Effects of mindfulness- and acceptance-based interventions for individuals with schizophrenia spectrum disorders: A systematic meta-review

IF 3.6 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-05-05 DOI:10.1016/j.schres.2025.03.040

Antonia Meinhart , Annika Schmueser , Steffen Moritz , Kerem Böge

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引用次数: 0

Abstract

Background

Mindfulness- and acceptance-based interventions (MBIs/ABIs) for persons with schizophrenia spectrum disorders (SSD) aim to cultivate purposeful attention, mind-body awareness, and targeted action-taking. This systematic meta-review assessed the current body of evidence regarding the effects of MBIs/ABIs for SSD symptoms.

Methods

The study was registered with PROSPERO (CRD42024535284) on June 3, 2024. Seven databases were searched between April 18 and April 19, 2024. Meta-analyses investigating the effects of MBIs/ABIs for SSD symptoms were considered. Two authors (AM, AS) independently completed data extraction and analysis. Evidence grading and methodology assessments were conducted using the Ioannidis' criteria, AMSTAR-2, and AMSTAR-Plus Content guidelines.

Findings

A total of 18 meta-analyses with up to 2572 participants were considered; 14 studies were eligible for analysis. Results were classified according to Ioannidis' criteria; the effect size of the highest ranked study with the largest number of primary studies is presented. Percentages indicate the number of studies reporting significant results. Significant evidence was found at end of treatment for overall symptomatology (MBIs: 100 %, n = 9, g = −0·7 (total range: −0·417 to −1·152), 95% CI: [−1·052, −0·347], I² = 95·36; ABIs: 25 %, n = 29, g = −1·065 (total range: −0·1 to −1·065) [−1·371, −0·759], I² = 85·1), positive (MBIs: 50 %, n = 6, g = −0·296 (total range: −0·155 to −0·416) [−0·528, −0·064], I² = 34·69; ABIs: 33·33 %, n = 3, g = −0·602 (total range: −0·602 to 0·147) [−1·014, −0·191], I² = 0), negative (MBIs: 100 %, n = 8, g = −0·94 (total range: −0·384 to −0.98) [−1·466, −0·413], I² = 86·42; ABIs: 25 %, n = 2, g = −0·631 (total range: −0·028 to −0.631) [−1·108, −1·154], I² = 0), affective symptoms (MBIs: 50 %, n = 9, g = −0·971 (total range: −0·275 to −0·971) [−1·413, −0·529], I² = 91·32; ABIs: 33·33 %, n = 3, g = −0·854 (total range: −0·472 to −0·854) [−1·255, −0·453, I² = 0), social functioning (MBIs: 100 %, n = 7, g = −1·368 (total range: −0·452 to −1·368) [−2·194, −0·542], I² = 94·3; ABIs: g total range: −0·878 to 0·625), mindfulness (MBIs: 66·66 %, n = 5, g = −0·805 (total range: −0·488 to −1·429) [−1·16, −0·45], I² = 0; ABIs: 66·66 %, n = 1, g = −0·959 (total range: −0·391 to −0·959) [−1·788, −0·129], I² = NA), and acceptance (MBIs: g total range: −0·381 to 0·381; ABIs: 50 %, n = 4, g = −0·393 (total range: −0·393 to 0·398) [−0·673, −0·113], I² = 0). Possible explanations for the differences in effect sizes for MBIs and ABIs are explored. Methodological assessments ranked ‘low’ or ‘critically low’ for all meta-analyses.

Interpretation

Although subject to several limitations, significant small to large effect sizes were evident for overall symptomatology, mindfulness, and social functioning. Small to large effect sizes were found for positive, negative, and affective symptoms. Future research should incorporate additional risk of bias assessments, increased sample sizes, and consider cultural contexts (as the largest effect sizes were reported by studies with a majority of samples from Mainland China and Hong Kong) regarding the therapeutic benefits of MBIs/ABIs.

Role of the funding source

There was no funding source for this study.

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基于正念和接受的干预措施对精神分裂症谱系障碍患者的影响：一项系统的荟萃综述

精神分裂症谱系障碍（SSD）患者的正念和接受干预（mbi /ABIs）旨在培养有目的的注意力、身心意识和有针对性的行动。本系统荟萃综述评估了目前关于mbi / abi对SSD症状影响的证据。方法该研究于2024年6月3日在PROSPERO注册（CRD42024535284）。在2024年4月18日至4月19日期间，对七个数据库进行了搜索。考虑了调查mbi / abi对SSD症状影响的荟萃分析。两位作者（AM， AS）独立完成数据提取和分析。使用Ioannidis标准、AMSTAR-2和AMSTAR-Plus内容指南进行证据分级和方法评估。共纳入18项荟萃分析，共纳入2572名受试者；14项研究符合分析条件。按照Ioannidis标准对结果进行分类；本文给出了初级研究数量最多、排名最高的研究的效应量。百分比表示报告显著结果的研究数量。在治疗结束时发现了显著的总体症状证据(mbi: 100%, n = 9, g = - 0.7（总范围：- 0.417至- 1.152），95% CI: [- 1.052, - 0.347], I2 = 95.36；abi: 25%, n = 29, g =−1·065(总范围:−−1·0·065)[1·371−−0·759),I2 = 85·1),正面的(可以发行:50%,n = 6, g =−0·296(总范围:0·155−−0·416)[0·528−−0·064),I2 = 34·69;abi: 33·33%,n = 3 g =−0·602(总范围:−0·602 0·147)[1·014−−0·191),I2 = 0)、负(可以发行:100%,n = 8 g =−0·94(总范围:0·384−−0.98)[1·466−−0·413),I2 = 86·42;abi: 25%, n = 2, g =−0·631(总范围:0·028−−0.631)[1·108−−1·154],I2 = 0),情感症状(可以发行:50%,n = 9, g =−0·971(总范围:0·275−−0·971)[1·413−−0·529),I2 = 91·32;abi: 33·33%,n = 3 g =−0·854(总范围:0·472−−0·854)[0·453−−1·255年,I2 = 0),社会功能(可以发行:100%,n = 7, g =−1·368(总范围:0·452−−1·368)[−2·194−0·542),I2 = 94 * 3;ABIs: g总范围：−0.878至0.625)，正念(mbi: 66.66%, n = 5, g =−0.805（总范围：−0.488至−1.429）[−1.16,−0.45],I2 = 0；ABIs: 66.66%, n = 1, g = - 0.959（总范围：- 0.391至- 0.959）[- 1.788,- 0.129],I2 = NA)，接受度(mbi: g总范围：- 0.381至0.381；abi: 50%, n = 4, g =−0·393(总范围:−0·393 0·398)[0·673−−0·113),I2 = 0)。探讨了mbi和abi效应量差异的可能解释。在所有的荟萃分析中，方法学评估排名“低”或“极低”。尽管存在一些局限性，但在整体症状学、正念和社会功能方面，显著的小到大的效应量是显而易见的。阳性、阴性和情感性症状的效应大小不等。未来的研究应纳入额外的偏倚风险评估，增加样本量，并考虑文化背景（因为大多数样本来自中国大陆和香港的研究报告了最大的效应量），以了解mbi / abi的治疗益处。资金来源的作用本研究没有资金来源。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.