinical practice, if proven in well-controlled clinical trials.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134743/

 

Improve Chronic Conditions with Mindfulness Taught over the Internet

Improve Chronic Conditions with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“It’s important for people living with health conditions to recognize what they are feeling, instead of trying to push painful thoughts and emotions away, which can actually amplify them. For those living with serious medical conditions, mindfulness can help them accept and respond to difficult feelings, including fear, loneliness and sadness. By bringing mindfulness to emotions (and the thoughts that may underlie them), we can begin to see them more clearly and recognize that they are temporary.” – Shauna Shapiro

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with the physical and psychological reactions to stress. The vast majority of the mindfulness training techniques, however, require a certified trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. This makes delivery to individuals in remote locations nearly impossible.

 

As an alternative, applications over the internet and on smartphones have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, eliminating the need to go repeatedly to specific locations, and being available to patients in remote areas. But, the question arises as to the level of compliance with the training and the effectiveness of these internet applications in inducing mindfulness and improving physical and psychological health in chronically ill patients.

 

In today’s Research News article “Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107686/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123540/  ), Russell and colleagues review and summarize the published research literature on the effectiveness of internet based mindfulness training programs for the treatment of patients with chronic diseases. They identified 10 randomized controlled studies that contained a control group where mindfulness training was performed over the internet. The patients were afflicted with chronic pain in 3 of the studies, and in single studies with fibromyalgia, heart disease, cancer post-treatment, anxiety disorder, major depressive disorder, residual depressive symptoms, and psychosis.

 

They found that internet-based mindfulness interventions in general had significant beneficial effects that improved patient functioning in comparison to the control groups. Half of the studies reported follow-up measurements that reflected persisting benefits. They noted that when measured participant adherence to the programs was in general low.

 

Hence, it appears that internet-based mindfulness interventions are safe and effective treatments for the well-being of patients with chronic diseases. This is potentially very important as these interventions can be administered inexpensively, conveniently, and to large numbers of patients regardless of their locations, greatly increasing the impact of the treatments.

 

There are some caveats. The majority of the participants by far were women and there was no study that compared the efficacy of the internet-based intervention to the comparable face-to-face intervention or another treatment. So, it was recommended that future studies include more males and a comparison to another treatment.

 

So, improve chronic conditions with mindfulness taught over the internet.

 

“MBSR programs might not reverse underlying chronic disease, but they can make it easier to cope with symptoms, improve overall well-being and quality of life and improve health outcomes.” – Monika Merkes

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Russell, L., Ugalde, A., Milne, D., Austin, D., & Livingston, P. M. (2018). Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review. JMIR Mental Health, 5(3), e53. http://doi.org/10.2196/mental.9645

 

Abstract

Background

Internet-supported mindfulness-based interventions (MBIs) are increasingly being used to support people with a chronic condition. Characteristics of MBIs vary greatly in their mode of delivery, communication patterns, level of facilitator involvement, intervention period, and resource intensity, making it difficult to compare how individual digital features may optimize intervention adherence and outcomes.

Objective

The aims of this review were to (1) provide a description of digital characteristics of internet-supported MBIs and examine how these relate to evidence for efficacy and adherence to the intervention and (2) gain insights into the type of information available to inform translation of internet-supported MBIs to applied settings.

Methods

MEDLINE Complete, PsycINFO, and CINAHL databases were searched for studies assessing an MBI delivered or accessed via the internet and engaging participants in daily mindfulness-based activities such as mindfulness meditations and informal mindfulness practices. Only studies using a comparison group of alternative interventions (active compactor), usual care, or wait-list were included. Given the broad definition of chronic conditions, specific conditions were not included in the original search to maximize results. The search resulted in 958 articles, from which 11 articles describing 10 interventions met the inclusion criteria.

Results

Internet-supported MBIs were more effective than usual care or wait-list groups, and self-guided interventions were as effective as facilitator-guided interventions. Findings were informed mainly by female participants. Adherence to interventions was inconsistently defined and prevented robust comparison between studies. Reporting of factors associated with intervention dissemination, such as population representativeness, program adoption and maintenance, and costs, was rare.

Conclusions

More comprehensive descriptions of digital characteristics need to be reported to further our understanding of features that may influence engagement and behavior change and to improve the reproducibility of MBIs. Gender differences in determinants and patterns of health behavior should be taken into account at the intervention design stage to accommodate male and female preferences. Future research could compare MBIs with established evidence-based therapies to identify the population groups that would benefit most from internet-supported programs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123540/

 

Improve Mental Illness with Yoga

Improve Mental Illness with Yoga

 

By John M. de Castro, Ph.D.

 

“for the general person, yoga greatly enhances mental health: mood, sense of self, motivation, sense of inner direction and purpose, as well as physical health—and physical health is so important for mental health.“– Eleanor Criswell

 

Yoga is a complex of practices including postures, movements, breathing practices and meditation. Although its benefits have been touted for centuries, it is only recently that scientific study was verified these benefits. Yoga practice has been repeatedly demonstrated in research studies to be beneficial for the psychological and physical health of the practitioners. It appears to be helpful for both healthy individuals and those suffering from physical and mental health issues.

 

In today’s Research News article “The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/ ),

Klatte and colleagues review, summarize, and perform a meta-analysis of the published research literature on effects of yoga practice on a variety of mental health problems. They focused on randomized controlled studies with adults suffering from psychiatric problems. They identified 25 published studies that met their criteria, including treatment of depression, schizophrenia, dependency, post-traumatic Stress Disorder (PTSD), and other mental illnesses.

 

They found that yoga practice produced, on the whole, large and significant improvements in the symptoms of the mental illnesses even in comparison to active control groups such as attention training and exercise. The beneficial effects of yoga practice were comparable to those produced by psychotherapy. But, the combination of yoga practice with psychotherapy produced even greater effects.

 

These are exciting and compelling findings that yoga practice is an effective treatment for mental illness on a par with individual psychotherapy. But, yoga practice has the advantage of being relatively inexpensive, can be practiced at home or in groups, and after a few weeks of instruction can be carried on without a therapist present. In addition, it can supplement traditional psychotherapy potentiating its effectiveness.

 

It would appear that the exercise component of yoga practice is not essential for its effectiveness as exercise only control groups show benefits but significantly less than the yoga practice groups. This suggests that the improvement of mindfulness that occurs in yoga practice has an additional beneficial role to play in treating mental illness. The combination of exercise with mindfulness training that occur with yoga  practice appears to be particularly effective in treating mental illnesses. These results suggest that yoga practice is safe and effective and should applied either as a stand-alone treatment or be combined with more traditional treatments.

 

So, improve mental illness with yoga.

 

“It will come as no surprise that the various forms of yoga have long been acknowledged as allies in mastering the mind and coping with stress. Science is Increasingly validating those claims, especially for depression, schizophrenia, anxiety, PTSD (post-traumatic stress disorder), and ADHD (attention deficit hyperactivity disorder).” – Mental Health America

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Klatte, R., Pabst, S., Beelmann, A., & Rosendahl, J. (2016). The Efficacy of Body-Oriented Yoga in Mental Disorders: A Systematic Review and Meta-Analysis. Deutsches Ärzteblatt International, 113(12), 195–202. http://doi.org/10.3238/arztebl.2016.0195

Abstract

Background

The efficacy of body-oriented yoga in the treatment of mental disorders has been investigated in numerous studies. This article is a systematic review and meta-analysis of the relevant publications.

Methods

All studies in which the efficacy of hatha-yoga, i.e., body-oriented yoga with asanas and pranayama, was studied in adult patients suffering from a mental disorder (as diagnosed by ICD or DSM criteria) were included in the analysis. The primary endpoint was disorder-specific symptom severity. The publications were identified by a systematic search in the PubMed, Web of Science, PsycINFO and ProQuest databases, supplemented by a search with the Google Scholar search engine and a manual search in the reference lists of meta-analyses and primary studies, as well as in specialized journals.

Results

25 studies with a total of 1339 patients were included in the analysis. A large and significant effect of yoga was seen with respect to the primary endpoint (symptom severity) (Hedges’ g = 0.91; 95% confidence interval [0.55; 1.28]; number needed to treat [NNT]: 2.03), with substantial heterogeneity (I2 = 69.8%) compared to untreated control groups. Small but significant effects of yoga were also seen in comparison with attention control (g = 0.39; [0.04; 0.73]; NNT: 4.55) and physical exercise (g = 0.30; [0.01; 0.59]; NNT: 5.75); no difference in efficacy was found between yoga and standard psychotherapy (g = 0.08; [-0.24; 0,40]; NNT: 21.89). In view of the relatively high risk of bias, these findings should be interpreted with caution.

Conclusion

Body-oriented yoga with asanas and pranayama as central components is a promising complementary treatment for mental disorders and should be investigated in further high-quality studies.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5400032/

Improve Bipolar Disorder with Mindfulness

Improve Bipolar Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness looks like a potentially effective way of managing bipolar disorder, especially the depressive pole, which may be the most difficult to treat with medication alone. Mindfulness exercises and meditations are useful for people with bipolar disorder (manic depression) because mindfulness decreases the relapse rate for depression, reduces stress and anxiety, which contribute significantly to the onset of both mania and depression and may worsen the course of the illness, and improves a person’s ability to manage thoughts and feelings and increases awareness of the way the person tends to internalize external stimuli.” Shamash Alidina

 

Bipolar Disorder, also known as Manic Depressive Disorder, is a mood disorder characterized by alternating states of extreme depression, relative normalcy, and extreme euphoria (mania). The symptoms of depression and mania are so severe that the individual is debilitated and unable to conduct their normal daily lives. The depression is so severe that suicide occurs in about 1% of cases of Bipolar Disorder. It is thought to result from imbalances in the monoamine neurotransmitter systems in the nervous system and appears to be highly linked to the genes. There are great individual differences in Bipolar Disorder. The extreme mood swings can last for a few days to months and can occur only once or reoccur frequently.

 

Bipolar Disorder affects about 1% of the population throughout the world at any time. But about 3% to 10% of the population may experience it sometime during their lives. It is usually treated with drugs. But, these medications are not always effective and can have difficult side effects. Hence, there is a great need for alternative treatments. Mindfulness practices and treatments have been shown to be effective for major mental disorders, including depression and anxiety disorders and to improve the regulation of emotions. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed for the treatment of depression and has been shown to be very effective. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. So, MBCT may be a safe and effective treatment for Bipolar Disorder.

 

In today’s Research News article “Mindfulness-Based Treatment for Bipolar Disorder: A Systematic Review of the Literature.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590538/, Bojic and Becerra reviewed and summarized the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of Bipolar Disorder. They identified 13 published research studies.

 

They report that the published research finds that MBCT in conjunction with drug treatments produces significant improvements in most of the symptoms of Bipolar Disorder. MBCT  was found to produce significant improvements in mood, including decreased mania, anxiety, and depression. In addition, there were significant increases in the patients’ ability to regulate their emotions and their ability to think clearly (cognitive abilities). The studies report that MBCT remains effective one year after the conclusion of treatment.

 

Thus the current state of the research suggests that Mindfulness-Based Cognitive Therapy (MBCT) is a safe, effective, and lasting treatment for Bipolar Disorder when used in addition to the standard drug treatments. These are important and exciting findings. They suggest that MBCT can help to relieve the suffering and improve the patients ability to conduct their lives.

 

So, improve bipolar disorder with mindfulness.

 

“The extreme highs and lows of bipolar disorder can be difficult to cope with, and difficult for those around you. The disorder causes anxiety at one end and depression at the other. Meditation is an easy and natural method for relaxing and reducing stress in anyone, and particularly in people with bipolar disorder.” – Anthony Watt

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Bojic, S., & Becerra, R. (2017). Mindfulness-Based Treatment for Bipolar Disorder: A Systematic Review of the Literature. Europe’s Journal of Psychology, 13(3), 573–598. http://doi.org/10.5964/ejop.v13i3.1138

 

Abstract

Despite the increasing number of studies examining the effects of mindfulness interventions on symptoms associated with Bipolar Disorder (BD), the effectiveness of this type of interventions remains unclear. The aim of the present systematic review was to (i) critically review all available evidence on Mindfulness Based Cognitive Therapy (MBCT) as a form of intervention for BD; (ii) discuss clinical implications of MBCT in treating patients with BD; and (iii) provide a direction for future research. The review presents findings from 13 studies (N = 429) that fulfilled the following selection criteria: (i) included BD patients; (ii) presented results separately for BD patients and control groups (where a control group was available); (iii) implemented MBCT intervention; (iv) were published in English; (v) were published in a peer reviewed journal; and (vi) reported results for adult participants. Although derived from a relatively small number of studies, results from the present review suggest that MBCT is a promising treatment in BD in conjunction with pharmacotherapy. MBCT in BD is associated with improvements in cognitive functioning and emotional regulation, reduction in symptoms of anxiety depression and mania symptoms (when participants had residual manic symptoms prior to MBCT). These, treatment gains were maintained at 12 month follow up when mindfulness was practiced for at least 3 days per week or booster sessions were included. Additionally, the present review outlined some limitations of the current literature on MBCT interventions in BD, including small study sample sizes, lack of active control groups and idiosyncratic modifications to the MBCT intervention across studies. Suggestions for future research included focusing on factors underlying treatment adherence and understanding possible adverse effects of MBCT, which could be of crucial clinical importance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590538/

Improve Schizophrenia with Mindfulness

Improve Schizophrenia with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness treatments do not aim to decrease the occurrence or severity of the symptoms of psychosis, but by helping to reduce the distress people experience.” – Tania Lecomte

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by both positive and negative symptoms. Positive symptoms include hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. Negative symptoms include a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. In addition, even when effective, antipsychotic drugs only treat the positive symptoms of schizophrenia, leaving the negative symptom intact including the loss of functionality and a lack of insight. Hence, there is a need for safe and effective alternative treatments for schizophrenia that can treat the negative symptoms.

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. Another treatment, psychoeducation specific for schizophrenia, has also been shown to reduces relapse rates and improve medication adherence. Psychoeducation consists of working with individual patients and their families to improve schizophrenia survival skills, focusing on stressful situation and coping strategies, and problem-solving. Since both mindfulness training and psychoeducation appear to be effective their combination may be particularly effective in treating schizophrenia.

 

In today’s Research News article “An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551382/, Chien and colleagues recruited patients who were diagnosed with schizophrenia and randomly assigned them to receive either treatment as usual, 6-weeks of psychoeducation alone, or 6-weeks of psychoeducation in combination with mindfulness training. The participants were measured before and after the treatment programs, and 6 and 18 weeks later for average number and length of re-hospitalizations, level of functioning, insight into illness, and schizophrenia symptoms.

 

They found that whereas the treatment as usual group had significant deterioration in all measures both intervention groups had significant improvements specifically in average length of rehospitalizations; patient functioning, including improvements in social and community functioning and self-management; patient mental state, including reductions in both positive and negative symptoms; and insight into their illness. In addition, there was a significant increase in complete remissions in the intervention groups. Importantly, in every case the psychoeducation in combination with mindfulness training produced significantly superior results to the psychoeducation alone condition.

 

These results suggest that psychoeducation alone is an effective treatment for schizophrenia, but the addition of mindfulness training markedly improves the outcomes. In the treatment as usual condition only 7% of the patients achieved remission while in the psychoeducation condition 27% achieved remission and with added mindfulness training 39% remissions were achieved. These are remarkable improvements in a very difficult condition to treat. The results suggest that teaching schizophrenia patients the skills to cope with their disease is very useful but that making them more mindful greatly improves this coping. It would appear that being able to look at and experience the symptoms of their disease in the present moment non-judgmentally improves the patients’ ability to cope with and alter their symptoms.

 

So, improve schizophrenia with mindfulness.

 

“mindfulness-based psycho-educational intervention expressly designed for patients with schizophrenia can be well tolerated and result in better illness outcomes than either standard treatment alone or standard treatment supplemented by a more typical psycho-educational approach. This is an important finding because of the widely held belief that psychotic patients can neither tolerate nor benefit from mindfulness-based interventions.” – American Mindfulness Research Association

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Chien, W. T., Bressington, D., Yip, A., & Karatzias, T. (2017). An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia. Psychological Medicine, 47(12), 2081–2096. http://doi.org/10.1017/S0033291717000526

 

Abstract

Background

We aimed to test a mindfulness-based psychoeducation group (MBPEG), v. a conventional psychoeducation group (CPEG) v. treatment as usual (TAU), in patients with schizophrenia-spectrum disorders over a 24-month follow-up.

Method

This single-blind, multi-site, pragmatic randomized controlled trial was conducted in six community treatment facilities across three countries (Hong Kong, mainland China and Taiwan). Patients were randomly allocated to one of the treatment conditions, and underwent 6 months of treatment. The primary outcomes were changes in duration of re-hospitalizations and mental state (Positive and Negative Syndrome Scale; PANSS) between baseline and 1 week, and 6, 12 and 18 months post-treatment.

Results

A total of 300 patients in each country were assessed for eligibility between October 2013 and 30 April 2014, 38 patients per country (n = 342) were assigned to each treatment group and included in the intention-to-treat analysis. There was a significant difference in the length of re-hospitalizations between the three groups over 24 months (F2,330 = 5.23, p = 0.005), with MBPEG participants having a shorter mean duration of re-hospitalizations than those in the other groups. The MBPEG and CPEG participants had significant differential changes in proportional odds ratios of complete remission (all individual PANSS items <3) over the 24-month follow-up (37 and 26%, respectively), as opposed to only 7.2% of the TAU group (χ2 = 8.9 and 8.0, p = 0.001 and 0.003, relative risk = 3.5 and 3.1, 95% confidence interval 2.0–7.2 and 1.6–6.3).

Conclusions

Compared with TAU and CPEG, MBPEG improves remission and hospitalization rates of people with schizophrenia spectrum disorders over 24 months.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551382/

Reduce Suspiciousness and Excessive Social Anxiety with Mindfulness

Reduce Suspiciousness and Excessive Social Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Our nervous system is like the soundtrack for every scene in life that we encounter. It is all but impossible to experience a scene as safe and happy when the music tells us otherwise. With a mindful, body-based approach, clients can learn to change their music.” – Jeena Cho

 

Meditation began as a spiritual practice and as such involves thoughts of an ultimate reality that transcends the mundane reality of everyday life. The beginning of such realizations can produce thinking that appears magical, that is not based in physical reality. This can appear to be magical thinking which can be confused with the types of ungrounded thinking that appears in schizophrenia. In addition, meditation practice, especially at meditation retreats, can unleash troubling thoughts often related to past trauma or emotional upheaval. As a result, vulnerable individuals may have serious psychological symptoms arise as a result of meditation practice. There has been very little study of these phenomena. Yet, such study may be quite important as meditation is generally seen as a safe practice, yet, in fact, meditation may lead to a state that resembles mental illnesses, such as schizophrenia, and meditators may be misdiagnosed.

 

In today’s Research News article “Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/, Antonova and colleagues study symptoms of schizotypy in meditators and its relationship to mindfulness. “Schizotypy is a psychological construct, encompassing a range of personality traits and cognitions that are similar to psychosis but less severe in nature . . . schizotypy is characterized by nine dimensions: ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, eccentric behavior or appearance, no close friends or confidants, odd speech, constricted affect and suspiciousness. Schizotypy clearly encompasses both psychosis-like symptoms and symptoms related to anxiety and depression.” They recruited male experienced meditators who had been practicing consistently for at least 2 years (average 7.5 years) and a group of male meditation naïve participants. Participants completed scales measuring mindfulness and symptoms of schizotypy.

 

They found that, although the two groups did not differ in total schizotypy symptoms, the meditation group scored significantly higher on the mindfulness facets of Observe, Non-judgment and Non-reactivity, and higher on the schizotypy symptom of magical thinking and significantly lower on suspiciousness and excessive social anxiety. They also found that the higher the levels of the mindfulness facets of Observe, Non-judgment and Non-reactivity the lower the levels of social anxiety and total schizotypy symptoms.

 

These are interesting results that support the contention that meditation training does not necessarily lead to the kinds of symptoms that reflect early stages of schizophrenia. To the contrary, meditation appears to be associated with stronger mental health as mindfulness was associated with lower levels of schizotypy, including suspiciousness and social anxiety. The increase in magical thinking is expected in that all of the meditators engaged in meditation as a spiritual practice in the Buddhist traditions. Hence, there were no indications of any meditation effects that would tend to precipitate psychosis.

 

It should be kept in mind that the results were correlational and as such causation cannot be concluded. In addition, only males were studied. It is also possible that meditators who would be susceptible to negative consequences of meditation practice would have dropped out from meditation practice and so not be represented in a sample of long-term meditators. So, more research is needed investigating the effects of meditation on schizotypy symptoms in beginning meditators and in females.

 

So, reduce suspiciousness and excessive social anxiety with mindfulness.

 

“mindfulness meditation improves somatic, psychological, and spiritual wellbeing. Thus, although poorly-practiced or poorly-taught meditation can actually be harmful to a person’s health, where mindfulness meditation is taught by an experienced and authentic teacher who is aware of all of the risks, then adverse side effects are unlikely.” – Edo Shonin

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Antonova, E., Amaratunga, K., Wright, B., Ettinger, U., & Kumari, V. (2016). Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators. Schizophrenia Research: Cognition, 5, 1–6. http://doi.org/10.1016/j.scog.2016.05.001

 

Abstract

Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males) from the Buddhist tradition (meditators) and 24 meditation-naïve individuals (all males). Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males). All participants completed the Schizotypal Personality Questionnaire (Raine, 1991), a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness). Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe), describing (Describe), acting with awareness (Awareness), non-judging of (Non-judgment) and non-reactivity to inner experience (Non-reactivity) facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/

Reduce Psychotic Symptoms with Meditation

Reduce Psychotic Symptoms with Meditation

 

By John M. de Castro, Ph.D.

 

 While meditating the last day I finally could see love as an underlying force in the universe, and I had a waking dream of some fractal patterns realigning, it is hard to describe with words. It is still embarrassing to remember all the details of this, but it can be summarized with one word: delirium. I was totally out of myself, and what is worse, I was acting in inappropriate ways with other people. For instance, I was being hosted by a girl, and I acted violently smashing a cup against a wall, and throwing a chair to the floor. I still remember how my mind was watching in horror how my body was acting. It was stuff for nightmares…” – TLDR

 

There have been a number of reports that mindfulness meditation can lead to psychotic like symptoms in a few individuals. This appears to be amplified by participation in meditation retreats. It has been reported that around 60% of participants in intensive meditation retreats experienced at least one negative side effect, including panic, depression and confusion and about 7% experienced psychotic-like symptoms. Hence, meditation, although highly beneficial, does have some potential negative effects for many people and extreme negative consequences for a few.

 

There has, unfortunately been very little research on these negative effects of meditation. In today’s Research News article “Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/, Antonova and colleagues, to address this issue, examine whether psychotic like symptoms are present in experienced meditators. They recruited male meditators who have been consistently practicing over at least 2 years, meditating at least 6 days per week for at least 45 minutes per day and males who had never practiced meditation and any other mindfulness practice. The participants were measured for five facets of mindfulness, including describing, observing, acting with awareness, non-judging, and non-reacting, and schizotypal personality characteristics, including ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect and suspiciousness.

 

They found that meditators had significantly lower scores on suspiciousness and excessive social anxiety, and higher scores on magical thinking. They were also higher in mindfulness, including observing, non-judging, and non-reacting. In addition, the higher the scores on acting with awareness and non-judging, the lower the levels of schizotypal personality characteristics including suspiciousness, excessive social anxiety, and constricted affect (blunted emotions). Hence, experienced meditators tend to have fewer psychotic-like symptoms and higher mindfulness and high levels of mindfulness were associated with lower psychotic-like symptoms.

 

These results are interesting and tend to counter the notion that meditation is associated with increased negative psychotic-like symptoms. This may be due, though, to the fact that people who meditate consistently over a long period of time are generally psychological healthy individuals to begin with. It is also possible that those individuals who are sensitive of the negative effects of meditation simply drop out and don’t continue meditating as the negative consequences present themselves. The higher levels of magical thinking in the meditators may result from the fact that the meditators all practiced in the Buddhist tradition where metaphysical ideas are taught.

 

This is an important line of research and could be best addressed with longitudinal research investigating beginning meditators and following their progress over an extended period of time. Unfortunately, the present results do not provide a clearer understanding of the potential hazards of meditation practice, particularly while engaging in meditation retreats. Perhaps research that closely follows meditators while participating in a retreat may help to elucidate the factors responsible for the reported negative consequences.

 

So, reduce psychotic symptoms with meditation.

 

“60 per cent of people who had been on a meditation retreat had suffered at least one negative side effect, including panic, depression and confusion, a study in the US found.” – Harriett Crawford

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Antonova, E., Amaratunga, K., Wright, B., Ettinger, U., & Kumari, V. (2016). Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators. Schizophrenia Research: Cognition, 5, 1–6. http://doi.org/10.1016/j.scog.2016.05.001

 

 

Abstract

Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males) from the Buddhist tradition (meditators) and 24 meditation-naïve individuals (all males). Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males). All participants completed the Schizotypal Personality Questionnaire (Raine, 1991), a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness). Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe), describing (Describe), acting with awareness (Awareness), non-judging of (Non-judgment) and non-reactivity to inner experience (Non-reactivity) facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514306/

Improve the Negative Symptoms of Schizophrenia with Tai Chi.

Improve the Negative Symptoms of Schizophrenia with Tai Chi.

 

By John M. de Castro, Ph.D.

 

“Tai Chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia.” – Supreme Chi Living

 

Schizophrenia is the most common form of psychosis. It effects about 1% of the population worldwide. It appears to be highly heritable and involves changes in the brain. It is characterized by positive symptoms such as hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. It is also characterized by negative symptoms involving a reduced ability to function normally, neglect of personal hygiene, lack of emotion, blank facial expressions, speaking in a monotone, loss of interest in everyday activities, social withdrawal, an inability to experience pleasure, and a lack of insight into their symptoms. The symptoms of schizophrenia usually do not appear until late adolescence or early adulthood.

 

Schizophrenia is very difficult to treat with psychotherapy and is usually treated with antipsychotic drugs. These drugs, however, are not always effective, sometimes lose effectiveness, and can have some difficult side effects. In addition, even when effective, antipsychotic drugs only treat the positive symptoms of schizophrenia, leaving the negative symptom intact including the loss of functionality and a lack of insight. Hence, there is a need for safe and effective alternative treatments for schizophrenia that can treat the negative symptoms.

 

Mindfulness training has been shown to be beneficial for a variety of mental health problems, including anxietydepressionAntisocial Personality DisorderBorderline personality disorderimpulsivityobsessive compulsive disorderphobiaspost-traumatic stress disorder, sexual dysfunction, and suicidality. It also appears to be helpful with psychosis. Mindfulness has also been shown to associated with lower symptom severity of schizophrenia. This suggests that mindfulness training may be an effective treatment for schizophrenia, including negative symptoms.  Tai Chi practice includes mindfulness training and also gentle physical exercise which may also be beneficial. Hence, it would seem reasonable to examine the ability of Tai Chi practice in treating the symptoms of schizophrenia.

 

In today’s Research News article “Tai Chi for Schizophrenia: A Systematic Review.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434269/ Zheng and colleagues review and perform a meta-analysis of published research studies examining the effectiveness of Tai Chi practice in treating schizophrenia. They found 6 published randomized controlled trials. They found that compared to controls Tai Chi practice produced significant reductions in the negative symptoms of schizophrenia but not the positive symptoms. In addition, they report that there is a significant improvement in social function.

 

These are important findings as antipsychotic drugs only improve the positive symptoms of schizophrenia and not the negative symptoms. Since, Tai Chi practice appears to improve the negative symptoms and not the positive symptoms, it would seem to be acting in a completely different way and by a different mechanism. Tai Chi is most frequently practiced socially and this may account for the improved social function. In addition, Tai Chi practice might be the perfect adjunctive treatment. The combination of Tai Chi practice and antipsychotic drugs should improve all of the symptoms of schizophrenia.

 

So, improve the negative symptoms of schizophrenia with Tai Chi.

 

“The usual method for treating schizophrenic patients focuses on self-care, symptom management, and dealing with daily functions. Unfortunately, physical and psychological well-being fall by the wayside, since simply dealing with day-to-day functions is enough of a struggle for most schizophrenic individuals. The mind-body connection provided by Tai-chi is believed to make it the optimal type of exercise for individuals with mental illnesses.”Katie Dabrowski

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wei Zheng, Qiang Li, Jingxia Lin, Yingqiang Xiang, Tong Guo, Qiong Chen, Dongbin Cai, Yutao Xiang. (2016). Tai Chi for Schizophrenia: A Systematic Review. Shanghai Archives of Psychiatry, 28(4), 185–194. http://doi.org/10.11919/j.issn.1002-0829.216051

 

Abstract

Background

Tai Chi as a form of moderate aerobic exercise originating in China, could promote balance and healing of the mind-body. Furthermore, Tai Chi has been used as an adjunctive treatment for patients with schizophrenia. However, no meta-analysis or systematic review on adjunctive Tai Chi for patients with schizophrenia has yet been reported.

Aim

A systematic review and meta-analysis was conducted to examine the efficacy of Tai Chi as an adjunctive treatment for schizophrenia using randomized controlled trial (RCT) data.

Method

Two evaluators independently and systematically searched both English- and Chinese-language databases for RCTs of Tai Chi for schizophrenia patients, selected studies, extracted data, conducted quality assessment and data synthesis. Statistical analyses were performed using the Review Manager (version 5.3). The Cochrane Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) was used to assess the strength of the evidence.

Results

In 6 RCTs conducted in mainland China and Hong Kong, there were 483 participants including 215 subjects in the intervention group and 268 subjects in the control group. The trials lasted 16.0 (6.2) weeks. Compared to control group, we found significant differences regarding improvement of negative symptoms assessed by the Positive and Negative Syndrome Scale (PANSS) negative symptom sub-score (2 trials) and Scale for the Assessment of Negative Symptoms (SANS) (3 trials) over the study period in the intervention group (5 trials with 6 treatment arms, n=451, SMD: -0.87 (95%CI: -1.51, -0.24), p=0.007; I2=90%). Furthermore, there is no significant difference regarding improvement of positive symptoms assessed by the PANSS positive symptom sub-score (2 trials) and Scale for the Assessment of Positive Symptoms (SAPS) (2 trials) over the study period (4 trials with 5 treatment arms, n=391, SMD: -0.09 (95%CI: -0.44, 0.26), p=0.60; I2=65%). All included RCTs did not report side effects. Based on the GRADE, the strength of the evidence for primary outcome was ‘very low’.

Conclusions

The data available on the effectiveness of adjunctive Tai Chi in patients with schizophrenia who are receiving antipsychotic is insufficient to arrive at a definitive conclusion about its efficacy. Furthermore, follow-up time in the available studies was relatively short, and all studies did not use blinded assessment of outcome measures. High-quality randomized trials are needed to inform clinical recommendations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434269/