An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia
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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 (χ 2 = 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.
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Recent randomised control studies and meta-analyses showed that mindfulness-based interventions significantly improved DM, negative emotions, positive symptoms and negative symptoms compared with control groups.
“Recent randomised control studies and meta-analyses showed that mindfulness-based interventions significantly improved DM, negative emotions, positive symptoms and negative symptoms compared with control groups.43–49”
From Dispositional Mindfulness and Psychotic Symptoms in Schizophrenia Spectrum Disorders: The Mediating Roles of Rumination and Negative Emotion (2022) · cites this paper as [47]
The Results (page unavailable) report significant between-group differences in positive and negative symptoms, supporting those parts of the claim for people with schizophrenia. The Introduction also reports a meta-analysis finding benefits for symptom severity. Our copy does not establish significant improvements in DM or negative emotions compared with controls, and this trial tested mindfulness combined with psychoeducation rather than mindfulness alone. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMM can relieve partial positive symptoms and negative symptoms of schizophrenia, enhance patients' awareness of their disease, shorten lengths of inpatient stay and reduce rehospitalisation rates.
“Furthermore, MM can relieve partial positive symptoms71 72 and negative symptoms69 72 of schizophrenia, enhance patients’ awareness of their disease, shorten lengths of inpatient stay and reduce rehospitalisation rates.71 72”
From Biological mechanism study of meditation and its application in mental disorders (2020) · cites this paper as [72]
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“…scale (1, “ absent ” to 7, “ extreme ” ) and has shown good internal consistency (Cronbach ’ s α = 0.87 – 0.93), interrater reliability ( ICC = 0.88, p = 0.01), and concurrent validity with the Brief Psychiatric-Rating Scale (Pearson ’ s r = 0.85 – 0.90) (Bell et al., 1992; Chien et al., 2017).”
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- Authors
- Chien, W. T., Bressington, D., Yip, A., & Karatzias, T.
- Affiliations
- Hong Kong Polytechnic University (HK)
- Edinburgh Napier University (GB)
- Corresponding author
- Chien, W. T.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-04-04
- Volume
- 47
- Issue
- 12
- Pages
- 2081-2096
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC5551382
- OpenAlex
- W2604914518
- Cited by
- 57
- References
- 34
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 8 · 2023: 4 · 2022: 13 · 2021: 9 · 2020: 7 · 2019: 6 · 2018: 3
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Update notices
- correction (2017-04-04)
- Open access
- hybrid
- doi.org
- Locations
- Psychological Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Output (Edinburgh Napier University) (publishedVersion, other-oa)
- PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion, cc-by)
- Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion, cc-by)
- Funders
- Hong Kong Polytechnic University
- Food and Health Bureau
- Health and Medical Research Fund
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- schizophrenia spectrum disorders, hospital readmission, remission, PANSS, community mental health services, long-term outcomes
- MeSH terms
- Adolescent, Adult, China, Female, Follow-Up Studies, Hong Kong, Humans, Male, Middle Aged, Patient Education as Topic, Patient Readmission, Schizophrenia, Taiwan, Single-Blind Method, Outcome Assessment, Health Care, Young Adult, Mindfulness
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