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Mindfulness and relaxation treatment reduce depressive symptoms in individuals with psychosis

Published online by Cambridge University Press:  07 July 2015

S. Moritz ,
B. Cludius ,
B. Hottenrott ,
B.C. Schneider ,
K. Saathoff ,
A.K. Kuelz  and
J. Gallinat
S. Moritz*
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr, 52, Hamburg, Germany
B. Cludius
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr, 52, Hamburg, Germany
B. Hottenrott
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr, 52, Hamburg, Germany
B.C. Schneider
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr, 52, Hamburg, Germany
K. Saathoff
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr, 52, Hamburg, Germany
A.K. Kuelz
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany
J. Gallinat
Affiliation:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr, 52, Hamburg, Germany
*
*Corresponding author. E-mail address: moritz@uke.uni-hamburg.de (S. Moritz).
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Abstract

Introduction

Self-help is increasingly accepted for the treatment of mental disorders, including psychosis, as both a provisional first step and a way to bridge the large treatment gap. Though mindfulness-based interventions do not belong to first line treatment strategies in psychosis and randomized controlled trials are lacking, encouraging preliminary findings speak for the usefulness of this approach. For the present study, we examined whether patients with psychosis benefit from mindfulness bibliotherapy.

Methods

A sample of 90 patients with psychosis (including a subsample with a verified diagnosis of schizophrenia) took part in the study via the Internet. Following baseline assessment, participants were randomized to either a mindfulness group or a Progressive Muscle Relaxation (PMR) control group and received the respective self-help manual including accompanying audio files. Symptom change was measured six weeks after the baseline assessment with self-rating scales including the Paranoia Checklist. The retention rate was 71%. The quality of the online dataset was confirmed by various strategies (e.g., psychosis lie scale; examination of response biases). The trial was registered at the ISRCTN registry (ISRCTN86762253).

Results

No changes across time or between groups were noted for the Paranoia Checklist. Both conditions showed a decline in depressive and obsessive-compulsive symptoms at a medium effect size (per protocol and intention to treat analyses).

Discussion/conclusion

The study provided partial support for the effectiveness of self-help mindfulness and PMR for depression in psychosis. Whether mindfulness delivered by a licensed therapist might lead to improved treatment adherence and a superior outcome relative to PMR remains to be established. The results underscore that bibliotherapy is a worthwhile approach to narrow the large treatment gap seen in psychosis.

Keywords

PsychosisSchizophreniaMindfulnessRelaxationCognitive-behavioral therapySelf-help intervention
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 6 , September 2015 , pp. 709 - 714
Copyright
Copyright © Elsevier Masson SAS 2015

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Footnotes

1

The authors have equally contributed to the manuscript and share first authorship. A.K.K. and J.G. also contributed equally.

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