心理干预的有害结果研究不足,包括针对精神病的基于正念的干预措施(MBI)。本系统综述总结了8项伤害指数的报告和患病率(死亡,不良事件,住院治疗,研究辍学,治疗未完成,治疗的副作用,症状恶化和危机服务的使用)在精神病MBIs的随机对照试验(RCT)中。还计算了每个危害指数的风险差异的荟萃分析。该综述包括39项研究,共有2684名参与者。报告每个危害指数的研究百分比,以及危害的普遍性,每个指数的差异很大。0%的研究报告了干预措施的副作用,而92%的研究报告了研究退出。风险差异(RD)的荟萃分析发现住院风险较高(RD(95%CI)=-0.136(-0.23至-0.05),p=0.003)和危机服务使用(RD(95%CI)=-0.160(-0.299,-0.024),p=0.02)在控制臂与干预臂相比,不良事件无显著差异,死亡,症状恶化,治疗未完成,退出和副作用的治疗。总的来说,各研究的伤害报告不一致,数据收集和报告的质量也各不相同.用于精神病的MBI似乎是安全的,并且可以降低住院和使用危机服务的风险。然而,由于缺乏对伤害的全面报告,因此无法对益处与危害进行平衡分析。未来对MBI有效性的研究应始终如一地实施,监测和报告伤害数据。
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.