Eight‐month intensive meditation‐based intervention improves refractory hallucinations and delusions and quality of life in male inpatients with schizophrenia: a randomized controlled trial

Aim This study investigated the impact of an 8‐month daily‐guided intensive meditation‐based intervention (iMI) on persistent hallucinations/delusions and health‐related quality of life (QoL) in male inpatients with schizophrenia with treatment‐refractory hallucinations and delusions (TRHDs). Methods A randomized controlled trial assigned 64 male inpatients with schizophrenia and TRHD equally to an 8‐month iMI plus general rehabilitation program (GRP) or GRP alone. Assessments were conducted at baseline and the third and eighth months using the Positive and Negative Syndrome Scale (PANSS), 36‐Item Short Form‐36 (SF‐36), and Five Facet Mindfulness Questionnaire (FFMQ). Primary outcomes measured PANSS reduction rates for total score, positive symptoms, and hallucinations/delusions items. Secondary outcomes assessed PANSS, SF‐36, and FFMQ scores for psychotic symptoms, health‐related QoL, and mindfulness skills, respectively. Results In the primary outcome, iMI significantly improved the reduction rates of PANSS total score, positive symptoms, and hallucination/delusion items compared with GRP at both the third and eighth months. Treatment response rates (≥25% reduction) for these measures significantly increased in the iMI group at the eighth month. Concerning secondary outcomes, iMI significantly reduced PANSS total score and hallucination/delusion items, while increasing scores in physical activity and mindfulness skills at both the third and eighth months compared with GRP. These effects were more pronounced with an 8‐month intervention compared with a 3‐month intervention. Conclusions An iMI benefits patients with TRHDs by reducing persistent hallucinations/delusions and enhancing health‐related QoL. Longer iMI duration yields superior treatment outcomes.