JOURNAL PRESENTATION
Presented By
Miss. More Kajal
1STYear M.Sc Nursing
TITLE OF THE STUDY
A Study To Assess The Effectiveness Of Acceptance- And Mindfulness-based Interventions For
Persons With Psychosis: A Systematic Review And Meta-analysis.
Author:
Jens Einar Jansen, John Gleeson, Mario Alvarez-jimenez, Simon Rice
Mental Health Center Copenhagen, Frederiksberg Hospital, Denmark
School Of Behavioral And Health Sciences, Australian Catholic University, Melbourne, Australia
Centre For Youth Mental Health, The University Of Melbourne, Australia
Origen: The National Centre Of Excellence In Youth Mental Health, Melbourne, Australia
Received 14 April 2019, Revised 3 October 2019, Accepted 11 November 2019, Available Online 26 November 2019, Version
Of Record 17 February 2020.
OBJECTIVE
• A systematic review and meta-analysis of the efficacy and safety of acceptance-
and mindfulness-based therapies for persons with a psychotic or
schizophrenia spectrum disorder.
INTRODUCTION
• Recent years have seen a renewed optimism with regards to recovery in people with
psychosis (. The first-line treatment is often pharmacotherapy, which has been found to
reduce symptoms and relapse short-term. However, the long-term benefits of
antipsychotic medication are increasingly being questioned . For many, medication
does not result in clinically meaningful improvement and the side-effects are
considerable, which often results in medication discontinuation.
• Mindfulness refers to deliberate attention to the present moment and is incorporated in
a range of different therapeutic approaches, including the so-called ‘third-wave’ or
contextual behavioural approaches such as acceptance and commitment therapy ,
dialectical behavioral therapy , compassion focused therapy and mindfulness-based
cognitive therapy . These therapies share a common focus on helping people to foster a
mindful or accepting stance towards their symptoms and distressing experiences,
instead of struggling to reduce, change or eradicate these.
• METHOD:
Cochrane methodology and the Preferred Reporting Items for Systematic Reviews and Meta-
Analyses (PRISMA) were followed in reporting the results with the exemption of protocol pre-
registration. Following PRISMA guidelines, relevant databases were searched for published
randomized controlled trials (RCTs) up to October 2018. Outcomes were severity of overall
symptomatology, hospitalization, positive and negative symptoms, depression, anxiety, social
functioning, quality of life, acceptance, mindfulness skills and safety of the interventions.
• STUDY SELECTION:
The computerized search retrieved 8811 citations, of which 175 were selected for detailed
evaluation. Eighteen studies were included in the systematic review and sixteen studies were
included in the meta-analysis after carefully applying the inclusion and exclusion criteria.
• STUDY CHARACTERISTICS:
Characteristics of the included studies are Eighteen studies comprising 1342 participants with
psychotic disorders or schizophrenia.
RESULTS
• Sixteen Studies Comprising 1268 People With A Schizophrenia Spectrum Disorder Were Included
In The Meta-analyses.
• Moderate To Large Effect Sizes Were Found For Overall Symptomatology And Hospitalization At
Endpoint (Smd .80, 95% Ci -1.31, -0.29 And MD 4.38, -5.58, -3.17 Respectively) And Follow-up
(SMD 1.10, -2.09, -0.10 And MD 7.18, -8.67, - 5.68 Respectively).
• There Were Significant Small Effects On Negative Symptoms (Smd .24; -0.44, -0.03), Small To
Moderate Effects For Depression (SMD .47; -0.80, -0.14), Social Functioning (SMD .43; -0.75, -
0.12) And Mindfulness (SMD .51; -0.97, -0.05), Moderate To Large Effects For Acceptance (SMD
.78; -1.44, -0.12), While No Significant Effects For Positive Symptoms (SMD .27; -0.65, 0.00),
Anxiety (SMD 2.11; -4.64, 0.42) Or Quality Of Life (SMD .43; -0.88, 0.02).
• Majority Of Studies (75%) Had Low Risk Of Bias And Sensitivity Analyses Supported The
Findings.
DISCUSSION
• The Current Study Examined The Evidence Of Acceptance- And Mindfulness-
based Interventions For Persons With A Schizophrenia Spectrum Disorder, And
Found Significant Efficacy On Many Outcomes Related To Symptomatology And
Social Functioning In Comparison With Treatment As Usual.
• Eighteen Studies Met Inclusion Criteria For The Qualitative Synthesis, While
Sixteen Studies, Comprising 1268 Persons With A Psychotic Or Schizophrenia
Spectrum Disorder Were Included In The Meta-analyses.
CONCLUSION
• Acceptance- And Mindfulness-based Approaches Appear To Be Effective And
Safe Interventions For Individuals With Schizophrenia Spectrum Disorders And
Could Be A Useful Extension Of Standard Case Management And
Psychopharmacology.
REFERENCES
• S.F. Austin Et Al.Predictors
Of Recovery In First Episode Psychosis: The OPUS Cohort At 10year Follow-up
• P. Chadwick Et Al.Group
Mindfulness-based Intervention For Distressing Voices: A Pragmatic Randomised
Controlled Trial
• R. Dersimonian Et Al.Meta-analysis In Clinical Trials
• G. Fervaha Et Al.Effect
Of Antipsychotic Medication On Overall Life Satisfaction Among Individuals Wi
th Chronic Schizophrenia: Findings From The NIMH CATIE Study
• Eur. Neuropsychopharmacology.
