Αbstract

Abstract. Background. Negative symptoms of schizophrenia have a severe impact on functional outcomes and treatment options are limited. Arts therapies are currently recommended but more evidence is required.
Aims. To assess body psychotherapy as a treatment for negative symptoms compared with an active control (trial registration: ISRCTN84216587).
Method. Schizophrenia out-patients were randomised into a 20-session body psychotherapy or Pilates group. The primary outcome was negative symptoms at end of treatment. Secondary outcomes included psychopathology, functional, social and treatment satisfaction outcomes at treatment end and 6-months later.
Results. In total, 275 participants were randomised. The adjusted difference in negative symptoms was 0.03 (95% CI –1.11 to 1.17), indicating no benefit from body psychotherapy. Small improvements in expressive deficits and movement disorder symptoms were detected in favour of body psychotherapy. No other outcomes were significantly different.
Conclusions. Body psychotherapy does not have a clinically relevant beneficial effect in the treatment of patients with negative symptoms of schizophrenia.
Röhricht, F., Papadopoulos, N., Holden, S., Clarke, T., & Priebe, S. (2011). Therapeutic processes and clinical outcomes of body psychotherapy in chronic schizophrenia–An open clinical trial. The Arts in Psychotherapy, 38(3), 196-203.
Persistent negative symptoms are an ongoing challenge in the treatment of chronic schizophrenia. Evidence from randomised controlled trials suggests that arts/non-verbal therapies may be effective in treating negative symptoms of schizophrenia. These treatments have not yet been evaluated in open clinical settings. The present uncontrolled clinical trial examines the therapeutic processes and clinical outcomes of group body psychotherapy (BPT) on marked negative symptoms in patients with chronic schizophrenia. Changes in symptom scores, subjective quality of life, social functioning and emotional processing between baseline and post-treatment were assessed. The ratings from clinical assessments of independent researchers were compared with the post-therapy summary assessment of the therapists.
A total of 39 eligible patients were referred, out of which 18 patients agreed to participate and received BPT in addition to treatment as usual within three therapy groups run by different therapists. Patients had high symptom levels and low psychosocial functioning at baseline. Negative symptoms and general psychopathology significantly reduced during treatment. Positive symptoms and other outcomes did not change. Researcher ratings of psychopathology were in line with the assessment of clinical outcome by therapists and qualitative observations on changes in movement behaviour during therapy.
The results of this study are consistent with findings from a RCT (Röhricht & Priebe, 2006), indicating that BPT is associated with reduced negative symptoms even when administered in routine clinical settings. Therapists’ qualitative judgements may be considered as a valid source for assessing treatment outcomes. Future studies should explore effects of longer term treatments on other outcomes.
Keywords: Body psychotherapy; Dance/movement therapy; Schizophrenia; Negative symptoms; Therapeutic processes