Mindfulness-based Illness Management Program for Schizophrenia

NCT ID: NCT01667601

Last Updated: 2019-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

449 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-08-31

Study Completion Date

2017-04-30

Brief Summary

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Only a few intervention studies have also focused on changing patients' negative thoughts and feelings towards the illness and their relationship to the suffering caused by those thoughts, which is evidenced to empower psychosocial functioning and control of distressing thoughts in severe depression and psychotic disorders by using the Mindfulness-Based Stress Reduction program. This controlled trial is designed to test the effects of a mindfulness-based Illness management program (MBPP) for Chinese patients with schizophrenia on their symptom severity, illness insight and psychosocial functioning.

Detailed Description

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Objectives: This study is to test the effectiveness of a mindfulness-based illness management program for Chinese outpatients with schizophrenia over a 24-month follow-up. The program is an integrated, insight-inducing educational program that addresses patients' awareness and knowledge of schizophrenia and skills of illness management.

Methods: A two-phase, single-blind, multi-site randomized controlled trial will be conducted with 449 Chinese patients with schizophrenia in Hong Kong, China and Taiwan. In the first phase, 107 participants will be randomly selected from the eligible patient lists of three outpatient clinics in Hong Kong only (i.e., 38 subjects from each clinic), and after baseline measurement, be assigned to either the mindfulness-based illness management program, conventional psycho-education group, or usual psychiatric care. For the second phase, the participants will be randomly selected from the eligible patient list in three study venues or countries (i.e., 114 subjects from each study site/ country) and after baseline measurement, be assigned similar to the first phase to one of the three study groups. The patients' mental and psychosocial functioning, insights into illness, and their re-hospitalization rates will be measured at recruitment and at one week, and 6, 12 and 24 months after completing the interventions.

Hypothesis: The patients in the mindfulness-based psycho-education program will report significantly greater improvements in their symptoms and re-hospitalization rates (primary outcomes) and other secondary outcomes (e.g., insight into illness and functioning) over the 24-month follow-up, when compared with those in psycho-education group or usual care.

Conclusions: The findings will provide evidence whether the mindfulness-based psycho-education program can better improve Chinese schizophrenia sufferers' psychosocial functioning and reduce their illness relapse.

Conditions

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Schizophrenia

Keywords

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mindfulness-based program Psychoeducation schizophrenia Chinese outpatients

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Mindfulness-based program

A structured, researcher-designed mindfulness-based psycho-education program (6 months), comprised of 12 bi-weekly, 2-hour group sessions (10-12 patients per group). The program was based on the psycho-education programs by Chien et al. (2010) and Lehman et al. (2004), as well as the 8-session Mindfulness-Based Stress Reduction Program by Kabat-Zinn (1990).

Group Type EXPERIMENTAL

Mindfulness-based program

Intervention Type BEHAVIORAL

The program was based on the psychoeducation programs by Chien et al and Lehman et al, as well as the 8-session Mindfulness-Based Stress Reduction Program by Kabat-Zinn(1990).

Routine Care

Routine psychiatric outpatient care, including medication, psychiatric consultation in outpatient clinic, brief education by psychiatric nurses, financial and social welfare advices by social workers, and individual counseling by clinical psychologist.

Group Type OTHER

Routine Care

Intervention Type OTHER

Psychiatric outpatient care provided by the outpatient departments, e.g., medical consultation, brief education by psychiatric nurses and financial advices or referrals by social workers.

Mindfulness-based program

Intervention Type BEHAVIORAL

The program was based on the psychoeducation programs by Chien et al and Lehman et al, as well as the 8-session Mindfulness-Based Stress Reduction Program by Kabat-Zinn(1990).

Psychoeducation group

Intervention Type BEHAVIORAL

A 5-month patient psychoeducation group program (12 sessions) led by the research team will be provided.

Psychoeducation group

A psychoeducation group program (12 sessions, bi-weekly) based on Dr. Macpherson's Family Psychoeducation Program in 1996 and Chien and Bressington's one in 2014/15 will be used.

References:

Chien WT, Bressington D. A randomized controlled trial of a nurse-led structured psychosocial intervention program for people with first-onset mental illness in psychiatric outpatient clinics. Psychiatry Res 2015;229:277-86.

Macpherson R, Jerrom B, Hughes AA. controlled study of education about drug treatment in schizophrenia. Br J Psychiatry 1996;168:709-17.

Group Type ACTIVE_COMPARATOR

Psychoeducation group

Intervention Type BEHAVIORAL

A 5-month patient psychoeducation group program (12 sessions) led by the research team will be provided.

Interventions

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Routine Care

Psychiatric outpatient care provided by the outpatient departments, e.g., medical consultation, brief education by psychiatric nurses and financial advices or referrals by social workers.

Intervention Type OTHER

Mindfulness-based program

The program was based on the psychoeducation programs by Chien et al and Lehman et al, as well as the 8-session Mindfulness-Based Stress Reduction Program by Kabat-Zinn(1990).

Intervention Type BEHAVIORAL

Psychoeducation group

A 5-month patient psychoeducation group program (12 sessions) led by the research team will be provided.

Intervention Type BEHAVIORAL

Other Intervention Names

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Routine Psychiatric Care Mindfulness-based illness management program Mindfulness-based care for schizophrenia program Conventional psychoeducation group Psychoeducation group intervention

Eligibility Criteria

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Inclusion Criteria

* outpatients;
* aged 18+; and
* diagnosed as schizophrenia and other psychotic disorders (\< or =5 years) according to the Diagnostic and Statistical Manual, 4th edition, as ascertained by the Structured Clinical Interview (SCID-I).

Exclusion Criteria

* not able to understand the psycho-education content and Chinese;
* mentally unstable at recruitment; and
* with co-morbidity of other severe mental health problems such as depression and substance misuse.
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Authority, Hong Kong

OTHER_GOV

Sponsor Role collaborator

Jilin Medical College, China

UNKNOWN

Sponsor Role collaborator

Taipei Medical University, Taiwan

UNKNOWN

Sponsor Role collaborator

The Hong Kong Polytechnic University

OTHER

Sponsor Role lead

Responsible Party

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Wai-Tong Chien

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Chien WT, PhD

Role: PRINCIPAL_INVESTIGATOR

The HK Polytechnic University

Locations

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Jilin Medical College

Jilin, Jilin, China

Site Status

KH/LKS Specialty OPD

Shatin, NT, Hong Kong

Site Status

TM Psy Centre

Tuenmen, NT, Hong Kong

Site Status

Taipei Medical University

Taipei, Xinyi, Taiwan

Site Status

Countries

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China Hong Kong Taiwan

References

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Chien WT, Lee IY. The mindfulness-based psychoeducation program for Chinese patients with schizophrenia. Psychiatr Serv. 2013 Apr 1;64(4):376-9. doi: 10.1176/appi.ps.002092012.

Reference Type BACKGROUND
PMID: 23412024 (View on PubMed)

Chien WT, Thompson DR. Effects of a mindfulness-based psychoeducation programme for Chinese patients with schizophrenia: 2-year follow-up. Br J Psychiatry. 2014 Jul;205(1):52-9. doi: 10.1192/bjp.bp.113.134635. Epub 2014 May 8.

Reference Type BACKGROUND
PMID: 24809397 (View on PubMed)

Lam, A.H.Y., & Chien, W.T. (2016). The effectiveness of mindfulness-based intervention for people with schizophrenia: A systematic review. Neuropsychiatry (London), 6(5), 208-222.

Reference Type BACKGROUND

Chien WT, Bressington D, Yip A, Karatzias T. An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia. Psychol Med. 2017 Sep;47(12):2081-2096. doi: 10.1017/S0033291717000526. Epub 2017 Apr 4.

Reference Type RESULT
PMID: 28374661 (View on PubMed)

Other Identifiers

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HSEARS20121211001

Identifier Type: -

Identifier Source: org_study_id