Systematic review of the safety of mindfulness-based interventions for psychosis
Systematic review of the safety of mindfulness-based interventions for psychosis
Harmful outcomes of psychological interventions are under-researched, including in mindfulness-based interventions (MBI) for psychosis. This systematic review summarizes reporting and prevalence of 8 harm indices (death, adverse events, hospitalisation, study drop out, noncompletion of therapy, side effects of therapy, symptom deterioration and crisis service use) in Randomised Controlled Trials (RCTs) of MBIs for psychosis. Meta-analyses of risk differences were also calculated for each harm index. The review included 39 studies, with a total n of 2684 participants across studies. The percentage of studies reporting on each index of harm, and the prevalence of harm, varied greatly across each index. 0% of studies reported on side effects of interventions compared to 92% of studies reporting on study dropout. Meta-analyses of risk differences (RD) found a higher risk of hospitalisation (RD (95% CI) = −0.136 (−0.23 to −0.05), p = 0.003) and crisis service use (RD (95% CI) = −0.160 (−0.299, −0.024), p = 0.02) in control arms compared to intervention arms, and no significant difference in adverse events, death, symptom deterioration, noncompletion of therapy, drop out and side effects of therapy. Overall, reporting of harm was inconsistent across studies and the quality of data collection and reporting varied. MBIs for psychosis appear to be safe and may reduce the risk of hospitalisation and use of crisis services. However, the absence of thorough reporting on harm precludes a balanced analysis of benefits versus harms. Future research into the effectiveness of MBIs should consistently operationalise, monitor and report data on harm.
Harm, Meta-analysis, Mindfulness, Psychosis, Safety, Systematic review
O'Brien-Venus, Bethany
afdfc4b2-d8eb-4666-87a7-274a3d37c7c2
Ellett, Lyn
96482ea6-04b6-4a50-a7ec-ae0a3abc20ca
Burgess-Barr, Susanna
14f5b60f-24e7-4167-85ca-66a6fae21ad4
Chadwick, Paul
13a767ec-4c8d-467b-85df-ca04a8d11a8e
8 June 2024
O'Brien-Venus, Bethany
afdfc4b2-d8eb-4666-87a7-274a3d37c7c2
Ellett, Lyn
96482ea6-04b6-4a50-a7ec-ae0a3abc20ca
Burgess-Barr, Susanna
14f5b60f-24e7-4167-85ca-66a6fae21ad4
Chadwick, Paul
13a767ec-4c8d-467b-85df-ca04a8d11a8e
O'Brien-Venus, Bethany, Ellett, Lyn, Burgess-Barr, Susanna and Chadwick, Paul
(2024)
Systematic review of the safety of mindfulness-based interventions for psychosis.
Clinical Psychology Review, 112, [102445].
(doi:10.1016/j.cpr.2024.102445).
Abstract
Harmful outcomes of psychological interventions are under-researched, including in mindfulness-based interventions (MBI) for psychosis. This systematic review summarizes reporting and prevalence of 8 harm indices (death, adverse events, hospitalisation, study drop out, noncompletion of therapy, side effects of therapy, symptom deterioration and crisis service use) in Randomised Controlled Trials (RCTs) of MBIs for psychosis. Meta-analyses of risk differences were also calculated for each harm index. The review included 39 studies, with a total n of 2684 participants across studies. The percentage of studies reporting on each index of harm, and the prevalence of harm, varied greatly across each index. 0% of studies reported on side effects of interventions compared to 92% of studies reporting on study dropout. Meta-analyses of risk differences (RD) found a higher risk of hospitalisation (RD (95% CI) = −0.136 (−0.23 to −0.05), p = 0.003) and crisis service use (RD (95% CI) = −0.160 (−0.299, −0.024), p = 0.02) in control arms compared to intervention arms, and no significant difference in adverse events, death, symptom deterioration, noncompletion of therapy, drop out and side effects of therapy. Overall, reporting of harm was inconsistent across studies and the quality of data collection and reporting varied. MBIs for psychosis appear to be safe and may reduce the risk of hospitalisation and use of crisis services. However, the absence of thorough reporting on harm precludes a balanced analysis of benefits versus harms. Future research into the effectiveness of MBIs should consistently operationalise, monitor and report data on harm.
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Safety of MBIs for Psychosis CSR Manuscript_R2_Clean
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Accepted/In Press date: 16 May 2024
e-pub ahead of print date: 18 May 2024
Published date: 8 June 2024
Keywords:
Harm, Meta-analysis, Mindfulness, Psychosis, Safety, Systematic review
Identifiers
Local EPrints ID: 491995
URI: http://eprints.soton.ac.uk/id/eprint/491995
ISSN: 0272-7358
PURE UUID: c06a5229-30c0-4c34-aa23-4f291adccf6b
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Date deposited: 11 Jul 2024 16:30
Last modified: 12 Jul 2024 02:10
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Contributors
Author:
Bethany O'Brien-Venus
Author:
Susanna Burgess-Barr
Author:
Paul Chadwick
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