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Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Apr 19, 2025; 15(4): 103362
Published online Apr 19, 2025. doi: 10.5498/wjp.v15.i4.103362
Mindfulness improves negative psychotic symptoms through reducing emotional and social withdrawal
Carmen Borrás-Sansaloni, Marina Ricco-Pérez, Antoni Mayol, Capilla Navarro-Guzmán, José Manuel García-Montes, Emilio Lopez-Navarro
Carmen Borrás-Sansaloni, Marina Ricco-Pérez, Capilla Navarro-Guzmán, Emilio Lopez-Navarro, Department of Psychology, University of Balearic Islands, Palma 07122, Balearic Islands, Spain
Carmen Borrás-Sansaloni, Marina Ricco-Pérez, Capilla Navarro-Guzmán, José Manuel García-Montes, Emilio Lopez-Navarro, Beatles Research Group, University of Balearic Islands, Palma 07122, Balearic Islands, Spain
Antoni Mayol, UCR Serralta, Balearic Public Health Service, Palma 07013, Balearic Islands, Spain
Antoni Mayol, Human Evolution and Cognition Research Group, University of the Balearic Islands, Palma 07122, Balearic Islands, Spain
José Manuel García-Montes, Department of Psychology, University of Almería, Almeria 04120, Andalusia, Spain
Author contributions: Borrás-Sansaloni C, Mayol A, Navarro-Guzmán C, and Lopez-Navarro E contributed to conceptualization; Navarro-Guzmán C and Lopez-Navarro E contributed to methodology; Ricco-Pérez M and Navarro-Guzmán C performed the formal analysis; Borrás-Sansaloni C, Ricco-Pérez M, and Mayol A contributed to the investigation; Borrás-Sansaloni C and Mayol A contributed to resources; Borrás-Sansaloni C, Ricco-Pérez M, and Lopez-Navarro E wrote the original draft; Borrás-Sansaloni C, Ricco-Pérez M, Mayol A, Navarro-Guzmán C, and Lopez-Navarro E reviewed and edited the draft; Lopez-Navarro E supervised the study and contributed to project administration; Mayol A, Navarro-Guzmán C, and Lopez-Navarro E acquired funding; All authors read and agreed to the published version of the manuscript.
Supported by the R+D Project funded by the Spanish Ministry of Science and Innovation MCIN/AEI/10.13039/501100011033 and by FEDER, EU, No. PID2021-122987OA-I00.
Institutional review board statement: The study was reviewed and approved by the Research Ethics Committee of the University of Balearic Islands, No. 6163/1806/2015.
Clinical trial registration statement: This study is registered at ISRCTN registry (No. ISRCTN52873519).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The datasets generated are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Emilio Lopez-Navarro, PhD, Assistant Professor, Department of Psychology, University of Balearic Islands, Valldemossa Road, Palma 07122, Balearic Islands, Spain. emilio.lopez@uib.es
Received: November 18, 2024
Revised: January 6, 2025
Accepted: February 17, 2025
Published online: April 19, 2025
Processing time: 127 Days and 15 Hours
Abstract
BACKGROUND

Psychotic disorders are characterized by both positive symptoms (hallucinations, delusions) and negative symptoms (emotional blunting, anhedonia) that impair daily functioning. While antipsychotic drugs and psychological interventions are effective when addressing positive symptoms, treatment of negative symptoms remains an ongoing challenge. Mindfulness-based interventions (MBIs) have been shown to reduce negative psychotic symptoms. However, as negative psychotic symptoms are assessed as a sole entity rather than a sum of manifestations, the effect of MBIs remains unclear.

AIM

To examine the effects of MBI in addition to integrated rehabilitation treatment (IRT) for people experiencing psychosis on each of the negative psychotic symptoms.

METHODS

A randomized controlled clinical trial with preintervention and postintervention measures was designed. The main outcome variable was negative psychotic symptoms assessed through the seven subscales of the Spanish version of the positive and negative syndrome scale. Data were analyzed using a repeated measures analysis of variance and reliable change index calculation.

RESULTS

There were no statistical differences between groups at the preintervention assessment. Statistically significant differences were found after MBI for the time in emotional withdrawal (F = 37.75, P < 0.001, η2 = 0.437) and social withdrawal (F = 37.75, P < 0.001, η2 = 0.437).

CONCLUSION

MBI added to IRT reduced the lack of interest and involvement with affective commitment to daily life activities, and interest and engagement in social activities increased. These negative psychotic symptoms were not improved by IRT alone.

Keywords: Mindfulness; Psychosis; Clinical trial; Emotional withdrawal; Social functioning; Schizophrenia

Core Tip: Mindfulness-based interventions when combined with integrated rehabilitation treatment significantly reduced emotional and social withdrawal in people with psychosis. These specific negative symptoms were not improved by integrated rehabilitation alone. This effect may be attributed to the role of mindfulness in fostering acceptance of psychotic experiences, enhancing emotional engagement, and promoting social interaction. The study highlights the potential for mindfulness as a valuable adjunct to rehabilitation treatment.