Mindfulness‐Based Intervention Improves Cognitive Function in Patients With Schizophrenia in Remitted: A Randomized Controlled Trial

BACKGROUND: Patients with schizophrenia exhibit deficits in facial emotion recognition (FER), attention, P300, and quality of life (QoL), which severely hinder functional recovery. This study aims to explore the effects of mindfulness-based intervention (MBI) on these outcomes and the potential mediating mechanisms. METHODS: In this 8-week randomized, single-blind, controlled study, a total of 70 remitted patients with schizophrenia were randomly assigned to the MBI group or the control group. The Five-Factor Mindfulness Scale (FFMQ), FER, P300 indices, Continuous Performance Test-Identical Pairs (CPT-IP), and Schizophrenia Quality of Life Scale (SQLS) were measured at baseline and week 8 to assess mindfulness levels, cognitive function, neurophysiological parameters, and QoL. Linear mixed models evaluated intervention effects. Mediation analyses used pre-post change scores with bootstrap resampling. RESULTS: For the primary outcome, MBI significantly improved FFMQ (β = 16.750, 95% CI [7.769, 25.731], p < 0.001). For the exploratory outcomes, significant improvements were observed for P300 latency (β = -63.602, 95% CI [-88.651, -38.554], p < 0.001) and CPT-IP (β = 8.219, 95% CI [4.004, 12.433], p < 0.001). FER and P300 amplitude showed nominal improvements only, and SQLS showed a non-significant trend. A significant indirect effect through FER change was observed for change in SQLS (indirect effect = -6.343, 95% CI [-11.467, -2.288]), but CPT-IP change did not mediate P300 amplitude improvement. CONCLUSION: MBI significantly improved the primary outcome of mindfulness (FFMQ) and showed promising exploratory improvements in processing speed (P300 latency) and sustained attention (CPT-IP). FER change may represent a potential indirect pathway associated with change in SQLS. These findings support MBI as a promising cognitive rehabilitation intervention. TRIAL REGISTRATION: https://www.chictr.org.cn, identifier ChiCTR 2500106735, registered on: 29/07/2025.