Feasibility of mindfulness-based therapy in patients recovering from a first psychotic episode: a pilot study.

Mindfulness-based therapy (MBT) for people recently recovering from a first episode of psychosis appears feasible and does not significantly worsen psychotic symptoms. In a small pilot study, 13 of 16 participants completed eight 1-hour sessions over four weeks. No significant increase in psychotic symptoms occurred, and no participants reported increased awareness of intrusive thoughts or hallucinations. Agoraphobic symptoms and psychoneuroticism decreased. However, one participant initially misunderstood instructions, leading to increased distress. The therapy did not raise mindfulness levels. The authors caution that instructions must be clearly understood and call for larger randomized trials.

Study at a glance

Abstract

Recently, a mindfulness therapy for people with psychotic disorders was developed. However, clinicians and researchers are cautious given case reports in which extensive meditation provoked psychotic symptoms in people with a psychotic disorder. The purpose of this study was to examine the feasibility, adverse effects and possible favourable effects of mindfulness-based therapy (MBT) in people recently recovering from a first episode of psychosis. A nonrandomized, non-controlled prospective follow-up study. Patients were offered an MBT that consisted of eight 1-hour sessions within a 4-week time span. Positive and Negative Syndrome Scale, Symptoms Checklist 90 and the Southampton Mindfulness Questionnaire were assessed before and after the therapy. Of the 16 persons who started MBT, 13 completed (81.5%) the therapy. No significant increase in psychotic symptoms was found. Between two meetings, one participant initially misunderstood the mindfulness instructions, which led to an increase in distress. No increased awareness of intrusive thoughts or visual or auditory hallucinations was reported by participants. We found a decrease in agoraphobic symptoms (p < 0.028) and in psychoneuroticism (P < 0.025). The MBT had no significant adverse effect on psychotic symptoms in patients in this small pilot study, neither did it raise the level of mindfulness in the participants. A decrease in psychological symptoms was found, although one patient experienced an increase in symptoms of distress. Our study demonstrates that therapists should be cautious that therapy and practice instructions are understood properly. Future studies are feasible and needed, in larger samples with an RCT design, in order to draw conclusions regarding the effects of the MBT.