Effects of mindfulness-based interventions (MBIs) on psychotic symptoms and psychological outcomes in patients with schizophrenia spectrum disorders: A systematic review and meta-analysis.
Chuntana Reangsing, Sathit Wongsuraprakit, Sasinun Punsuwun, Sarah Oerther
Psychiatry Research December 1, 2024 DOI: 10.1016/j.psychres.2024.116272 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Peer reviewed |
|---|---|
| Sample size | 1,632 |
| Population | Patients with schizophrenia spectrum disorders |
| Intervention | Mindfulness-based interventions |
| Topics | Meditation |
| Keywords | Meta-analysis Mindfulness-based interventions Schizophrenia |
| Citations | 5 |
| Key findings | Mindfulness-based interventions significantly reduced psychotic symptoms and improved global functioning, insight, and mindfulness in patients with schizophrenia spectrum disorders, with greater benefits from mixed-format delivery and home assignments. |
Abstract
Mindfulness refers to the practice of consciously attending to the present moment without judgement. Although mindfulness-based intervention have been extensively researched. Less is known about the effect of this intervention on psychotic symptoms in patients with schizophrenia spectrum disorders. Thus, we synthesized the effects of mindfulness-based interventions (MBIs) on psychotic symptoms, global functioning, insight, and mindfulness in patients with schizophrenia spectrum disorders. Nine electronic databases were searched from inception to March 2024 including Academic Search Complete, CINAHL, Cochrane, Ovid APA InFo, ProQuest, PubMed, Scopus, Mindfulness Journal and Web of Science. We reviewed studies on outcomes for patients with schizophrenia spectrum disorders receiving mindfulness-based interventions. We only reviewed all experimental and quasi-trials studies written in English. A random-effects model was used to compute the effect size. We used Funnel plot, Q statistics, and I2 to test the heterogeneity across studies. Also, we examined moderators to explore sources of heterogeneity. Across 24 included studies (N = 1,632), 796 schizophrenia patients participated in mindfulness interventions; 836 served as controls. Most schizophrenia patients were males (69 %, s = 7). Mean age ranged from 24.4 to 59.5 years. Overall, mindfulness-based interventions showed reduced psychotic symptoms (g = 0.70, 95 %CI 0.04, 1.36, I2 = 96 %), increased global functioning (g = 1.28, 95 %CI 0.50, 2.05), insight (g = 1.21, 95 %CI 0.88, 1.55) and mindfulness (g = 0.56, 95 %CI 0.15, 0.97) compared to control groups, but with substantial heterogeneity. With subgroup analysis, every one-year of mean age of patients with schizophrenia increased, psychotic symptom worsened (slope = -0.071, tau2 = 0.77, Qbetween = 166.3, p = .016). Additionally, for every day of MBIs practice increased, psychotic symptoms improved (Slope = 0.012, tau2 = 1.37, Qbetween = 251.6, p = .033), patients' functioning improved (slope = 0.013, tau2 = 0.69, Qbetween = 142.1, p = .017) and patients' insight improved (slope = 0.001, tau2 = 0.012, Qbetween = 8.6, p = .043). Providing MBIs as a mixed format (individual plus group intervention) had a greater effect (g = 1.538) on improving patients' insight than providing MBIs only to individuals (g = 0.889). Also, providing MBIs with a home assignment had a greater effect (g = 1.517) on improving patients' insight than providing MBIs without a home assignment (g = 0.787). No primary studies reported the adverse effects. MBIs significantly improved psychotic symptoms, global functioning, insight, and mindfulness among patients with schizophrenia spectrum disorders, especially MBIs with home assignment. Clinicians and health providers should consider using MBIs as alternative complementary treatment for improving psychotic symptoms and increasing global functioning, insight and mindfulness.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 3
- Use of religious and spiritual complementary practices among Chinese patients with schizophrenia: prevalence, perceived helpfulness, and associated factors Frontiers in Psychiatry October 21, 2026
- A narrative review of research status and prospects of mindfulness-based interventions in schizophrenia Frontiers in Psychology October 12, 2026
- Effect of meditation on clinical symptoms and gray matter volume in chronic schizophrenia: a randomized controlled trial. European Archives of Psychiatry and Clinical Neuroscience May 19, 2026
Cites 18
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- Review of the Neural Oscillations Underlying Meditation Frontiers in Neuroscience March 26, 2018
- An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia Psychological Medicine April 4, 2017
- Mindfulness for psychosis: Current evidence, unanswered questions and future directions Psychology and Psychotherapy Theory Research and Practice June 30, 2023
- Are Formal and Informal Home Mindfulness Practice Quantities Associated With Outcomes? Results From a Pilot Study of a Four-Week Mindfulness Intervention for Chronic Pain Management. Global Advances in Integrative Medicine and Health 2024
and 13 more in the library