Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-08T01:20:50.783Z Has data issue: false hasContentIssue false
  • English
  • Français

Meditation-induced psychosis: a narrative review and individual patient data analysis

Published online by Cambridge University Press:  31 October 2019

Pawan Sharma Open the ORCID record for Pawan Sharma [Opens in a new window] ,
Ananya Mahapatra  and
Rishab Gupta
Pawan Sharma*
Affiliation:
Department of Psychiatry, Patan Academy of Health Sciences, School of Medicine, Lalitpur, Nepal
Ananya Mahapatra
Affiliation:
Department of Psychiatry, Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi, India
Rishab Gupta
Affiliation:
Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
*
*Address for correspondence: Dr Pawan Sharma, Lecturer, Department of Psychiatry, Patan Academy of Health Sciences, School of Medicine, Lalitpur, Nepal. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Meditation is associated with health benefits; however, there are reports that it may trigger or exacerbate psychotic states. In this review, we aim to collate case reports of psychotic disorders occurring in association with meditative practice and to discuss the relationship between psychosis and meditation.

Methodology:

We performed case-based analysis of all the existing studies published in English language using PubMed, PsycINFO, Cochrane, Scopus, EMBASE, CINAHL and Google Scholar with the search terms; ‘Psychosis’ OR ‘Psychotic Symptoms’ OR ‘Schizophrenia’ AND ‘Meditation.’

Results:

A total of 19 studies and 28 cases were included in the review. The patients described had an age range of 18–57 years; there was equal distribution of males and females. The diagnoses included acute psychosis in 14 cases, schizophrenia in 7 cases, mania with psychotic symptoms in 3 cases, and schizoaffective disorder in 1 case. The types of meditation described were Transcendent, Mindfulness, Buddhist Meditation like Qigong, Zen, and Theraveda, and others like Bikram yoga, Pranic Healing, and Hindustan Type meditation. Of the 28 cases reported, 14 patients had certain precipitating factors like insomnia, lack of food intake, history of mental illness, stress, and psychoactive substance use.

Conclusion:

There are case reports of psychotic disorder arising in association with meditative practice; however, it is difficult to attribute a causal relationship between the two. At the same time, there is a body of research describing the beneficial effect of meditative practice in clinical settings for patients with psychotic disorders. Appropriately designed studies are needed to further investigate the relationship between meditative practice and psychosis.

Keywords

Meditationpsychosisschizophrenia
Type
Review Article
Information
Irish Journal of Psychological Medicine , Volume 39 , Issue 4 , December 2022 , pp. 391 - 397
Copyright
© College of Psychiatrists of Ireland 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Antonova, E, Amaratunga, K, Wright, B, Ettinger, U, Kumari, V (2016). Schizotypy and mindfulness: magical thinking without suspiciousness characterizes mindfulness meditators. Schizophrenia Research Cognition 5, 1–6. doi: 10.1016/j.scog.2016.05.001.CrossRefGoogle ScholarPubMed
Aust, J, Bradshaw, T (2017). Mindfulness interventions for psychosis: a systematic review of the literature. Journal of Psychiatric and Mental Health Nursing 24, 69–83. doi: 10.1111/jpm.12357.CrossRefGoogle ScholarPubMed
Baena Mures, RA, Niell Galmes, L, Lázaro Pascual, Y, Gonzalez, MS (2016). ‘Bouffée délirante’ induced by meditation. European Psychiatry 33, S533. doi: 10.1016/j.eurpsy.2016.01.1971.CrossRefGoogle Scholar
Baer, RA (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical psychology: Science and Practice 10, 125–143. doi: 10.1093/clipsy.bpg015 Google Scholar
Baer, R, Crane, C, Miller, E, Kuyken, W (2019). Doing no harm in mindfulness-based programs: conceptual issues and empirical findings. Clinical Psychology Review 71, 101–114. doi: 10.1016/j.cpr.2019.01.001 CrossRefGoogle ScholarPubMed
Braboszcz, C, Hahusseau, S, Delorme, A (2010). Meditation and neuroscience: from basic research to clinical practice. In Integrative Clinical Psychology, Psychiatry and Behavioral Medicine: Perspectives, Practices and Research (ed. Carlstedt, R.), pp. 1910–1929. Springer Publishing: New York, NY.Google Scholar
Cardoso, R, de Souza, E, Camano, L, Leite, JR (2004). Meditation in health: an operational definition. Brain Research. Brain Research Protocols 14, 58–60. doi: 10.1016/j.brainresprot.2004.09.002.CrossRefGoogle ScholarPubMed
Chadwick, P, Hughes, S, Russell, D, Russell, I, Dagnan, D (2009). Mindfulness groups for distressing voices and paranoia: a replication and randomized feasibility trial. Behavioural and Cognitive Psychotherapy 37, 403–412. doi: 10.1017/S1352465809990166.CrossRefGoogle ScholarPubMed
Chan-Ob, T, Boonyanaruthee, V (1999). Meditation in association with psychosis. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet 82, 925–930.Google ScholarPubMed
Davis, DM, Hayes, JA (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy (Chicago, Ill.) 48, 198–208. doi: 10.1037/a0022062.CrossRefGoogle ScholarPubMed
Deepeshwar, S, Vinchurkar, SA, Visweswaraiah, NK, Nagendra, HR (2015). Hemodynamic responses on prefrontal cortex related to meditation and attentional task. Frontiers in Systems Neuroscience 8, 252. doi: 10.3389/fnsys.2014.00252.CrossRefGoogle ScholarPubMed
Dietrich, A (2003). Functional neuroanatomy of altered states of consciousness: the transient hypofrontality hypothesis. Consciousness and Cognition 12, 231–256.CrossRefGoogle ScholarPubMed
French, AP, Schmid, AC, Ingalls, E (1975). Transcendental meditation, altered reality testing, and behavioral change: a case report. The Journal of Nervous and Mental Disease 161, 55–58.CrossRefGoogle ScholarPubMed
García-Albea, J, González-Vives, S, Tejeira, C, López-Ibor, JJ, López-Ibor, MI (2012). Psychoses induced by exceptional states of consciousness. Actas Esp Psiquiatr 40, 80–95.Google Scholar
Gunaratana, H (2002). Mindfulness in Plain English. 1993. Reprint, Wisdom: Boston, MA.Google Scholar
Hussain, D, Bhushan, B (2010). Psychology of meditation and health: present status and future directions. International Journal of Psychology and Psychological Therapy 10. Available at: (http://www.redalyc.org/resumen.oa?id=56017068007) Accessed 28 October 2017.Google Scholar
Hwang, W-C (2007). Qi-gong psychotic reaction in a Chinese American woman. Culture, Medicine and Psychiatry 31, 547–560. doi: 10.1007/s11013-007-9065-z.CrossRefGoogle Scholar
Jacobsen, P, Morris, E, Johns, L, Hodkinson, K (2011). Mindfulness groups for psychosis; key issues for implementation on an inpatient unit. Behavioural and Cognitive Psychotherapy 39, 349–353. doi: 10.1017/S1352465810000639.CrossRefGoogle Scholar
Kabat-Zinn, J (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47. doi: 10.1016/0163-8343(82)90026-3 CrossRefGoogle ScholarPubMed
Kennedy, RB (1976). Self-induced depersonalization syndrome. The American Journal of Psychiatry 133, 1326–1328. doi: 10.1176/ajp.133.11.1326.Google ScholarPubMed
Khoury, B, Lecomte, T, Gaudiano, BA, Paquin, K (2013). Mindfulness interventions for psychosis: a meta-analysis. Schizophrenia Research 150, 176–184. doi: 10.1016/j.schres.2013.07.055.CrossRefGoogle ScholarPubMed
Kiene, H, Hamre, HJ, Kienle, GS (2013). In support of clinical case reports: a system of causality assessment. Global Advances in Health and Medicine 2, 64–75. doi: 10.7453/gahmj.2012.061.CrossRefGoogle ScholarPubMed
Kuijpers, HJH, van der Heijden, FMMA, Tuinier, S, Verhoeven, WM (2007). Meditation-induced psychosis. Psychopathology 40, 461–464. doi: 10.1159/000108125.CrossRefGoogle ScholarPubMed
Lewis, DA, Lieberman, JA (2000). Catching up on schizophrenia: natural history and neurobiology. Neuron 28, 325–334. doi: 10.1016/S0896-6273(00)00111-2.CrossRefGoogle ScholarPubMed
Lim, RF, Lin, KM (1996). Cultural formulation of psychiatric diagnosis. Case no. 03. Psychosis following Qi-gong in a Chinese immigrant. Culture, Medicine and Psychiatry 20, 369–378.Google Scholar
Linden, SC, Harris, M, Whitaker, C, Healy, D (2010). Religion and psychosis: the effects of the Welsh religious revival in 1904-1905. Psychological Medicine 40, 1317–1323. doi: 10.1017/S0033291709991917.CrossRefGoogle ScholarPubMed
Lu, JS, Pierre, JM (2007). Psychotic episode associated with Bikram yoga. The American Journal of Psychiatry 164, 1761. doi: 10.1176/appi.ajp.2007.07060960.CrossRefGoogle ScholarPubMed
McGee, M (2008). Meditation and psychiatry. Psychiatry (Edgmont) 5, 28–41.Google ScholarPubMed
Mohandas, E (2008). Neurobiology of spirituality. Mens Sana Monographs 6, 63–80. doi: 10.4103/0973-1229.33001.CrossRefGoogle ScholarPubMed
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG (2009). Reprint – preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Physical Therapy 89, 873–880.CrossRefGoogle ScholarPubMed
Monti, DA, Beitman, BD (2010). Integrative Psychiatry. Oxford University Press: New York, NY.Google Scholar
Moritz, S, Cludius, B, Hottenrott, B, Schneider, BC, Saathoff, K, Kuelz, AK, Gallinat, J. (2015). Mindfulness and relaxation treatment reduce depressive symptoms in individuals with psychosis. European Psychiatry: The Journal of the Association of European Psychiatrists 30, 709–714. doi: 10.1016/j.eurpsy.2015.05.002.CrossRefGoogle ScholarPubMed
Nakaya, M, Ohmori, K (2010). Psychosis induced by spiritual practice and resolution of pre-morbid inner conflicts. German Journal of Psychiatry 13, 161–163.Google Scholar
Newberg, AB, Iversen, J (2003). The neural basis of the complex mental task of meditation: neurotransmitter and neurochemical considerations. Medical Hypotheses 61, 282–291.CrossRefGoogle ScholarPubMed
Ospina, MB, Bond, K, Karkhaneh, M, Buscemi, N, Dryden, DM, Barnes, V, Carlson, LE, Dusek, JA, Shannahoff-Khalsa, D (2008). Clinical trials of meditation practices in health care: characteristics and quality. Journal of Alternative and Complementary Medicine (New York, N.Y.) 14, 1199–1213. doi: 10.1089/acm.2008.0307.CrossRefGoogle ScholarPubMed
Pérez-Alvarez, M, García-Montes, JM, Perona-Garcelán, S, Vallina-Fernández, O (2008). Changing relationship with voices: new therapeutic perspectives for treating hallucinations. Clinical Psychology & Psychotherapy 15, 75–85. doi: 10.1002/cpp.563.CrossRefGoogle ScholarPubMed
Prakash, R, Aggarwal, N, Kataria, D, Prasad, S (2018). Meditation induced psychosis: Case report. Asian Journal of Psychiatry 31, 109–110. doi: 10.1016/j.ajp.2018.02.001.CrossRefGoogle ScholarPubMed
Rubia, K (2009). The neurobiology of meditation and its clinical effectiveness in psychiatric disorders. Biological Psychology 82, 1–11. doi: 10.1016/j.biopsycho.2009.04.003.CrossRefGoogle ScholarPubMed
Sadzio, J, Vieker, H, Gruber, O, Zilles, D (2014). Development of schizoaffective psychosis in the course of a long-term occupation as spiritual healer: coincidence or causality? The American Journal of Psychiatry 171, 145–148. doi: 10.1176/appi.ajp.2013.13020174.CrossRefGoogle ScholarPubMed
Sethi, S, Bhargava, SC (2003). Relationship of meditation and psychosis: case studies. The Australian and New Zealand Journal of Psychiatry 37, 382.Google ScholarPubMed
Shapiro, DH (1994). Examining the content and context of meditation: a challenge for psychology in the areas of stress management, psychotherapy, and religion/values. Journal of Humanistic Psychology 34, 101–135. doi: 10.1177/00221678940344008.CrossRefGoogle Scholar
Sharma, P, Singh, S, Gnanavel, S, Kumar, N (2016). Meditation – a two edged sword for psychosis: a case report. Irish Journal of Psychological Medicine 33, 247–249. doi: 10.1017/ipm.2015.73.CrossRefGoogle ScholarPubMed
Sherrill, HN, Sherrill, J, Cáceda, R (2017). Psychotic mania induced by diffuse meditation. Psychiatry Research 258, 604. doi: 10.1016/j.psychres.2016.12.035.CrossRefGoogle ScholarPubMed
Shonin, E, Van Gordon, W, Griffiths, MD (2013). Mindfulness-based interventions: towards mindful clinical integration. Frontiers in Psychology 4, 194. doi: 10.3389/fpsyg.2013.00194.CrossRefGoogle ScholarPubMed
VanderKooi, L (1997). Buddhist teachers’ experience with extreme mental states in western meditators. Journal of Transpersonal Psychology References 29, 31–46.Google Scholar
Van Gordon, W, Shonin, E, Garcia-Campayo, J (2017). Are there adverse effects associated with mindfulness? Australian & New Zealand Journal of Psychiatry 51, 977–979. doi: 10.1177/0004867417716309 CrossRefGoogle ScholarPubMed
Visceglia, E, Lewis, S (2011). Yoga therapy as an adjunctive treatment for schizophrenia: a randomized, controlled pilot study. Journal of Alternative and Complementary Medicine (New York, N.Y.) 17, 601–607. doi: 10.1089/acm.2010.0075.CrossRefGoogle ScholarPubMed
Walsh, R, Roche, L (1979). Precipitation of acute psychotic episodes by intensive meditation in individuals with a history of schizophrenia. The American Journal of Psychiatry 136, 1085–1086. doi: 10.1176/ajp.136.8.1085.Google ScholarPubMed
Yorston, GA (2001). Mania precipitated by meditation: a case report and literature review. Mental Health, Religion & Culture 4, 209–213. doi: 10.1080/713685624 CrossRefGoogle Scholar
Supplementary material: File

Sharma et al. supplementary material

Table S1

Download Sharma et al. supplementary material(File)
File 30.5 KB