Entraînement à la pleine conscience en groupe pour atténuer les symptômes psychotiques persistants

RésuméObjectifsVingt à 50 % des personnes atteintes de schizophrénie souffrent de symptômes psychotiques malgré un traitement neuroleptique. Il est donc primordial de développer des méthodes thérapeutiques pour aider les patients à mieux gérer ces symptômes. L’entraînement à la pleine conscience offre une piste dans cette direction au travers de nouvelles perspectives pour modifier le rapport aux symptômes positifs.Patients et méthodeQuatre patients atteints de schizophrénie et une patiente souffrant d’un trouble schizo-affectif ont participé à huit séances de pleine conscience en groupe. Avant, pendant et après l’entraînement, ces personnes ont évalué hebdomadairement la gêne causée par un symptôme psychotique ciblé.RésultatsLa courbe des évaluations des participants montre une diminution de la gêne provoquée par le symptôme cible entre le début et la fin de l’entraînement.ConclusionsCette expérience pilote encourage la poursuite de recherches mieux contrôlées dans ce domaine.

ObjectivesTwenty to 50% of patient suffering from schizophrenia may endure persistent psychotic symptom despite antipsychotic medication. These persistent symptoms interfere with social and work functioning. Psychosocial interventions are needed to improve the course of schizophrenia. The experience of psychosis is often described as very painful. However the use of strategies to block or avoid thoughts, feelings and bodily sensations connected to psychosis is often not efficient and could even contribute worsen the mental state. The type of relationship that people keep with psychosis could, for that reason, have an impact on the experience of distress. Mindfulness training offers a way to change this relation to positive symptoms of schizophrenia.Patients and methodsFour patients with a diagnosis of schizophrenia and one with a schizoaffective disorder followed eight group sessions of mindfulness. Seven different topics were pointed during the sessions, one at a time: introduction to mindfulness; the thoughts; breathing; “allow”; “accept”; coping strategies I; coping strategies II; mindfulness in everyday life. The participants fulfilled weekly evaluations of the discomfort caused by a target psychotic symptom chosen by them.ResultsThe curve of the discomfort caused by the target symptom improved from before to after training. During semi-structured individual interviews participants reported using “mindful answers” to cope with symptoms, paranoid thoughts and emotions after training. We also have noticed a change in attitude toward thoughts, feelings, and emotions in general, after training. Moreover, we observe that three of the five participants wished to sign up for a second therapeutic group with mindfulness.ConclusionsThis therapeutic pilot group demonstrated the feasibility of mindfulness training for outpatients suffering from schizophrenia with persistent psychotic symptoms. The answers of the participants through individual evaluations also showed effects in term of psychological process. In fact, all of them said that they had learned to concentrate in conscience on their psychotic symptoms, and could more or less allowed symptoms to come and go without reacting. This assessment encourages the perspective of future studies to evaluate more rigorously the relevance and adaptation of training with mindfulness in group setting to face persistent psychotic symptoms.