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Yosep I, Mardhiyah A, Sriati A. Mindfulness Intervention for Improving Psychological Wellbeing Among Students During COVID-19 Pandemic: A Scoping Review. J Multidiscip Healthc 2023; 16:1425-1437. [PMID: 37251107 PMCID: PMC10224675 DOI: 10.2147/jmdh.s411849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
The COVID-19 pandemic can cause mental health problems such as stress, social anxiety, depression, and decrease social life on students. Mental health problems need to be taken seriously to develop the stage of development and improve the psychological well-being of students on learning in the school. The aim of this study was to explore mindfulness interventions to improve psychological well-being among students. This study used the Scoping Review method. Literature from CINAHL, PubMed, and Scopus databases. The keywords used in English are psychological wellbeing, students, and mindfulness. The inclusion criteria were full text, study design randomized control trial or quasi-experimental, English language, population and sample were students, and the publication period is the last 10 years (2013-2022). From 2194 articles based on initial research, we found 10 articles were analyzed related to mindfulness interventions consisting of several methods, namely internet-based mindfulness, mindfulness-based intervention, and mindfulness-based stress reduction. Most of samples the study from the United States with the range samples were 20-166 students. Mindfulness interventions can be carried out improve the psychological well-being of students. Mindfulness therapy is done by fully concentrating the mind in meditation so that it can improve psychological health. Providing mindfulness therapy involves health workers such as nurses and psychologists to provide comprehensive therapy covering both physical and psychological aspects.
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Affiliation(s)
- Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Aat Sriati
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
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2
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Bharti T, Mishra N, Ojha SC. Mindfulness and Subjective Well-Being of Indian University Students: Role of Resilience during COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:bs13050353. [PMID: 37232590 DOI: 10.3390/bs13050353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/03/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023] Open
Abstract
The coronavirus (COVID-19) pandemic is presently a global health issue that negatively affects the mental health and well-being of students globally. The latest investigations have recognized the role of mindfulness in individual subjective well-being. This study explores the mediating role of resilience in the overall relationship between mindfulness and subjective well-being among Indian university students during the COVID-19 pandemic. The data was collected between 10 August 2020 to 24 October 2020 via a self-administered questionnaire from 589 university students in India. Results revealed that resilience has a partial mediating role between mindfulness and subjective well-being. The results substantiate that resilience has an important role in mindfulness, exercising its advantageous effects on mental health of the students in higher education institutions. This research adds to the knowledge base of mindfulness and subjective well-being of university students, especially in contingent times. Lastly, the study contributes to the existing mindfulness theory.
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Affiliation(s)
- Teena Bharti
- Indian Institute of Management Bodh Gaya, Bihar 823234, India
| | - Nidhi Mishra
- Indian Institute of Management Bodh Gaya, Bihar 823234, India
| | - Satish Chandra Ojha
- School of Entrepreneurship and Management (formerly STEP-HBTI), Harcourt Butler Technical University, Kanpur 208002, India
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3
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Aliche CJ, Ifeagwazi CM, Nwamarah JU, Okechukwu FO, Ngwu EC. Mediating roles of positive reappraisal and stigma resistance in the relationship between mindfulness and quality of life among stable schizophrenia patients. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04563-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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4
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Phan-Le NT, Brennan L, Parker L. The search for scientific meaning in mindfulness research: Insights from a scoping review. PLoS One 2022; 17:e0264924. [PMID: 35507587 PMCID: PMC9067662 DOI: 10.1371/journal.pone.0264924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 02/18/2022] [Indexed: 11/19/2022] Open
Abstract
There are on-going debates about what is and is not 'mindfulness'. These debates are stifling rigorous academic research as scientific precision is a precursor to shared meaning. While mindfulness is a growing field of research, these divergent and conflated meanings are limiting deeper interdisciplinary research. Interventions designed in one practice context may not be useful in other contexts because meaning is not transferred between settings. This review clarifies the various research domains that study mindfulness and the conceptual and operational definitions in each domain. This two-stage study comprises a scoping review of mindfulness classifications and a comparative content mapping of mindfulness studies from 2015 to 2021. The initial comprehensive search strategy followed the preferred reporting items for scoping reviews and meta-analysis (PRISMA) method. The comparative analysis was conducted using Leximancer. Findings illustrate a complex growing research corpus on mindfulness that is somewhat confused. The results from the scoping review show three shared domains in mindfulness classifications: short-term effects of mindfulness, long-term effects of mindfulness, and mindfulness practices. The results from the content mapping show four domains of mindfulness research: mental health, behavioural change, cognitive neuroscience, and ethical mindfulness. Operational definitions of mindfulness are not articulated clearly in these domains. Conceptual and operational definitions in the 'ethical mindfulness' domain are not yet developed. To enhance scientific progress in mindfulness research, further investigations of mindfulness classifications need to be developed. Content mapping and semantic typology is a potential candidate for future classification. More attention should be paid to developing operational definitions according to specific research domains. Scholars in the ethical mindfulness domain will need solid conceptual and operational definitions to support their research efforts.
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Affiliation(s)
- Nhat Tram Phan-Le
- School of Media and Communication, RMIT University, Melbourne, Australia
| | - Linda Brennan
- School of Media and Communication, RMIT University, Melbourne, Australia
| | - Lukas Parker
- School of Media and Communication, RMIT University, Melbourne, Australia
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5
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Harmanci P, Budak FK. The Effect of Psychoeducation Based on Motivational Interview Techniques on Medication Adherence, Hope, and Psychological Well-Being in Schizophrenia Patients. Clin Nurs Res 2021; 31:202-216. [PMID: 34596461 DOI: 10.1177/10547738211046438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study was conducted to determine the effect of psychoeducation based on motivational interview techniques on medication adherence, hope, and psychological well-being in schizophrenia patients. There are many studies using Motivational Interviewing for individuals with schizophrenia. However, there are no studies on whether the concept of "adherence to treatment," which is clearly shown to be corrected with 6 to 8 weeks of motivational interviewing, will positively affect concepts such as "hope and well-being," which require longer interventions, in a shorter time. In this context, there are not enough studies in which motivational interviewing techniques are integrated into psychoeducational interventions that can be organized with more individuals. The study was conducted with a pretest-posttest control group design. The sample size of the study was determined as 150 schizophrenia patients including 75 in the experimental group and 75 in the control group based on power analysis. The researcher provided the patients in the experimental group with a six-session psychoeducation program based on motivational interview techniques. A "Descriptive Characteristics Form," the "Herth Hope Index," the "Morisky Medication Adherence Scale," and the "Psychological Well-Being Scale" were used to collect the data. In the study, psychoeducation based on motivational interview techniques created a statistically significant difference in the medication adherence, hope and psychological well-being levels of the patients in the experimental and control groups (p < .05). Psychoeducation based on motivational interview techniques provided for schizophrenia patients was found to be effective in enhancing their medication adherence, hope, and psychological well-being levels.
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6
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Kasperek‐Zimowska B, Bednarek A, Giguere M, Parnowska D, Żochowska A, Malewicz‐Sawicka M. The impact of positive psychotherapy of psychoses on the subjective well‐being of people suffering from chronic schizophrenia—Preliminary report. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Agata Bednarek
- Daily Psychiatric Ward Institute of Psychiatry and Neurology Warsaw Poland
| | - Marta Giguere
- Daily Psychiatric Ward Institute of Psychiatry and Neurology Warsaw Poland
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Özdemir AA, Kavak Budak F. The Effects of Mindfulness-Based Stress Reduction Training on Hope, Psychological Well-Being, and Functional Recovery in Patients with Schizophrenia. Clin Nurs Res 2021; 31:183-193. [PMID: 34382427 DOI: 10.1177/10547738211039069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study tested the effects of mindfulness-based stress reduction (MBSR) training on multiple outcomes in patients with schizophrenia. We compared MBSR, psychoeducation, and control groups in a randomized controlled research design. Outcome measures assessed hope, psychological wellbeing, and functional recovery over three time points in 137 participants. The results of this study indicate that MBSR training was more effective in terms of increasing the level of hope, psychological well-being, and functional recovery of schizophrenia patients when compared with psychoeducation and control patients.
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8
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Çetin N, Aylaz R. The relationship of mindfulness-based psychoeducation provided to schizophrenic patients with their sociodemographic characteristics in increasing insight. Perspect Psychiatr Care 2021; 57:105-116. [PMID: 32420650 DOI: 10.1111/ppc.12531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/26/2020] [Accepted: 05/03/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study is to determine the relationship between sociodemographic characteristics and mindfulness-based psychoeducation given to schizophrenic patients for increasing insight. DESIGN AND METHODS This study was conducted as pre-experimental single group pretest-posttest model in a Community Mental Health Center (CMHC) located in the city center of Balıkesir, Turkey, with 55 patients. FINDINGS In patients graduating from university, posttest mean score of overall Beck Cognitive Insight Scale was higher than its pretest mean score and the difference between the mean scores was statistically significant (P < .05). PRACTICAL IMPLICATIONS It is recommended to place mindfulness-based psychoeducation programs into routine treatment in CMHCs to increase the insight of schizophrenic patients.
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Affiliation(s)
- Nurdan Çetin
- Department of Mental Health Nursing, 2. Army Altay Military Barracks, Malatya, Turkey
| | - Rukuye Aylaz
- Department of Public Health Nursing, School of Health, Inonu University, Malatya, Turkey
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Langer ÁI, Schmidt C, Vergara R, Mayol-Troncoso R, Lecaros J, Krogh E, Vergara C, Díaz M, Rivera G, Aguirre-Baez R, Gaspar PA. Examining the effect of a mindfulness based program for the improvement of cognitive function in an early stage of schizophrenia. A random controlled trial. Schizophr Res 2020; 223:370-372. [PMID: 32763112 DOI: 10.1016/j.schres.2020.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/28/2020] [Accepted: 07/19/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Álvaro I Langer
- Mind-Body Lab, Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile; Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile; Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile; Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile.
| | - Carlos Schmidt
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile; Brain, Cognition and Behavior PhD Program, University of Barcelona, Spain
| | - Rodrigo Vergara
- Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Chile
| | - Rocío Mayol-Troncoso
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile; Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Chile
| | | | - Edwin Krogh
- Mind-Body Lab, Instituto de Neurociencias Clínicas, Facultad de Medicina, Universidad Austral de Chile, Chile
| | - Carolina Vergara
- Servicio de Psiquiatría y Salud Mental Hospital El Pino, San Bernardo, Santiago, Chile
| | - Marcela Díaz
- Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Chile
| | - Gerardo Rivera
- Mind-Body Lab, Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile; Mind-Body Lab, Instituto de Neurociencias Clínicas, Facultad de Medicina, Universidad Austral de Chile, Chile
| | - Rodrigo Aguirre-Baez
- Mind-Body Lab, Instituto de Estudios Psicológicos, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Pablo A Gaspar
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile; Clínica Psiquiátrica Universitaria, Hospital Clínico y Facultad de Medicina, Universidad de Chile, Chile; Clínica Alemana de Santiago, RM, Chile; Instituto Milenio de Neurociencias, BNI, RM, Chile
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10
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Rasmussen AR, Reich D, Lavoie S, Li E, Hartmann JA, McHugh M, Whitford TJ, Nelson B. The relation of basic self-disturbance to self-harm, eating disorder symptomatology and other clinical features: Exploration in an early psychosis sample. Early Interv Psychiatry 2020; 14:275-282. [PMID: 31264785 DOI: 10.1111/eip.12850] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/30/2019] [Accepted: 06/09/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS The notion of basic self-disturbance has been proposed as a core feature of schizophrenia-spectrum disorders and as an indicator of future transition to psychosis in high-risk populations. However, the relation of this notion to many clinical characteristics has not been explored. The aim of this study was: (a) to investigate the distribution of self-disturbance and other symptoms dimensions in ultra-high risk (UHR), first-episode psychosis (FEP) and healthy control groups; and (b) to explore the association of self-disturbance with a history of self-harm, suicidal attempt, eating disorder symptomatology, school bullying victimization and sexual or physical abuse. METHODS Patients with UHR status (n = 38) or FEP (n = 26) and healthy controls (n = 33) were assessed with the Examination of Anomalous Self-Experience (EASE) and the Comprehensive Assessment of at Risk Mental States (CAARMS). The clinical-historical variables were assessed through medical records. RESULTS The FEP group scored significantly higher on the EASE than the UHR group, which scored significantly higher than the healthy control group, which had a very low score. Multivariate logistic regression analyses revealed that higher EASE score was significantly associated with a history of self-harm, disordered eating and bullying victimization (but not with suicide attempts or sexual/physical abuse) after controlling for positive, negative and depressive symptoms. CONCLUSION These novel findings suggest that self-disturbance may be related to a history of school bullying victimization, self-harm and eating disorder symptomatology in patients with or at-risk of psychosis. If further confirmed, these findings are potentially relevant to clinical risk assessment and therapy.
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Affiliation(s)
- Andreas R Rasmussen
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Mental Health Center Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Reich
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Suzie Lavoie
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Emily Li
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Jessica A Hartmann
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Meredith McHugh
- Health Care for the Homeless, Baltimore, Maryland.,Youth Empowered Society, Baltimore, Maryland
| | - Thomas J Whitford
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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11
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Perlini C, Bellani M, Rossetti MG, Rossin G, Zovetti N, Rossi A, Bressi C, Piccolo LD, Brambilla P. Mindfulness-based interventions in the early phase of affective and non-affective psychoses: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD. J Affect Disord 2020; 263:747-753. [PMID: 31630830 DOI: 10.1016/j.jad.2019.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/12/2019] [Accepted: 10/08/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND In the last 10 years, psychological approaches based on mindfulness techniques have been proposed for the management of psychotic experiences. METHOD In this brief review we summarized, to our knowledge for the first time, published studies on mindfulness-based interventions (MBIs) applied to the early phase of major psychoses (affective and non-affective). RESULTS Despite the great variability in terms of MBIs protocols, available studies on young people at risk to develop or with a first episode of psychosis suggest MBIs as a feasible, well-tolerated and effective approach in ameliorating symptoms, functioning, emotion regulation, and finally reducing the psychological distress associated with the onset of mania and/or psychotic experience. LIMITATIONS The small sample size and inconsistencies between studies in terms of design, MBIs protocols and outcome measures suggest being cautious in interpreting and generalizing results. Moreover, specific guidelines are missing for the adaptation of MBIs to youth at risk of developing affective psychoses. CONCLUSIONS Preliminary findings show that MBIs may be considered a promising adjunctive therapy for the treatment of major psychoses in the early phases of the illness. However, the conduct of further studies in larger samples and with a more rigorous methodology is warranted to confirm the beneficial effect of MBIs in the early stages of major psychoses.
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Affiliation(s)
- Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy.
| | - Maria Gloria Rossetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy; Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Rossin
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Niccolò Zovetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Italy
| | - Alberto Rossi
- Department of Mental Health, ULSS9 Scaligera, Verona, Italy
| | - Cinzia Bressi
- Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lidia Del Piccolo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Paolo Brambilla
- Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioural Sciences, University of Texas at Houston Medical School, Houston, TX, USA.
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12
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Bosnjak Kuharic D, Kekin I, Hew J, Rojnic Kuzman M, Puljak L. Interventions for prodromal stage of psychosis. Cochrane Database Syst Rev 2019; 2019:CD012236. [PMID: 31689359 PMCID: PMC6823626 DOI: 10.1002/14651858.cd012236.pub2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psychosis is a serious mental condition characterised by a loss of contact with reality. There may be a prodromal period or stage of psychosis, where early signs of symptoms indicating onset of first episode psychosis (FEP) occur. A number of services, incorporating multimodal treatment approaches (pharmacotherapy, psychotherapy and psychosocial interventions), developed worldwide, now focus on this prodromal period with the aim of preventing psychosis in people at risk of developing FEP. OBJECTIVES The primary objective is to assess the safety and efficacy of early interventions for people in the prodromal stage of psychosis. The secondary objective is, if possible, to compare the effectiveness of the various different interventions. SEARCH METHODS We searched Cochrane Schizophrenia's study-based Register of studies (including trials registers) on 8 June 2016 and 4 August 2017. SELECTION CRITERIA All randomised controlled trials (RCTs) evaluating interventions for participants older than 12 years, who had developed a prodromal stage of psychosis. DATA COLLECTION AND ANALYSIS Review authors independently inspected citations, selected studies, extracted data, and assessed study quality. MAIN RESULTS We included 20 studies with 2151 participants. The studies analysed 13 different comparisons. Group A comparisons explored the absolute effects of the experimental intervention. Group B were comparisons within which we could not be clear whether differential interactive effects were also ongoing. Group C comparisons explored differential effects between clearly distinct treatments. A key outcome for this review was 'transition to psychosis'. For details of other main outcomes please see 'Summary of findings' tables. In Group A (comparisons of absolute effects) we found no clear difference between amino acids and placebo (risk ratio (RR) 0.48 95% confidence interval (CI) 0.08 to 2.98; 2 RCTs, 52 participants; very low-quality evidence). When omega-3 fatty acids were compared to placebo, fewer participants given the omega-3 (10%) transitioned to psychosis compared to the placebo group (33%) during long-term follow-up of seven years (RR 0.24 95% CI 0.09 to 0.67; 1 RCT, 81 participants; low-quality evidence). In Group B (comparisons where complex interactions are probable) and in the subgroup focusing on antipsychotic drugs added to specific care packages, the amisulpiride + needs-focused intervention (NFI) compared to NFI comparison (no reporting of transition to psychosis; 1 RCT, 102 participants; very low-quality evidence) and the olanzapine + supportive intervention compared to supportive intervention alone comparison (RR 0.58 95% CI 0.28 to 1.18; 1 RCT, 60 participants; very low-quality evidence) showed no clear differences between groups. In the second Group B subgroup (cognitive behavioural therapies (CBT)), when CBT + supportive therapy was compared with supportive therapy alone around 8% of participants allocated to the combination of CBT and supportive therapy group transitioned to psychosis during follow-up by 18 months, compared with double that percentage in the supportive therapy alone group (RR 0.45 95% CI 0.23 to 0.89; 2 RCTs, 252 participants; very low-quality evidence). The CBT + risperidone versus CBT + placebo comparison identified no clear difference between treatments (RR 1.02 95% CI 0.39 to 2.67; 1 RCT, 87 participants; very low-quality evidence) and this also applies to the CBT + needs-based intervention (NBI) + risperidone versus NBI comparison (RR 0.75 95% CI 0.39 to 1.46; 1 RCT, 59 participants; very low-quality evidence). Group C (differential effects) also involved six comparisons. The first compared CBT with supportive therapy. No clear difference was found for the 'transition to psychosis' outcome (RR 0.74 95% CI 0.28 to 1.98; 1 RCT, 72 participants; very low-quality evidence). The second subgroup compared CBT + supportive intervention was compared with a NBI + supportive intervention, again, data were equivocal, few and of very low quality (RR 6.32 95% CI 0.34 to 117.09; 1 RCT, 57 participants). In the CBT + risperidone versus supportive therapy comparison, again there was no clear difference between groups (RR 0.76 95% CI 0.28 to 2.03; 1 RCT, 71 participants; very low-quality evidence). The three other comparisons in Group C demonstrated no clear differences between treatment groups. When cognitive training was compared to active control (tablet games) (no reporting of transition to psychosis; 1 RCT, 62 participants; very low quality data), family treatment compared with enhanced care comparison (RR 0.54 95% CI 0.18 to 1.59; 2 RCTs, 229 participants; very low-quality evidence) and integrated treatment compared to standard treatment comparison (RR 0.57 95% CI 0.28 to 1.15; 1 RCT, 79 participants; very low-quality evidence) no effects of any of these approaches was evident. AUTHORS' CONCLUSIONS There has been considerable research effort in this area and several interventions have been trialled. The evidence available suggests that omega-3 fatty acids may prevent transition to psychosis but this evidence is low quality and more research is needed to confirm this finding. Other comparisons did not show any clear differences in effect for preventing transition to psychosis but again, the quality of this evidence is very low or low and not strong enough to make firm conclusions.
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Affiliation(s)
- Dina Bosnjak Kuharic
- University Psychiatric Hospital VrapčeBolnicka cesta 32ZagrebGrad ZagrebCroatia10000
| | - Ivana Kekin
- Clinical Hospital Centre ZagrebDepartment of PsychiatryKispaticeva 1210 000ZagrebCroatia
| | - Joanne Hew
- South London and Maudsley NHS Foundation TrustDepartment of Acute Care PsychiatryLadywell Unit, University Hospital LewishamLondonUK
| | - Martina Rojnic Kuzman
- Clinical Hospital Centre ZagrebDepartment of PsychiatryKispaticeva 1210 000ZagrebCroatia
| | - Livia Puljak
- Catholic University of CroatiaCenter for Evidence‐Based Medicine and Health CareIlica 242ZagrebCroatia10000
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MacDougall AG, Price E, Vandermeer MRJ, Lloyd C, Bird R, Sethi R, Shanmugalingam A, Carr J, Anderson KK, Norman RMG. Youth-focused group mindfulness-based intervention in individuals with early psychosis: A randomized pilot feasibility study. Early Interv Psychiatry 2019; 13:993-998. [PMID: 30318868 DOI: 10.1111/eip.12753] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 09/12/2018] [Accepted: 09/22/2018] [Indexed: 01/18/2023]
Abstract
AIM To assess the feasibility of a randomized pilot trial that evaluated the acceptability and potential clinical utility of the Mindfulness Ambassador Program (MAP), a unique, standardized 12-session facilitated group mindfulness-based intervention (MBI) for youth experiencing early psychosis. METHODS Twenty-one patients of an early psychosis intervention program were randomized to receive MAP (n = 11) or treatment as usual (n = 10). Acceptability was measured by group attendance rate and client satisfaction; feasibility of the study design was measured by the recruitment and retention rate. The means, standard deviations, and 95% confidence intervals were described for outcomes of interest. RESULTS MAP is associated with a high degree of acceptability and has beneficial effects for depression and fatigue. The randomized trial design is feasible. CONCLUSIONS This study provides important pilot data supporting a larger randomized trial of effectiveness for MAP as a group MBI for early psychosis. Details of MAP and study limitations are discussed.
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Affiliation(s)
- Arlene G MacDougall
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | | | | | - Chantelle Lloyd
- Lawson Health Research Institute, London, Ontario, Canada.,Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
| | - Richelle Bird
- Lawson Health Research Institute, London, Ontario, Canada.,Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada
| | - Rickinder Sethi
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Aturan Shanmugalingam
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Jason Carr
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Kelly K Anderson
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Ross M G Norman
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Prevention and Early Intervention Program for Psychoses, London Health Sciences Centre, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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14
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Shields GE, Buck D, Elvidge J, Hayhurst KP, Davies LM. Cost-Effectiveness Evaluations of Psychological Therapies for Schizophrenia and Bipolar Disorder: A Systematic Review. Int J Technol Assess Health Care 2019; 35:317-326. [PMID: 31328702 PMCID: PMC6707812 DOI: 10.1017/s0266462319000448] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES This review aims to assess the cost-effectiveness of psychological interventions for schizophrenia/bipolar disorder (BD), to determine the robustness of current evidence and identify gaps in the available evidence. METHODS Electronic searches (PsycINFO, MEDLINE, Embase) identified economic evaluations relating incremental cost to outcomes in the form of an incremental cost-effectiveness ratio published in English since 2000. Searches were concluded in November 2018. Inclusion criteria were: adults with schizophrenia/BD; any psychological/psychosocial intervention (e.g., psychological therapy and integrated/collaborative care); probability of cost-effectiveness at explicitly defined thresholds reported. Comparators could be routine practice, no intervention, or alternative psychological therapies. Screening, data extraction, and critical appraisal were performed using pre-specified criteria and forms. Results were summarized qualitatively. The protocol was registered on the PROSPERO database (CRD42017056579). RESULTS Of 3,864 studies identified, 12 met the criteria for data extraction. All were integrated clinical and economic randomized controlled trials. The most common intervention was cognitive behavioral therapy (CBT, 6/12 studies). The most common measure of health benefit was the quality-adjusted life-year (6/12). Follow-up ranged from 6 months to 5 years. Interventions were found to be cost-effective in most studies (9/12): the probability of cost-effectiveness ranged from 35-99.5 percent. All studies had limitations and demonstrated uncertainty (particularly related to incremental costs). CONCLUSIONS Most studies concluded psychological interventions for schizophrenia/BD are cost-effective, including CBT, although there was notable uncertainty. Heterogeneity across studies makes it difficult to reach strong conclusions. There is a particular need for more evidence in the population with BD and for longer-term evidence across both populations.
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Affiliation(s)
| | - Deborah Buck
- Personal and Social Services Research Unit, University of Manchester
| | - Jamie Elvidge
- National Institute for Health and Care Excellence, United Kingdom
| | | | - Linda Mary Davies
- Centre for Health Economics, Division of Population Health, University of Manchester
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15
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Grandi F, Burgueño L, Irurtia MJ. [Effectiveness of a mindfulness-based stress reduction program for family caregivers of people with dementia. Systematic review of randomised clinical trials]. Rev Esp Geriatr Gerontol 2019; 54:109-115. [PMID: 30482461 DOI: 10.1016/j.regg.2018.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/31/2018] [Accepted: 09/04/2018] [Indexed: 11/17/2022]
Abstract
Family caregivers of people with dementia usually have high levels of anxiety, depression, and overload symptoms, and are reasons for being considered a clinically vulnerable population. The objective of the present review is to examine the effectiveness of the mindfulness-based stress reduction program (MBSR) applied to this population. A search was made in the electronic databases for randomised trials with pre-post measurement in the last 15 years. The methodological quality was obtained using the Jadad scale. Finally, 5 articles were included, obtaining a sample of 309 participants. The score on the Jadad scale was 3.4 out of 5. In general, the MBSR program reduces anxiety and depression symptoms, as well as overload levels in the post-measurement. However, some studies showed a significant reduction in the psychological effects of the program during follow-up. More empirical studies are needed that can establish a more homogeneous protocol that reduces the ambiguity of some results.
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Affiliation(s)
- Fabrissio Grandi
- Facultad de Psicología, Universidad Complutense, Madrid, España.
| | - Lucas Burgueño
- Consultoría Especialista en Gestión de Estrés y Mindfulness Aplicado (CEMYC), Valladolid, España
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