title: An international multi-site, randomized controlled trial of a mindfulness-based psychoeducation group programme for people with schizophrenia.
abstract: BACKGROUND
  We aimed to test a mindfulness-based psychoeducation group (MBPEG), v. a conventional psychoeducation group (CPEG) v. treatment as usual (TAU), in patients with schizophrenia-spectrum disorders over a 24-month follow-up.
  
  
  METHODS
  This single-blind, multi-site, pragmatic randomized controlled trial was conducted in six community treatment facilities across three countries (Hong Kong, mainland China and Taiwan). Patients were randomly allocated to one of the treatment conditions, and underwent 6 months of treatment. The primary outcomes were changes in duration of re-hospitalizations and mental state (Positive and Negative Syndrome Scale; PANSS) between baseline and 1 week, and 6, 12 and 18 months post-treatment.
  
  
  RESULTS
  A total of 300 patients in each country were assessed for eligibility between October 2013 and 30 April 2014, 38 patients per country (n = 342) were assigned to each treatment group and included in the intention-to-treat analysis. There was a significant difference in the length of re-hospitalizations between the three groups over 24 months (F 2,330 = 5.23, p = 0.005), with MBPEG participants having a shorter mean duration of re-hospitalizations than those in the other groups. The MBPEG and CPEG participants had significant differential changes in proportional odds ratios of complete remission (all individual PANSS items <3) over the 24-month follow-up (37 and 26%, respectively), as opposed to only 7.2% of the TAU group (χ2 = 8.9 and 8.0, p = 0.001 and 0.003, relative risk = 3.5 and 3.1, 95% confidence interval 2.0-7.2 and 1.6-6.3).
  
  
  CONCLUSIONS
  Compared with TAU and CPEG, MBPEG improves remission and hospitalization rates of people with schizophrenia spectrum disorders over 24 months.
authors.affiliation: Mental Health Care Research Group,School of Nursing,Faculty of Health and Social Sciences,The Hong Kong Polytechnic University,Hung Hom,Hong Kong,People's Republic of China.
authors.forename: W T
authors.initials: WT
authors.lastname: Chien
authors.affiliation: Mental Health Care Research Group,School of Nursing,Faculty of Health and Social Sciences,The Hong Kong Polytechnic University,Hung Hom,Hong Kong,People's Republic of China.
authors.forename: D
authors.initials: D
authors.lastname: Bressington
authors.affiliation: Mental Health Care Research Group,School of Nursing,Faculty of Health and Social Sciences,The Hong Kong Polytechnic University,Hung Hom,Hong Kong,People's Republic of China.
authors.forename: A
authors.initials: A
authors.lastname: Yip
authors.affiliation: School of Health & Social Care,Edinburgh Napier University,Edinburgh,UK.
authors.forename: T
authors.initials: T
authors.lastname: Karatzias
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D002681:China; D005500:Follow-Up Studies; D006723:Hong Kong; D064866:Mindfulness / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods; D010359:Patient Readmission / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000628:therapy; D016037:Single-Blind Method; D013624:Taiwan
keywords: Mindfulness-based interventions; psychoeducation; randomized controlled trials; re-hospitalization; schizophrenia spectrum disorders