Brief mindfulness-oriented interventions (MOIs) to improve psychiatric symptoms in a psychiatric inpatient unit: a randomized controlled feasibility trial

ABSTRACT

Background

Mindfulness-based interventions are effective in treating numerous psychiatric symptoms, but data about brief mindfulness-oriented intervention (MOI) use with psychiatric inpatients are limited. We investigated whether a brief MOI was feasible and effective in reducing psychosis and other symptoms in a psychiatric inpatient unit.

Methods

In an assessor-blinded feasibility randomized-controlled trial, adult psychiatric inpatients were randomized to the intervention or control group. Feasibility outcomes included enrollment rate, retention rate and intervention-completion rate. The quantitative outcome was the impact on symptom reduction (mean and % difference in Brief Psychiatric Rating Scale (BPRS) between baseline and 7-day follow-up scores). Exploratory outcomes included improvement in quality of sleep, mindfulness and quality of life. Qualitative intervention feedback was obtained from therapists and participants.

Results

Feasibility outcomes were 39.2% participant enrollment, 85% study completion and 81.8% intervention completion. No symptom outcomes significantly differed. There were no significant differences in exploratory outcomes. Interventionists reported system-level barriers in treatment delivery; patients subjectively reported enjoying the intervention.

Discussion

The MOI is feasible in the inpatient psychiatric setting. There were no significant effects on psychiatric symptoms during the follow-up period, but no adverse effects were reported. Therapeutic effects could be further investigated in longer-term interventions and larger confirmatory RCTs.

KEYWORDS:

• Mindfulness
• inpatient psychiatry
• psychotic symptoms
• schizophrenia

Key points

– There are few studies examining the feasibility and effects of modified mindfulness interventions in inpatient units.

– Our brief MOI was found to be feasible to implement in a psychiatric inpatient unit, and patients subjectively reported enjoying the intervention.

– The MOI did not significantly improve psychiatric symptoms or other mental health outcomes, but there were no reports of increase in or exacerbation of psychotic symptoms and no adverse effects.

– Future research could investigate the effectiveness of the MOIs with larger clinical trials and longer-term interventions, follow-up assessments and systematic qualitative assessments.

Disclosure statement

Soham Rej received an investigator-initiated research grant from Satellite Healthcare for an unrelated project.

Author contribution

Study Conception and Design: GM, SR, STP, SC, NS, KN, DE, AK, SS, RP, NH. Data Acquisition: JN, JVA, DE. Data interpretation: GM, CR, SR, SE, STP, SC, MY, JI, JN, AP, NA, RP, SS, RP, KL, MS, SE, HS, NH. Drafting manuscript: GM, CR, SE, HS, SR. Revising manuscript critically for important intellectual content: all authors. Final approval of the version to be published: all authors. Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: all authors.

Additional information

Funding

This study was supported by the Lady Davis Institute, the Fonds de Recherche Québec – Santé (FRQS) and charitable donations to the Jewish General Hospital Division of Geriatric Psychiatry. Dr. Rej received the Satellite Healthcare Applied Pragmatic Clinical Research Program Research Grant for an unrelated project.