Effectiveness of group body psychotherapy for negative symptoms of schizophrenia: multicentre randomised controlled trial

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.

[1]  Joshua D. Angrist,et al.  Identification of Causal Effects Using Instrumental Variables , 1993 .

[2]  Marianna Adams,et al.  Pilates and Mindfulness: A Qualitative Study , 2012 .

[3]  F. Röhricht.  Body oriented psychotherapy. The state of the art in empirical research and evidence-based practice: A clinical perspective , 2009 .

[4]  Christian Gold,et al.  Dose-response relationship in music therapy for people with serious mental disorders: systematic review and meta-analysis. , 2009, Clinical psychology review.

[5]  T. Wykes,et al.  Effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia – a multi-centre randomised controlled trial , 2013, BMC Psychiatry.

[6]  D. Veale,et al.  National Collaborating Centre for Mental Health , 2006 .

[7]  P. May,et al.  BODY‐EGO TECHNIQUE: AN APPROACH TO THE SCHIZOPHRENIC PATIENT , 1965, The Journal of nervous and mental disease.

[8]  S. Evans,et al.  Application and Results of the Manchester Short Assessment of Quality of Life (Mansa) , 1999, The International journal of social psychiatry.

[9]  R. Gur,et al.  Toward the next generation of negative symptom assessments: the collaboration to advance negative symptom assessment in schizophrenia. , 2011, Schizophrenia bulletin.

[10]  S. Priebe,et al.  [Disturbances of body experience in schizophrenic patients]. , 1997, Fortschritte der Neurologie-Psychiatrie.

[11]  J. Leff,et al.  The TAPS Project. 4: An Observational Study of the Social Life of Long-Stay Patients , 1990, British Journal of Psychiatry.

[12]  S. Priebe,et al.  Objective social outcomes index (SIX): a method to summarise objective indicators of social outcomes in mental health care , 2008, Acta psychiatrica Scandinavica.

[13]  S. Marder,et al.  The effects of risperidone on the five dimensions of schizophrenia derived by factor analysis: combined results of the North American trials. , 1997, The Journal of clinical psychiatry.

[14]  Raquel E. Gur,et al.  journal homepage: www. elsevier.com/locate/schres Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS) , 2022 .

[15]  S. Priebe,et al.  Effect of body-oriented psychological therapy on negative symptoms in schizophrenia: a randomized controlled trial , 2006, Psychological Medicine.

[16]  J. A. Darby.  Alteration of some body image indexes in schizophrenics. , 1970, Journal of consulting and clinical psychology.

[17]  Xi-Jing Chen,et al.  Music therapy for people with schizophrenia and schizophrenia-like disorders. , 2011, The Cochrane database of systematic reviews.

[18]  G. Simpson,et al.  A RATING SCALE FOR EXTRAPYRAMIDAL SIDE EFFECTS , 1970, Acta psychiatrica Scandinavica. Supplementum.

[19]  S. Kay,et al.  The positive and negative syndrome scale (PANSS) for schizophrenia. , 1987, Schizophrenia bulletin.

[20]  T. Johnson,et al.  Group art therapy as an adjunctive treatment for people with schizophrenia: multicentre pragmatic randomised trial , 2012, BMJ : British Medical Journal.

[21]  Mark Oppe,et al.  EQ-5D value sets : inventory, comparative review, and user guide , 2007 .

[22]  J. Xia,et al.  Dance therapy for schizophrenia. , 2009, The Cochrane database of systematic reviews.

[23]  Katherine E Henson,et al.  Risk of Suicide After Cancer Diagnosis in England , 2018, JAMA psychiatry.

[24]  S. Priebe,et al.  Do negative symptoms of schizophrenia change over time? A meta-analysis of longitudinal data , 2014, Psychological Medicine.

[25]  A. Cohen,et al.  The structure of negative symptoms within schizophrenia: implications for assessment. , 2006, Schizophrenia bulletin.

[26]  N C Andreasen,et al.  Two-year outcome in first-episode schizophrenia: predictive value of symptoms for quality of life. , 1998, The American journal of psychiatry.

[27]  Clive E Adams,et al.  Schizophrenia. Full National Clinical Guideline on Core Interventions in Primary and Secondary Care National Collaborating Centre for Mental Health , 2004 .

[28]  J. McGrath,et al.  A Systematic Review of the Prevalence of Schizophrenia , 2005, PLoS medicine.

[29]  Brian Kirkpatrick,et al.  The NIMH-MATRICS consensus statement on negative symptoms. , 2006, Schizophrenia bulletin.

[30]  C. Attkisson,et al.  Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire. , 1983, Evaluation and program planning.

[31]  M. Bender,et al.  Movement and drama therapy with long-stay schizophrenics. , 1974, The British journal of medical psychology.

[32]  S. Priebe,et al.  Specific body image pathology in acute schizophrenia , 2001, Psychiatry Research.

[33]  J. Addington,et al.  Assessing Depression in Schizophrenia: The Calgary Depression Scale , 1993, British Journal of Psychiatry.

[34]  S. Barry,et al.  Negative symptoms and psychosocial functioning in schizophrenia: Neglected but important targets for treatment , 2012, European Psychiatry.

[35]  M. Knapp,et al.  Client Socio-Demographic and Service Receipt Inventory – European Version: development of an instrument for international research , 2000, British Journal of Psychiatry.

[36]  B. Khoury,et al.  Mindfulness interventions for psychosis: A meta-analysis , 2013, Schizophrenia Research.

[37]  Xi-Jing Chen,et al.  Music therapy for people with schizophrenia and schizophrenia-like disorders. , 2017, The Cochrane database of systematic reviews.

[38]  S. Priebe,et al.  An exploratory randomized controlled trial of body psychotherapy for patients with chronic depression. , 2013, Journal of affective disorders.