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Müller J, Herpertz J, Taylor J, Suslow T, Lane RD, Donges US. Emotional awareness for self and others and empathic abilities in clinical depression during acute illness and recovery. BMC Psychiatry 2024; 24:488. [PMID: 38965469 PMCID: PMC11225305 DOI: 10.1186/s12888-024-05877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 05/29/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND The present longitudinal investigation had two major goals. First, we intended to clarify whether depressed patients are characterized by impairments of emotional awareness for the self and the other during acute illness and whether these impairments diminish in the course of an inpatient psychiatric treatment program. Previous research based on the performance measure Levels of Emotional Awareness Scale (LEAS) provided inconsistent findings concerning emotional self-awareness in clinical depression. Second, we investigated whether cognitive and affective empathic abilities change from acute illness to recovery in depressed patients. METHODS Fifty-eight depressed patients were tested on admission and after 6-8 weeks of inpatient psychiatric treatment. A sample of fifty-three healthy individuals were also examined twice at an interval of 6-8 weeks. The LEAS and the Interpersonal Reactivity Index (IRI) were administered to assess emotional awareness and empathic abilities. Written texts were digitalized and then analyzed using the electronic scoring program geLEAS, the German electronic Levels of Emotional Awareness Scale. RESULTS Depressed patients reported more depressive symptoms than healthy controls and less severe depressive symptomatology at time 2 compared to time 1. Independent of time, depressed individuals tended to show lower geLEAS self scores and had lower geLEAS other scores than healthy individuals. Depressed patients showed higher personal distress scores than healthy individuals at both measurement times. No group differences were observed for the cognitive empathy scales of the IRI (perspective taking and fantasy) and empathic concern, but empathic concern decreased significantly in depressed patients from time 1 to time 2. Empathic abilities as assessed by the IRI were not significantly correlated with emotional awareness for others, neither in the whole sample, nor in the patient and control subsample. CONCLUSIONS Depressed patients seem to be characterized by impairments in emotional awareness of others during acute illness and recovery, but they also tend to show deficits in emotional self-awareness compared to healthy individuals. Self-reported cognitive empathic abilities seem to be at normal levels in depressed patients, but their heightened self-focused affective empathy may represent a vulnerability factor for depressive disorders.
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Affiliation(s)
- Janine Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin Gropius Krankenhaus, Eberswalde, Germany
- Department of Psychiatry and Psychotherapy, Campus Charite Mitte, Universitätsmedizin, Berlin, Germany
| | - Julian Herpertz
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jacob Taylor
- David A. Dunlap Department of Astronomy and Astrophysics, University of Toronto, Toronto, Canada
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Richard D Lane
- Departments of Psychiatry, Psychology and Neuroscience, University of Arizona, Tucson, USA
| | - Uta-Susan Donges
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin Gropius Krankenhaus, Eberswalde, Germany.
- Department of Psychiatry and Psychotherapy, Campus Charite Mitte, Universitätsmedizin, Berlin, Germany.
- Department of Psychotherapy Science, Sigmund Freud University, Berlin, Germany.
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Dobreva I, Thomas J, Marr A, O'Connell R, Roche M, Hannaway N, Dore C, Rose S, Liu K, Bhome R, Baldwin-Jones S, Roberts J, Archibald N, Alston D, Amar K, Edwards E, Foley JA, Haunton VJ, Henderson EJ, Jha A, Lindop F, Magee C, Massey L, Ruiz-Mendoza E, Mohamed B, Patterson K, Ramaswamy B, Schrag A, Silverdale M, Suárez-González A, Subramanian I, Foltynie T, Williams-Gray CH, Yarnall AJ, Carroll C, Bale C, Hugill C, Weil RS. Improving Conversations about Parkinson's Dementia. Mov Disord Clin Pract 2024; 11:814-824. [PMID: 38696333 PMCID: PMC11233842 DOI: 10.1002/mdc3.14054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND People with Parkinson's disease (PD) have an increased risk of dementia, yet patients and clinicians frequently avoid talking about it due to associated stigma, and the perception that "nothing can be done about it". However, open conversations about PD dementia may allow people with the condition to access treatment and support, and may increase participation in research aimed at understanding PD dementia. OBJECTIVES To co-produce information resources for patients and healthcare professionals to improve conversations about PD dementia. METHODS We worked with people with PD, engagement experts, artists, and a PD charity to open up these conversations. 34 participants (16 PD; 6 PD dementia; 1 Parkinsonism, 11 caregivers) attended creative workshops to examine fears about PD dementia and develop information resources. 25 PD experts contributed to the resources. RESULTS While most people with PD (70%) and caregivers (81%) shared worries about cognitive changes prior to the workshops, only 38% and 30%, respectively, had raised these concerns with a healthcare professional. 91% of people with PD and 73% of caregivers agreed that PD clinicians should ask about cognitive changes routinely through direct questions and perform cognitive tests at clinic appointments. We used insights from the creative workshops, and input from a network of PD experts to co-develop two open-access resources: one for people with PD and their families, and one for healthcare professionals. CONCLUSION Using artistic and creative workshops, co-learning and striving for diverse voices, we co-produced relevant resources for a wider audience to improve conversations about PD dementia.
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Affiliation(s)
- Ivelina Dobreva
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, Russell Square House, London, United Kingdom
| | - Joanne Thomas
- Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Anne Marr
- Central Saint Martins, University of the Arts, London, United Kingdom
| | | | - Moïse Roche
- Division of Psychiatry, University College London, London, United Kingdom
| | - Naomi Hannaway
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, Russell Square House, London, United Kingdom
| | - Charlotte Dore
- Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Sian Rose
- Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Ken Liu
- Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Rohan Bhome
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, Russell Square House, London, United Kingdom
| | | | | | - Neil Archibald
- South Tees Hospital NHS Foundation Trust, Middlesbrough, United Kingdom
| | | | - Khaled Amar
- Royal Bournemouth Hospital, NHS Foundation Trust, Bournemouth, United Kingdom
| | | | - Jennifer A Foley
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
- UCL Queen Square Institute of Neurology, Univeristy College London, London, United Kingdom
| | | | - Emily J Henderson
- Ageing and Movement Research Group, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Older People's Unit, Royal United Hospitals NHS Foundation Trust, Bath, United Kingdom
| | - Ashwani Jha
- UCL Queen Square Institute of Neurology, Univeristy College London, London, United Kingdom
| | - Fiona Lindop
- Parkinson's UK, London, United Kingdom
- Derby Hospitals NHS Foundation Trust, Derby, United Kingdom
| | - Cathy Magee
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Luke Massey
- Poole Hospital NHS Foundation Trust, Poole, United Kingdom
| | - Eladia Ruiz-Mendoza
- North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, United Kingdom
| | - Biju Mohamed
- University Hospital of Wales, Cardiff, United Kingdom
| | - Katherine Patterson
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, Russell Square House, London, United Kingdom
| | - Bhanu Ramaswamy
- Parkinson's UK, London, United Kingdom
- Sheffield Hallam University, Sheffield, United Kingdom
| | - Anette Schrag
- Department of Clinical Neuroscience, Institute of Neurology, UCL, London, United Kingdom
| | - Monty Silverdale
- Department of Neurology, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Aida Suárez-González
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, Russell Square House, London, United Kingdom
| | - Indu Subramanian
- Department of Neurology, David Geffen School of Medicine, Los Angeles, California, USA
- Parkinson's Disease Research, Education, and Clinical Center (PADRECC), Veterans Administration Greater Los Angeles Health Care System, Los Angeles, California, USA
| | - Tom Foltynie
- UCL Queen Square Institute of Neurology, Univeristy College London, London, United Kingdom
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Caroline H Williams-Gray
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom
- Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - Alison J Yarnall
- Translational and Clinical Research Institute, Newcastle University, Newcastle, United Kingdom
| | - Camille Carroll
- Faculty of Health, University of Plymouth, Drake Circus, Plymouth, United Kingdom
| | | | | | - Rimona S Weil
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, Russell Square House, London, United Kingdom
- Wellcome Centre for Human Neuroimaging, London, United Kingdom
- UCL Queen Square Institute of Neurology, Univeristy College London, London, United Kingdom
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
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Parkinson S, Cole B, Trevelyan C. Art and mentalizing in early intervention psychosis: rationale and therapist insights on a new psychoeducational course. Front Psychiatry 2024; 15:1243990. [PMID: 39011340 PMCID: PMC11248587 DOI: 10.3389/fpsyt.2024.1243990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 05/29/2024] [Indexed: 07/17/2024] Open
Abstract
In this paper, we explore the rationale for a combined art therapy and mentalization-based treatment (MBT) group course for those experiencing a first episode of psychosis (FEP). We discuss the theoretical background for how art and MBT theory can help us better understand and work with groups of individuals experiencing FEP, particularly focusing on avoidance and insecure attachment styles. We outline the delivery of a ten-week psychoeducational Art MBT course within an Early Intervention in Psychosis (EIP) Service and discuss our experiential insights into this new modality as co-therapists. We conclude by proposing that art therapy and mentalizing practice together offer an accessible, useful and practical group structure for EIP services, which could improve individuals' mentalizing capacity and overall social functioning.
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Affiliation(s)
- Sarah Parkinson
- Avon and Wiltshire Mental Health Partnership National Health Service (NHS) Trust, Bath, United Kingdom
| | - Bethany Cole
- Avon and Wiltshire Mental Health Partnership National Health Service (NHS) Trust, Bath, United Kingdom
| | - Clare Trevelyan
- Avon and Wiltshire Mental Health Partnership National Health Service (NHS) Trust, Bath, United Kingdom
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Du SC, Li CY, Lo YY, Hu YH, Hsu CW, Cheng CY, Chen TT, Hung PH, Lin PY, Chen CR. Effects of Visual Art Therapy on Positive Symptoms, Negative Symptoms, and Emotions in Individuals with Schizophrenia: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2024; 12:1156. [PMID: 38891231 PMCID: PMC11171575 DOI: 10.3390/healthcare12111156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/01/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Abstract
Schizophrenia is characterized by psychiatric symptoms and emotional issues. While pharmacological treatments have limitations, non-pharmacological interventions are essential. Art therapy has the potential to enhance emotional expression, communication, and health; however, the effectiveness of visual art therapy remains uncertain. This systematic review and meta-analysis synthesizes the findings of randomized controlled trials (RCTs) of visual art therapy on positive symptoms, negative symptoms, and emotions in patients with schizophrenia. This study reviews RCTs published prior to February, 2024. The PubMed, Embase, Cochrane Library, CEPS, CNKI, Wanfang, and Yiigle databases were searched, and three independent researchers screened the studies. In this meta-analysis, standardized mean difference (SMD) was employed as a measure to calculate effect sizes for continuous variables using a random effects model, while the meta-regression and subgroup analyses were performed with patient and intervention characteristics. A total of 31 studies revealed visual art therapy had a significant small-to-moderate effect on positive symptoms (SMD = 0.407, 95% CI 0.233 to 0.581), a moderate effect on negative symptoms (SMD = 0.697, 95% CI 0.514 to 0.880), a moderate effect on depression (SMD = 0.610, 95% CI 0.398 to 0.821), and a large effect on anxiety (SMD = 0.909, 95% CI 0.386 to 1.433). The subgroup analysis revealed painting and handcrafts had significant effects on positive symptoms, negative symptoms, and emotions. Combined Chinese calligraphy and painting had significant effects on positive symptoms, depression, and anxiety. Better improvement was noted among the Asian population, and a longer weekly treatment duration was associated with better improvement in positive symptoms. Female participants tended to have more improvements in negative symptoms and anxiety through visual art therapy. The results indicate that visual art therapy has positive effects on the psychiatric symptoms and emotions of individuals with schizophrenia. We recommend future research further investigate art therapy modalities and durations.
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Affiliation(s)
- Shih-Cing Du
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
| | - Chih-Yen Li
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Ya-Yun Lo
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Yu-Hsuan Hu
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Chi-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Chung-Yin Cheng
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Tzu-Ting Chen
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Pei-Hsuan Hung
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
| | - Chyi-Rong Chen
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan; (C.-Y.L.); (Y.-Y.L.); (Y.-H.H.); (T.-T.C.); (P.-H.H.)
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan; (C.-W.H.); (C.-Y.C.); (P.-Y.L.)
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Utas-Akhan L, Avci D, Basak I. Art Therapy as a Nursing Intervention for Individuals With Schizophrenia. J Psychosoc Nurs Ment Health Serv 2024; 62:29-38. [PMID: 37956349 DOI: 10.3928/02793695-20231025-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The aim of the current study was to determine the effects of group art therapy on clinical symptoms, alexithymia, and quality of life among people with schizophrenia. This single-blinded, randomized controlled trial was performed with 66 individuals with schizophrenia from a community mental health center in western Turkey between September 2021 and February 2022. Following art therapy, the intervention group had lower severity of positive, negative, and general psycho-pathology symptoms; lower levels of alexithymia; and higher levels of psychological health, social relationships, and total quality of life than the control group; and the difference between groups was statistically significant (p < 0.05). Results reveal that art therapy combined with pharmacological therapy contributes to good clinical outcomes among individuals with schizophrenia. This evidence can guide psychiatric nurses to use art therapy to reduce psychopathology severity and increase functionality and quality of life among individuals with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, 62(5), 29-38.].
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Deng F, Bueber MA, Cao Y, Tang J, Bai X, Cho Y, Lee J, Lin Z, Yang Q, Keshavan MS, Stone WS, Qian M, Yang LH, Phillips MR. Assessing social cognition in patients with schizophrenia and healthy controls using the reading the mind in the eyes test (RMET): a systematic review and meta-regression. Psychol Med 2024; 54:847-873. [PMID: 38173096 DOI: 10.1017/s0033291723003501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The reading the mind in the eyes test (RMET) - which assesses the theory of mind component of social cognition - is often used to compare social cognition between patients with schizophrenia and healthy controls. There is, however, no systematic review integrating the results of these studies. We identified 198 studies published before July 2020 that administered RMET to patients with schizophrenia or healthy controls from three English-language and two Chinese-language databases. These studies included 41 separate samples of patients with schizophrenia (total n = 1836) and 197 separate samples of healthy controls (total n = 23 675). The pooled RMET score was 19.76 (95% CI 18.91-20.60) in patients and 25.53 (95% CI 25.19-25.87) in controls (z = 12.41, p < 0.001). After excluding small-sample outlier studies, this difference in RMET performance was greater in studies using non-English v. English versions of RMET (Chi [Q] = 8.54, p < 0.001). Meta-regression analyses found a negative association of age with RMET score and a positive association of years of schooling with RMET score in both patients and controls. A secondary meta-analysis using a spline construction of 180 healthy control samples identified a non-monotonic relationship between age and RMET score - RMET scores increased with age before 31 and decreased with age after 31. These results indicate that patients with schizophrenia have substantial deficits in theory of mind compared with healthy controls, supporting the construct validity of RMET as a measure of social cognition. The different results for English versus non-English versions of RMET and the non-monotonic relationship between age and RMET score highlight the importance of the language of administration of RMET and the possibility that the relationship of aging with theory of mind is different from the relationship of aging with other types of cognitive functioning.
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Affiliation(s)
- Fei Deng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- University of Nottingham School of Economics (Ningbo China), Zhejiang, China
| | - Marlys A Bueber
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yourong Cao
- Guangxi Medical University School of Public Health, Guangxi, China
- The Reproductive Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Jeff Tang
- New York University, New York, NY, USA
| | - Xinyu Bai
- Guangxi Medical University School of Public Health, Guangxi, China
- Guangxi Academy of Medical Sciences & The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Young Cho
- New York State Psychiatric Institute, New York, NY, USA
| | - Jiwon Lee
- Teachers College, Columbia University, New York, NY, USA
| | - Zhuozhi Lin
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Qi Yang
- Ningxia Medical University School of Public Health, Ningxia, China
| | - Matcheri S Keshavan
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - William S Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Min Qian
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Lawrence H Yang
- New York University, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Michael R Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
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Beals K, Torregrossa LJ, Smith R, Lane RD, Sheffield JM. Impaired emotional awareness is associated with childhood maltreatment exposure and positive symptoms in schizophrenia. Front Psychiatry 2024; 14:1325617. [PMID: 38283891 PMCID: PMC10811959 DOI: 10.3389/fpsyt.2023.1325617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/14/2023] [Indexed: 01/30/2024] Open
Abstract
Objectives Evidence suggests that emotional awareness-the ability to identify and label emotions-may be impaired in schizophrenia and related to positive symptom severity. Exposure to childhood maltreatment is a risk factor for both low emotional awareness and positive symptoms. Methods The current investigation examines associations between a performance-based measure of emotional awareness, positive symptom severity, and childhood maltreatment exposure in 44 individuals with a schizophrenia-spectrum disorder and 48 healthy comparison participants using the electronic Levels of Emotional Awareness Scale (eLEAS), Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire (CTQ). Results Patients demonstrated significant deficits in emotional awareness overall, which was true for both self and others. In patients, lower emotional awareness was significantly associated with more severe positive symptoms. Emotional awareness was significantly impaired in patients with schizophrenia with self-reported maltreatment exposure, relative to other groups. Severity of maltreatment was not significantly associated with emotional awareness or positive symptoms when looking continuously, and there was no significant indirect effect. Conclusion These data suggest that emotional awareness impairments observed in schizophrenia may be exacerbated by exposure to childhood maltreatment, possibly putting individuals at greater risk for experiencing positive symptoms of psychosis.
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Affiliation(s)
- Kendall Beals
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Social Cognition and Recovery in Schizophrenia Lab, Department of Psychology, The University of Southern Mississippi, Hattiesburg, MS, United States
| | - Lénie J. Torregrossa
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Richard David Lane
- Department of Psychiatry, University of Arizona, Tucson, AZ, United States
| | - Julia M. Sheffield
- Sheffield Lab, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Luo X, Zhang Z, Shi X, He C, Wang J, Wu Q, Huang G. Arts therapies for mental disorders in COVID-19 patients: a comprehensive review. Front Public Health 2023; 11:1289545. [PMID: 38111478 PMCID: PMC10726037 DOI: 10.3389/fpubh.2023.1289545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
Background and objective The COVID-19 global pandemic has necessitated the urgency for innovative mental health interventions. We performed a comprehensive review of the available literature on the utility and efficacy of arts therapies in treating mental health problems, with special emphasis on their deployment during the COVID-19 pandemic, aiming to provide some evidence for the application of this therapy. Methods The potential studies were systematically sourced from five authoritative databases: PubMed, Embase, the Cochrane Library, Web of Science, and the CNKI database. The evaluation of these studies was conducted based on stringent criteria, including validity, suitability, therapeutic potential, and consistency. Each piece of included literature was meticulously scored in accordance with these criteria, thus ensuring the inclusion of only the most robust studies in this review. The data from these Randomized Controlled Trials (RCTs) were carefully extracted using the PICO(S) framework, ensuring a comprehensive and systemic approach to data collection. In order to emphasize the variability in the effects of differing arts therapies on COVID-19-induced psychiatric disturbances, the sourced literature was systematically categorized and scrutinized based on distinct modalities. Results Out of the 7,250 sourced articles, 16 satisfied the inclusion conditions. The therapies were predominantly meditation (n = 7), supplemented by individual studies on color therapy (n = 3), music therapy (n = 2), and single studies on horticultural therapy, dance therapy, mindfulness and music therapy, and yoga and music therapy (n = 4 collectively). These various forms of arts therapies had a positive short to medium-term impact on the mental health of COVID-19 patients. Besides improving patients' physical and mental health, these therapies can also be employed to mitigate mental health issues among healthcare professionals. Conclusion The COVID-19 pandemic has profound and long-lasting implications for public mental health. Diverse forms of arts therapies are potentially effective in addressing related psychiatric symptoms. The integration of artificial intelligence might further enhance the efficacy and scalability of arts therapies in future implementations.
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Affiliation(s)
- Xuexing Luo
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau SAR, China
| | - Zheyu Zhang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau SAR, China
| | - Xiaojun Shi
- Department of Hepatology, The 4th People's Hospital of Qinghai Province, Xining, Qinghai, China
| | - Caihong He
- Operation Management Centre, Guangzhou Wanqu Cooperative Institute of Design, Guangzhou, Guangdong, China
| | - Jue Wang
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, Macau SAR, China
- Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangzhou, Guangdong, China
| | - Qibiao Wu
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, Macau SAR, China
- Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau SAR, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangzhou, Guangdong, China
| | - Guanghui Huang
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau SAR, China
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Romm KL, Synnes O, Bondevik H. Creative writing as a means to recover from early psychosis- Experiences from a group intervention. Arts Health 2023; 15:292-305. [PMID: 36224522 DOI: 10.1080/17533015.2022.2130379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 09/24/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND In this paper, we explore the subjective experiences of a group intervention in creative writing (CW) for young adults being treated for psychosis. METHOD A qualitative and exploratory design was applied. Five out of eight patients who were offered a course in CW with two-hour weekly sessions for 12 weeks took part in this study. The five participants who followed through were interviewed after project termination. Systematic text condensation was applied to the transcribed interviews. RESULTS The analysis revealed three overarching themes: a) the group was valued as a creative community, b) there was safety in the structured yet flexible framing of the course, c) the participants experienced creative freedom that enabled a feeling of mastery. CONCLUSION CW was well conceived. The feelings of connectedness and mastery were prominent. The participants experienced growth on several levels. Our findings support previous work on arts therapy as a means to recovery.
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Affiliation(s)
- Kristin Lie Romm
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, NORMENT Norwegian Centre for Mental Disorders Research, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Oddgeir Synnes
- Centre of Diaconia and Professional Practice, VID Specialised University, Oslo, Norway
| | - Hilde Bondevik
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
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10
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Sprotte Y. Computerized text and voice analysis of patients with chronic schizophrenia in art therapy. Sci Rep 2023; 13:16062. [PMID: 37749186 PMCID: PMC10520069 DOI: 10.1038/s41598-023-43069-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/19/2023] [Indexed: 09/27/2023] Open
Abstract
This explorative study of patients with chronic schizophrenia aimed to clarify whether group art therapy followed by a therapist-guided picture review could influence patients' communication behaviour. Data on voice and speech characteristics were obtained via objective technological instruments, and these characteristics were selected as indicators of communication behaviour. Seven patients were recruited to participate in weekly group art therapy over a period of 6 months. Three days after each group meeting, they talked about their last picture during a standardized interview that was digitally recorded. The audio recordings were evaluated using validated computer-assisted procedures, the transcribed texts were evaluated using the German version of the LIWC2015 program, and the voice recordings were evaluated using the audio analysis software VocEmoApI. The dual methodological approach was intended to form an internal control of the study results. An exploratory factor analysis of the complete sets of output parameters was carried out with the expectation of obtaining typical speech and voice characteristics that map barriers to communication in patients with schizophrenia. The parameters of both methods were thus processed into five factors each, i.e., into a quantitative digitized classification of the texts and voices. The factor scores were subjected to a linear regression analysis to capture possible process-related changes. Most patients continued to participate in the study. This resulted in high-quality datasets for statistical analysis. To answer the study question, two results were summarized: First, text analysis factor called Presence proved to be a potential surrogate parameter for positive language development. Second, quantitative changes in vocal emotional factors were detected, demonstrating differentiated activation patterns of emotions. These results can be interpreted as an expression of a cathartic healing process. The methods presented in this study make a potentially significant contribution to quantitative research into the effectiveness and mode of action of art therapy.
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Affiliation(s)
- Yvonne Sprotte
- Art Therapy Department, Dresden University of Fine Arts (Hochschule für Bildende Künste Dresden), Dresden, Germany.
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11
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Elyoseph Z, Hadar-Shoval D, Asraf K, Lvovsky M. ChatGPT outperforms humans in emotional awareness evaluations. Front Psychol 2023; 14:1199058. [PMID: 37303897 PMCID: PMC10254409 DOI: 10.3389/fpsyg.2023.1199058] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
The artificial intelligence chatbot, ChatGPT, has gained widespread attention for its ability to perform natural language processing tasks and has the fastest-growing user base in history. Although ChatGPT has successfully generated theoretical information in multiple fields, its ability to identify and describe emotions is still unknown. Emotional awareness (EA), the ability to conceptualize one's own and others' emotions, is considered a transdiagnostic mechanism for psychopathology. This study utilized the Levels of Emotional Awareness Scale (LEAS) as an objective, performance-based test to analyze ChatGPT's responses to twenty scenarios and compared its EA performance with that of the general population norms, as reported by a previous study. A second examination was performed one month later to measure EA improvement over time. Finally, two independent licensed psychologists evaluated the fit-to-context of ChatGPT's EA responses. In the first examination, ChatGPT demonstrated significantly higher performance than the general population on all the LEAS scales (Z score = 2.84). In the second examination, ChatGPT's performance significantly improved, almost reaching the maximum possible LEAS score (Z score = 4.26). Its accuracy levels were also extremely high (9.7/10). The study demonstrated that ChatGPT can generate appropriate EA responses, and that its performance may improve significantly over time. The study has theoretical and clinical implications, as ChatGPT can be used as part of cognitive training for clinical populations with EA impairments. In addition, ChatGPT's EA-like abilities may facilitate psychiatric diagnosis and assessment and be used to enhance emotional language. Further research is warranted to better understand the potential benefits and risks of ChatGPT and refine it to promote mental health.
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Affiliation(s)
- Zohar Elyoseph
- Department of Psychology and Educational Counseling, The Center for Psychobiological Research, Max Stern Yezreel Valley College, Emek Yezreel, Israel
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, England
| | - Dorit Hadar-Shoval
- Department of Psychology and Educational Counseling, The Center for Psychobiological Research, Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Kfir Asraf
- Psychology Department, Center for Psychobiological Research, Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Maya Lvovsky
- Psychology Department, Center for Psychobiological Research, Max Stern Yezreel Valley College, Emek Yezreel, Israel
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12
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Ettinger T, Berberian M, Acosta I, Cucca A, Feigin A, Genovese D, Pollen T, Rieders J, Kilachand R, Gomez C, Kaimal G, Biagioni M, Di Rocco A, Ghilardi FM, Rizzo JR. Art therapy as a comprehensive complementary treatment for Parkinson's disease. Front Hum Neurosci 2023; 17:1110531. [PMID: 37250693 PMCID: PMC10215005 DOI: 10.3389/fnhum.2023.1110531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Parkinson's disease (PD) is the second most prevalent neurodegenerative disease. Complementary and alternative therapies are increasingly utilized to address its complex multisystem symptomatology. Art therapy involves motoric action and visuospatial processing while promoting broad biopsychosocial wellness. The process involves hedonic absorption, which provides an escape from otherwise persistent and cumulative PD symptoms, refreshing internal resources. It involves the expression in nonverbal form of multilayered psychological and somatic phenomena; once these are externalized in a symbolic arts medium, they can be explored, understood, integrated, and reorganized through verbal dialogue, effecting relief and positive change. Methods 42 participants with mild to moderate PD were treated with 20 sessions of group art therapy. They were assessed before and after therapy with a novel arts-based instrument developed to match the treatment modality for maximum sensitivity. The House-Tree-Person PD Scale (HTP-PDS) assesses motoric and visuospatial processing-core PD symptoms-as well as cognition (thought and logic), affect/mood, motivation, self (including body-image, self-image, and self- efficacy), interpersonal functioning, creativity, and overall level of functioning. It was hypothesized that art therapy will ameliorate core PD symptoms and that this will correlate with improvements in all other variables. Results HTP-PDS scores across all symptoms and variables improved significantly, though causality among variables was indeterminate. Discussion Art therapy is a clinically efficacious complementary treatment for PD. Further research is warranted to disentangle causal pathways among the aforementioned variables, and additionally, to isolate and examine the multiple, discrete healing mechanisms believed to operate simultaneously in art therapy.
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Affiliation(s)
- Tom Ettinger
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Marygrace Berberian
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Ikuko Acosta
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Alberto Cucca
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
- Doctoral Program in Neural and Cognitive Neurosciences, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Andrew Feigin
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Danilo Genovese
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Travis Pollen
- Department of Exercise Science, Thomas Jefferson University, Philadelphia, PA, United States
| | - Julianne Rieders
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - Rohita Kilachand
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Clara Gomez
- Steinhardt Graduate Art Therapy Program, New York University, New York, NY, United States
| | - Girija Kaimal
- Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Milton Biagioni
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | | | - Felice M. Ghilardi
- Department of Neurology, The Marlene and Paolo Fresco Institute for Parkinson’s and Movement Disorders, New York University Grossman School of Medicine, New York, NY, United States
| | - John-Ross Rizzo
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, United States
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13
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Bighelli I, Wallis S, Reitmeir C, Schwermann F, Salahuddin NH, Leucht S. Effects of psychological treatments on functioning in people with Schizophrenia: a systematic review and meta-analysis of randomized controlled trials. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01526-1. [PMID: 36477405 DOI: 10.1007/s00406-022-01526-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
Functioning is recognized as a key treatment goal in alleviating the burden of schizophrenia. Psychological interventions can play an important role in improving functioning in this population, but the evidence on their efficacy is limited. We therefore aimed to evaluate the effect of psychological interventions in functioning for patients with schizophrenia. To conduct this systematic review and meta-analysis, we searched for published and unpublished randomized controlled trials (RCTs) in EMBASE, MEDLINE, PsycINFO, BIOSIS, Cochrane Library, WHO International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov and the Study register of the Cochrane Schizophrenia Group. The outcome functioning was measured with validated scales. We performed random-effects pairwise meta-analysis to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs). We included 58 RCTs (5048 participants). Psychological interventions analyzed together (SMD = - 0.37, 95% CI - 0.49 to - 0.25), cognitive behavioral therapy (30 RCTs, SMD = - 0.26, 95% CI - 0.39 to - 0.12), and third wave cognitive-behavioral therapies (15 RCTs, SMD = - 0.60, 95% CI - 0.83 to - 0.37) were superior to control in improving functioning, while creative therapies (8 RCTs, SMD = 0.01, 95% CI - 0.38 to 0.39), integrated therapies (4 RCTs, SMD = - 0.21, 95% CI - 1.20 to 0.78) and other therapies (4 RCTs, SMD = - 0.74, 95% CI - 1.52 to 0.04) did not show a benefit. Psychological interventions, in particular cognitive behavioral therapy and third wave cognitive behavioral therapies, have shown a therapeutic effect on functioning. The confidence in the estimate was evaluated as very low due to risk of bias, heterogeneity and possible publication bias.
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Affiliation(s)
- Irene Bighelli
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany.
| | - Sofia Wallis
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Cornelia Reitmeir
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Felicitas Schwermann
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Nurul Husna Salahuddin
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine, Klinikum Rechts Der Isar, Technical University of Munich, Ismaningerstraße 22, 81675, Munich, Germany
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14
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Shukla A, Choudhari SG, Gaidhane AM, Quazi Syed Z. Role of Art Therapy in the Promotion of Mental Health: A Critical Review. Cureus 2022; 14:e28026. [PMID: 36134083 PMCID: PMC9472646 DOI: 10.7759/cureus.28026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/15/2022] [Indexed: 11/05/2022] Open
Abstract
Art therapy is used most commonly to treat mental illnesses and can aid in controlling manifestations correlated with psychosocially challenging behaviours, slowing cognitive decline, and enhancing the quality of life. Art therapy can help people express themselves more freely, improve their mental health, and improve interpersonal relationships. The basis of art therapy is established on the idea that people can recover and feel better via artistic expression. This review examines the current research on how active participation in the arts might improve mental health. A detailed literature search was carried out utilizing essential databases such as PubMed, the WHO's mental health database, and Google and Google Scholar. This review study looks into research done on art therapy and its potential advantages for adult mental health rehabilitation. It focuses on visual art therapy since it’s a key to reducing variation within the "creative arts" and defines the peculiar elements and effectiveness of art therapy used by mental health services. It was found that the use of art therapy as an adjunct treatment showed improved mental health in patients.
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15
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Joschko R, Roll S, Willich SN, Berghöfer A. The effect of active visual art therapy on health outcomes: protocol of a systematic review of randomised controlled trials. Syst Rev 2022; 11:96. [PMID: 35578277 PMCID: PMC9109400 DOI: 10.1186/s13643-022-01976-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Art therapy is a form of complementary therapy to treat a wide variety of health problems. Existing studies examining the effects of art therapy differ substantially regarding content and setting of the intervention, as well as their included populations, outcomes, and methodology. The aim of this review is to evaluate the overall effectiveness of active visual art therapy, used across different treatment indications and settings, on various patient outcomes. METHODS We will include randomised controlled studies with an active art therapy intervention, defined as any form of creative expression involving a medium (such as paint etc.) to be actively applied or shaped by the patient in an artistic or expressive form, compared to any type of control. Any treatment indication and patient group will be included. A systematic literature search of the Cochrane Library, EMBASE (via Ovid), MEDLINE (via Ovid), CINAHL, ERIC, APA PsycArticles, APA PsycInfo, and PSYNDEX (all via EBSCOHost), ClinicalTrials.gov and the WHO's International Clinical Trials Registry Platform (ICTRP) will be conducted. Psychological, cognitive, somatic and economic outcomes will be used. Based on the number, quality and outcome heterogeneity of the selected studies, a meta-analysis might be conducted, or the data synthesis will be performed narratively only. Heterogeneity will be assessed by calculating the p-value for the chi2 test and the I2 statistic. Subgroup analyses and meta-regressions are planned. DISCUSSION This systematic review will provide a concise overview of current knowledge of the effectiveness of art therapy. Results have the potential to (1) inform existing treatment guidelines and clinical practice decisions, (2) provide insights to the therapy's mechanism of change, and (3) generate hypothesis that can serve as a starting point for future randomised controlled studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO ID CRD42021233272.
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Affiliation(s)
- Ronja Joschko
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany.
| | - Stephanie Roll
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Anne Berghöfer
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Luisenstr. 57, 10117, Berlin, Germany
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16
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Barrett H, Holttum S, Wright T. Therapist and client experiences of art therapy in relation to psychosis: a thematic analysis. INTERNATIONAL JOURNAL OF ART THERAPY 2022. [DOI: 10.1080/17454832.2022.2046620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Sue Holttum
- Canterbury Christ Church University, Salomons Institute for Applied Psychology, Tunbridge Wells, UK
| | - Tim Wright
- West London Mental Health Trust, Art Therapy, London, UK
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17
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Higher emotional awareness is associated with greater domain-general reflective tendencies. Sci Rep 2022; 12:3123. [PMID: 35210517 PMCID: PMC8873306 DOI: 10.1038/s41598-022-07141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 02/08/2022] [Indexed: 11/21/2022] Open
Abstract
The tendency to reflect on the emotions of self and others is a key aspect of emotional awareness (EA)—a trait widely recognized as relevant to mental health. However, the degree to which EA draws on general reflective cognition vs. specialized socio-emotional mechanisms remains unclear. Based on a synthesis of work in neuroscience and psychology, we recently proposed that EA is best understood as a learned application of domain-general cognitive processes to socio-emotional information. In this paper, we report a study in which we tested this hypothesis in 448 (125 male) individuals who completed measures of EA and both general reflective cognition and socio-emotional performance. As predicted, we observed a significant relationship between EA measures and both general reflectiveness and socio-emotional measures, with the strongest contribution from measures of the general tendency to engage in effortful, reflective cognition. This is consistent with the hypothesis that EA corresponds to the application of general reflective cognitive processes to socio-emotional signals.
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18
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Maaßen E, Büttner M, Bröcker AL, Stuke F, Bayer S, Hadzibegovic J, Just SA, Bertram G, Rau R, von Haebler D, Lempa G, Montag C. Measuring Emotional Awareness in Patients With Schizophrenia and Schizoaffective Disorders. Front Psychol 2021; 12:725787. [PMID: 34858263 PMCID: PMC8632138 DOI: 10.3389/fpsyg.2021.725787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
The ability to mentalize (i.e., to form representations of mental states and processes of oneself and others) is often impaired in people with schizophrenia spectrum disorders. Emotional awareness (EA) represents one aspect of affective mentalizing and can be assessed with the Levels of Emotional Awareness Scale (LEAS), but findings regarding individuals with schizophrenia spectrum disorders are inconsistent. The present study aimed at examining the usability and convergent validity of the LEAS in a sample of N = 130 stabilized outpatients with schizophrenia or schizoaffective disorders. An adequacy rating was added to the conventional LEAS rating to account for distortions of content due to, for example, delusional thinking. Scores of the patient group were compared with those of a matched healthy control sample. Correlation with symptom clusters, a self-report measure of EA, a measure of synthetic metacognition (MAS-A-G), and an expert rating capturing EA from the psychodynamic perspective of psychic structure (OPD-LSIA) were examined. Regarding self-related emotional awareness, patients did not score lower than controls neither in terms of conventional LEAS nor in terms of adequacy. Regarding other-related emotional awareness, however, patients showed a reduced level of adequacy compared to controls whereas no such difference was found for conventional LEAS scores. Higher conventional LEAS scores were associated with fewer negative symptoms, and higher structural integration of self-perceptions measured by the OPD-LSIA. Higher adequacy of responses correlated with fewer symptoms of disorganization as well as excitement, higher scores of self-reflection on the MAS-A-G as well as self- and object-perception and internal and external communication as measured by the subscales of the OPD-LSIA. Findings suggest that the LEAS might not be sensitive enough to detect differences between mildly symptomatic patients with schizophrenia or schizoaffective disorders and healthy controls. However, LEAS ratings are still suitable to track intraindividual changes in EA over time. Observing the adequacy of patients’ responses when using the LEAS may be a promising way to increase diagnostical utility and to identify patterns of formal and content-related alterations of mentalizing in this patient group. Methodological indications for future studies are discussed.
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Affiliation(s)
- Eva Maaßen
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Marielle Büttner
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Anna-Lena Bröcker
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Frauke Stuke
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Samuel Bayer
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Psychoanalytic University Berlin, Berlin, Germany
| | - Jasmina Hadzibegovic
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sandra Anna Just
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gianna Bertram
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Richard Rau
- Department of Psychology, University of Münster, Münster, Germany
| | - Dorothea von Haebler
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Psychoanalytic University Berlin, Berlin, Germany
| | | | - Christiane Montag
- Department of Psychiatry and Psychotherapy, Psychiatric University Clinic at St. Hedwig Hospital, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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19
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Varchmin L, Montag C, Treusch Y, Kaminski J, Heinz A. Traumatic Events, Social Adversity and Discrimination as Risk Factors for Psychosis - An Umbrella Review. Front Psychiatry 2021; 12:665957. [PMID: 34744806 PMCID: PMC8569921 DOI: 10.3389/fpsyt.2021.665957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 09/17/2021] [Indexed: 12/17/2022] Open
Abstract
Exposure to childhood trauma is a well-known risk factor for severe mental disorders including schizophrenia and other non-affective psychoses. Beyond childhood trauma, there is increasing evidence that bullying, social exclusion, and discrimination during adolescence and adulthood may increase the risk of developing a psychotic disorder, and that such forms of traumatization may also underlie the elevated psychosis risk among migrants or persons with a visible minority status. In this umbrella review, we systematically assess meta-analyses regarding trauma and social adversity. A systematic literature review yielded 11 meta-analyses that met inclusion criteria and could be summarized quantitatively with a random effect model. Furthermore, six meta-analyses were evaluated qualitatively. Heterogeneity and publication bias were apparent in several meta-analyses. We observed that most significant social risk factors for psychosis were vulnerability for racist discrimination [OR = 3.90 (3.25-4.70)], migration [OR = 2.22 (1.75-2.80)], and childhood adversities [OR = 2.81 (2.03-3.83)]. Furthermore, social factors increasing the risk for psychosis were variation/impairment of parental communication, aversive adult life events, bullying, and factors associated with social isolation and discrimination. In spite of these environmental risk factors, there is a lack of evidence regarding treatment of trauma and psychosis, although some psychotherapeutic and art therapy approaches appear to be promising. Beyond individual interventions, stigmatization, racism, and other forms of discrimination need to be targeted to increase solidarity and communal support.
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Affiliation(s)
- Leonie Varchmin
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Psychotherapy, University Clinic of the Charité in St. Hedwig Hospital, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
| | - Yvonne Treusch
- Hochschule Döpfer (HSD) Döpfer, University of Applied Science, Cologne, Germany
| | - Jakob Kaminski
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Charité Campus Mitte (CCM), Berlin, Germany
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20
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Hu J, Zhang J, Hu L, Yu H, Xu J. Art Therapy: A Complementary Treatment for Mental Disorders. Front Psychol 2021; 12:686005. [PMID: 34456801 PMCID: PMC8397377 DOI: 10.3389/fpsyg.2021.686005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/28/2021] [Indexed: 01/05/2023] Open
Abstract
Art therapy, as a non-pharmacological medical complementary and alternative therapy, has been used as one of medical interventions with good clinical effects on mental disorders. However, systematically reviewed in detail in clinical situations is lacking. Here, we searched on PubMed for art therapy in an attempt to explore its theoretical basis, clinical applications, and future perspectives to summary its global pictures. Since drawings and paintings have been historically recognized as a useful part of therapeutic processes in art therapy, we focused on studies of art therapy which mainly includes painting and drawing as media. As a result, a total of 413 literature were identified. After carefully reading full articles, we found that art therapy has been gradually and successfully used for patients with mental disorders with positive outcomes, mainly reducing suffering from mental symptoms. These disorders mainly include depression disorders and anxiety, cognitive impairment and dementias, Alzheimer's disease, schizophrenia, and autism. These findings suggest that art therapy can not only be served as an useful therapeutic method to assist patients to open up and share their feelings, views, and experiences, but also as an auxiliary treatment for diagnosing diseases to help medical specialists obtain complementary information different from conventional tests. We humbly believe that art therapy has great potential in clinical applications on mental disorders to be further explored.
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Affiliation(s)
- Jingxuan Hu
- College of Creative Design, Shenzhen Technology University, Shenzhen, China
| | - Jinhuan Zhang
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.,Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liyu Hu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Haibo Yu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Lane RD, Smith R. Levels of Emotional Awareness: Theory and Measurement of a Socio-Emotional Skill. J Intell 2021; 9:42. [PMID: 34449662 PMCID: PMC8395748 DOI: 10.3390/jintelligence9030042] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 08/02/2021] [Accepted: 08/09/2021] [Indexed: 12/13/2022] Open
Abstract
Emotional awareness is the ability to conceptualize and describe one's own emotions and those of others. Over thirty years ago, a cognitive-developmental theory of emotional awareness patterned after Piaget's theory of cognitive development was created as well as a performance measure of this ability called the Levels of Emotional Awareness Scale (LEAS). Since then, a large number of studies have been completed in healthy volunteers and clinical populations including those with mental health or systemic medical disorders. Along the way, there have also been further refinements and adaptations of the LEAS such as the creation of a digital version in addition to further advances in the theory itself. This review aims to provide a comprehensive summary of the evolving theoretical background, measurement methods, and empirical findings with the LEAS. The LEAS is a reliable and valid measure of emotional awareness. Evidence suggests that emotional awareness facilitates better emotion self-regulation, better ability to navigate complex social situations and enjoy relationships, and better physical and mental health. This is a relatively new but promising area of research in the domain of socio-emotional skills. The paper concludes with some recommendations for future research.
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Affiliation(s)
- Richard D. Lane
- Department of Psychiatry, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA
| | - Ryan Smith
- Laureate Institute for Brain Research, 6655 South Yale Ave., Tulsa, OK 74136, USA;
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Strube S, Steinberg H. The Work of Oskar Herzberg-Did Psychosis or the Residence in a Psychiatric Institution Serve as a Catalyst for Creativity?: A Thought-Provoking Impulse to Reconsider the Interrelationship Between Mental Illness and Art. J Nerv Ment Dis 2021; 209:409-414. [PMID: 34009861 DOI: 10.1097/nmd.0000000000001328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT In the 1920s, the Heidelberg psychiatrist and art historian Hans Prinzhorn collected pictorial works by "mentally ill people"-today's Prinzhorn Collection.His colleague Paul Schilder sent him works by Oskar Herzberg thereto, which Prinzhorn included as "Case 355" in his famous work Bildnerei der Geisteskranken.Using Herzberg as an example, we approached the general issue of the relationship between mental illness, creativity, and art from a historical psychiatric perspective.It was not before his admission to the Leipzig clinic due to his schizophrenic illness that Herzberg began to paint. Prinzhorn and his doctor Ernst Jolowicz considered this late start of artistic activities to be the expression of an immanent creative urge caused by exceptional psychotic experiences. Our study intends to view such artworks outside a rather pathological context. Therefore, we discuss being secluded in psychiatry, supplied painting utensils, and released from his daily constrains as other possible triggering factors for Herzberg's artistic development.
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Affiliation(s)
- Sebastian Strube
- Research Center for the History of Psychiatry, Department of Psychiatry, Leipzig University, Leipzig, Germany
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Holttum S, Wright T, Wood C. Art therapy with people diagnosed with psychosis: therapists’ experiences of their work and the journey to their current practice. INTERNATIONAL JOURNAL OF ART THERAPY 2021. [DOI: 10.1080/17454832.2021.1893370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Sue Holttum
- Salomons Institute for Applied Psychology, Canterbury Christ Church University, Canterbury, UK
| | | | - Chris Wood
- Art Therapy Courses Northern Programme, Sheffield Health and Social Care NHS Trust, Sheffield, UK
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Lane RD. The construction of emotional experience: State‐related emotional awareness and its application to psychotherapy research and practice. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Richard D. Lane
- Department of Psychiatry University of Arizona Tucson AZ USA
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Entwicklung einer psychoanalytisch begründeten Typologie von psychotischen Erkrankungen. FORUM DER PSYCHOANALYSE 2020. [DOI: 10.1007/s00451-020-00390-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ZusammenfassungDer Artikel begründet die Notwendigkeit eines genuin psychoanalytischen und gleichsam in der empirischen Psychotherapieforschung anschlussfähigen Beitrags zum Verständnis psychotischer Erkrankungen. Die sequenziell erklärende Mixed-Methods-Studie „Therapie und Psychodynamik von Patient*innen mit psychotischen Symptomen“ (T3PS-Studie) fokussiert auf die Binnendifferenzierung psychotischer Erkrankungen. Hierfür soll eine psychoanalytisch begründete Typologie dieser Patient*innen anhand messender und hermeneutischer Methoden entwickelt und validiert werden. Zur Entwicklung der Typologie sieht das Studiendesign psychodynamische, psychopathologische und weitere diagnostische Interviews mit stationären Patientinnen und Patienten (N = 100) vor. Zusätzlich werden am Ende der Behandlung Beziehungsepisodeninterviews mit Mitgliedern des Behandlungsteams geführt und Fragebogen eingesetzt. Mittels zunächst statistischer Modellierung und anschließender qualitativer Konzeptbildung sollen schließlich Prototypen psychotischer Erkrankungen entlang der in der Operationalisierten Psychodynamischen Diagnostik (OPD) erfassbaren psychoanalytischen Konzepte von Konflikt, Struktur und Beziehungsdynamik identifiziert werden. Die klinische Nützlichkeit dieser Typologie soll durch systematische Untersuchungen einzelner Behandlungsverläufe nach dem Hermeneutic Single-Case Efficacy Design (HSCED) geprüft werden.
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Wood C. Hearing Voices Movement and Art Therapy. ART THERAPY 2020. [DOI: 10.1080/07421656.2020.1756138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Laws KR, Conway W. Do adjunctive art therapies reduce symptomatology in schizophrenia? A meta-analysis. World J Psychiatry 2019; 9:107-120. [PMID: 31911894 PMCID: PMC6940592 DOI: 10.5498/wjp.v9.i8.107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/03/2019] [Accepted: 10/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Art therapies are advocated by national bodies, such as the United Kingdom’s National Institute for Health and Care Excellence, to alleviate the negative symptoms associated with schizophrenia. The last decade has however, seen several new larger well-controlled trials published suggesting an update is timely.
AIM To asses randomised controlled trials (RCT) of art therapies for reducing the symptoms of schizophrenia – particularly negative symptoms.
METHODS Searches of PubMed and Scopus were conducted until May 2019 for RCTs examining the impact of art therapies on psychosis (positive, negative and total) symptoms in people diagnosed with schizophrenia. Study quality was assessed using the Cochrane risk of bias tool. Random effects meta-analyses were used to derive overall effect sizes. Moderator analyses were conducted using both meta-regression and categorical comparisons.
RESULTS We identified 133 articles, of which 9 RCTs involving 948 participants (475 assigned to art therapies and 473 controls) met our inclusion criteria. Using random effects models, we calculated pooled effect sizes (Hedges g) for end-of-trial symptomatic outcomes. Effect sizes both for total symptoms [g = -0.27, 95% confidence interval (CI) -0.60 to 0.05, k = 6] and for positive symptoms (g = -0.10, 95%CI -0.35 to 0.15, k = 6) were non-significant; however, we did find significant reduction of negative symptoms (g = -0.42, 95%CI -0.70 to -0.14, k = 9). Meta-regression revealed that negative symptom reduction was larger in trials with a greater proportion of women and in trials with younger patients. Crucially, the negative symptom reduction following art therapies was limited to lower quality trials and did not emerge in trials that used blind assessment of outcomes.
CONCLUSION This review presents a comprehensive meta-analysis of art therapies in schizophrenia in terms of both studies included and participant numbers. We found that art therapies did not significantly reduce total or positive symptoms. A "small" therapeutic effect was found for negative symptoms, but we show that the effect is not present in blind trials and may be subject to publication bias.
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Affiliation(s)
- Keith R Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, United Kingdom
| | - William Conway
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, United Kingdom
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Abstract
Different alternative forms of therapy have been studied in relation to their applicability and effectiveness. The use of art therapy in the treatment of depressive disorder is an example frequently employed in several countries. The aim of this research was to identify and discuss which artistic techniques have been applied most frequently in the treatment of depressive disorders and what their main effects are. The research was conducted in the MEDLINE/PubMed, American Psychological Association (APA) and Web of Science databases. The articles were selected through the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA protocol). 14 articles were selected, among which the main techniques of art therapy used were: manual work (drawing, painting, and modeling), music, poetry, photography, theater and contemplation of art pieces. It was found that most of the researches are European and as a field of knowledge they depart mainly from medicine. Of the 14 researches of this review, only two failed in the use of art therapy techniques as a therapeutic tool. It can be understood that art therapy is a safe and reliable tool for treatment not only of depression but also of other mental disorders.
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Shore A, Rush S. Finding clarity in chaos: Art therapy lessons from a psychiatric Hospital. ARTS IN PSYCHOTHERAPY 2019. [DOI: 10.1016/j.aip.2019.101575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Caccamo F, Capani A, Marogna C. Evaluation of Symptoms and Alexithymia in Psychiatric Patients: A Naturalistic Longitudinal Study in a Day Hospital. Int J Group Psychother 2019; 69:328-344. [PMID: 38449196 DOI: 10.1080/00207284.2019.1604142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aimed to examine the effectiveness of a time-limited (10 months), combined individual and group treatment in a Day Hospital (DH) setting. Participants (N = 73) completed measures of general symptoms and alexithymia. We hypothesized improvements in these symptoms at the end of the overall therapeutic treatment. Results showed significant improvement in ability to identify and describe emotions and feelings, and in general symptoms. Differences in age and personality disorders were found at the end of the treatment: younger patients had less difficulty in identifying emotions, and psychotic patients have higher difficulty to describe feelings compared to patients with personality disorders. Furthermore, patients with schizophrenia had lower pathological symptoms compared to patients with mood disorders. This naturalistic longitudinal study demonstrates that DH treatments in group setting increase the patient's ability to symbolize and to connect their symptoms to thought and emotions.
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The challenge of well-being and quality of life: A meta-analysis of psychological interventions in schizophrenia. Schizophr Res 2019; 208:16-24. [PMID: 30833133 DOI: 10.1016/j.schres.2019.01.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 11/08/2018] [Accepted: 01/27/2019] [Indexed: 02/03/2023]
Abstract
Well-being is a critical outcome in the recovery from psychosis and the prevention of symptoms. Previous reviews of the effectiveness of psychological interventions have focused on psychotic symptoms and general psychopathology, not recognising well-being as an essential outcome. This study conducted a meta-analysis of the effects of psychological interventions on the well-being and quality of life (QoL) of people with schizophrenia and analysed some critical moderating factors. A systematic literature search was conducted yielding 12986 published reports, 2043 of which were clinical trials. After a detailed review, 36 articles were included in the analyses. Measures of related concepts, well-being and quality of life were included in the present meta-analysis to reflect the current state of the literature and to ensure the representativeness of RCTs that have evaluated the effect of psychological interventions on the extent to which people with schizophrenia experience a good life. Our findings reflect a significant, small, treatment effect on the outcomes of well-being. Subgroup analysis also suggested a significant moderating effect when the primary aim of the intervention was well-being. These findings suggest that symptom or functional improvement does not necessarily lead to an improvement in well-being and would imply the need to focus specifically on those. We recommend psychological interventions that target well-being as a complementary strategy in mental health promotion and treatment. In addition, we stress the need to include well-being outcome measure in RCT as well as to clearly identify the different domains of well-being being measured.
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Laranjeira C, Campos C, Bessa A, Neves G, Marques MI. Mental Health Recovery Through "Art Therapy": A Pilot Study in Portuguese Acute Inpatient Setting. Issues Ment Health Nurs 2019; 40:399-404. [PMID: 30943062 DOI: 10.1080/01612840.2018.1563255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The main aims of the study are to a) evaluate the effectiveness of a three session program of "art therapy" on changing emotional indicators (depression, anxiety, stress, and psychological well-being) in individuals with mental illness and b) analyze the meanings attributed to creative self-expression. We performed a pre-experimental mixed approach study, with a pretest-posttest design, with twelve Portuguese male subjects, admitted to an acute psychiatry unit. The instruments used were Depression, Anxiety and Stress Scale [DASS-21]; and Ryff Scales of Psychological Well-Being [SPWB - 18] and a semi-structured interview. Comparison of the pre- and posttest indicated improvement in anxiety, stress, self-acceptance, purpose of life, and overall psychological well-being. The categories resulting from the thematic analysis of the interviews revealed the usefulness of the program in the participant recovery process. This type of psychosocial intervention in specialized clinical practice in Mental Health Nursing minimizes the disease's impact in an organizational culture that should increasingly be oriented toward recovery.
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Affiliation(s)
| | - Clara Campos
- b Hospital da Universidade de Coimbra , Coimbra , Portugal
| | - Aida Bessa
- b Hospital da Universidade de Coimbra , Coimbra , Portugal
| | - Goreti Neves
- b Hospital da Universidade de Coimbra , Coimbra , Portugal
| | - Maria Isabel Marques
- c Escola Superior de Enfermagem de Coimbra , Avenida Bissaya Barreto , Coimbra , Portugal
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Chiang M, Reid-Varley WB, Fan X. Creative art therapy for mental illness. Psychiatry Res 2019; 275:129-136. [PMID: 30901671 DOI: 10.1016/j.psychres.2019.03.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 03/15/2019] [Accepted: 03/15/2019] [Indexed: 12/22/2022]
Abstract
Creative art therapy (CAT) for severe mental illness (SMI) represents an extremely heterogenous body of literature that encompasses the use of a large variety of creative mediums (i.e. visual art, music, dance, drama, writing) in the treatment of mental disorders. The present review provides a narrative summary of the findings on the use of CAT for the selected SMI, being: schizophrenia, trauma-related disorders, major depression, and bipolar disorder. A database search of PubMed and the Cochrane Library was conducted related to the use of CAT in the treatment of mental disorders published between January 2008 and March 2019. A total of 9697 citations were identified to match the search criteria and 86 full-texts were reviewed. Although literature suggests CAT to be a potentially low-risk and high benefit intervention to minimize symptoms and maximize functioning in individuals living with SMI, the lack of methodological rigor, and inconsistency in study methods and outcome measures have prevented the advancement of CAT for use in SMI. Although creation of a single CAT regimen for all psychiatric disorders stands neither practical nor advisable, greater standardization of methods would improve evaluation of CAT interventions. Future research should elucidate biological mechanisms underlying CAT methods.
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Affiliation(s)
- Mathew Chiang
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA 01605, USA
| | | | - Xiaoduo Fan
- UMass Memorial Health Care/University of Massachusetts Medical School, Worcester, MA 01605, USA.
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Abstract
Cognitive impairments in substance use disorders have been extensively researched, especially since the advent of cognitive and computational neuroscience and neuroimaging methods in the last 20 years. Conceptually, altered cognitive function can be viewed as a hallmark feature of substance use disorders, with documented alterations in the well-known "executive" domains of attention, inhibition/regulation, working memory, and decision-making. Poor cognitive (sometimes referred to as "top-down") regulation of downstream motivational processes-whether appetitive (reward, incentive salience) or aversive (stress, negative affect)-is recognized as a fundamental impairment in addiction and a potentially important target for intervention. As addressed in this special issue, cognitive impairment is a transdiagnostic domain; thus, advances in the characterization and treatment of cognitive dysfunction in substance use disorders could have benefit across multiple psychiatric disorders. Toward this general goal, we summarize current findings in the abovementioned cognitive domains of substance use disorders, while suggesting a potentially useful expansion to include processes that both precede (precognition) and supersede (social cognition) what is usually thought of as strictly cognition. These additional two areas have received relatively less attention but phenomenologically and otherwise are important features of substance use disorders. The review concludes with suggestions for research and potential therapeutic targeting of both the familiar and this more comprehensive version of cognitive domains related to substance use disorders.
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Versluis A, Verkuil B, Lane RD, Hagemann D, Thayer JF, Brosschot JF. Ecological momentary assessment of emotional awareness: Preliminary evaluation of psychometric properties. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-0074-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractThe Levels of Emotional Awareness Scale (LEAS) is a well-validated performance measure of trait emotional awareness (EA), which is associated with psychological and physical problems. EA is, however, expected to vary over time and we aimed to adapt the LEAS to permit the measurement of EA in daily life as a function of momentary state. Twenty-five students completed 12 ecological momentary assessments (EMAs) of EA across 2 days. The correlation between the mean EMAs of EA and trait EA, and the change over time in EA, was also examined. Findings revealed a significant positive correlation between state and trait EA. The within-person reliability was substantial, suggesting that EMAs can reliably assess EA over time across individuals. Importantly, latent state-trait analysis showed that about 50% of EA variability was due to state variance whereas only 2% of EA variability was due to trait variance. Preliminary psychometric properties suggest that the developed method allows for the measurement of EA in daily life and supports the claim that EA can be measured using both hypothetical (as in the LEAS) and real-life (using EMAs) scenarios.
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Bozzatello P, Bellino S, De Marzi G, Macrì A, Piterà R, Montemagni C, Rocca P. Effectiveness of psychosocial treatments on symptoms and functional domains in schizophrenia spectrum disorders: a prospective study in a real-world setting. Disabil Rehabil 2018; 41:2799-2806. [PMID: 29986607 DOI: 10.1080/09638288.2018.1480666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: Data of investigations suggested that psychosocial interventions are required to provide a more complete and effective treatment of schizophrenia spectrum disorders. In particular, art therapy was found an effective psychosocial intervention in SSD. Moreover, some authors reported that Befriending was as effective as cognitive behavior therapy in the treatment of schizophrenic patients. The aim of this study is to test Befriending in comparison with Group Art Therapy in patients with SSD, in order to identify differences of effects between treatments.Materials and methods: All subjects were evaluated at baseline and after six months with the Clinical Global-Impression-Severity Scale; the 18-item Italian version of the Brief Psychiatric Rating Scale; the Coping Inventory for Stressful Situations; the Rosenberg Self-Esteem Scale; the Global Assessment of Functioning scale; and the Personal and Social Performance scale. Statistical analysis was performed with chi-square tests for categorical variables and analyses of variance for continuous variables to compare the two groups at baseline. A two-way analysis of variance for repeated measures was performed for clinical and psychosocial variables.Results: A significant improvement over trial duration (within-group effect) was observed for both treatments in psychosocial functioning, self-esteem, and thought disturbance. Befriending was found superior to Art therapy (between-group effect) in improving psychosocial functioning. Both interventions were found efficacious in improving emotion-oriented coping strategies (within group effect), with a significant difference (between group effect) favoring Befriending.Conclusions: Both interventions, in spite of some differences of efficacy, can be considered an important contribution to improve the patients' real-world functioning.Implications for rehabilitationOur study confirmed the need to include a set of psychosocial interventions for patients with schizophrenia spectrum disorders among usual treatment modalities.Techniques such as Befriending and Art therapy can be considered an important contribution to the treatment instruments required by the new community model for mental health.Befriending was found superior to Art therapy (between group effect) in improving psychosocial functioning.Both interventions were found efficacious in improving emotion-oriented coping strategies (within group effect), with a significant difference (between group effect) favoring Befriending.
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Affiliation(s)
- Paola Bozzatello
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Department of Neuroscience and Mental Health Struttura Semplice Complessa a Valenza Dipartimentale (SSCVD), Coordinamento Assistenziale Psichiatrico Ospedale-Territorio, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvio Bellino
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Department of Neuroscience and Mental Health Struttura Semplice Complessa a Valenza Dipartimentale (SSCVD), Coordinamento Assistenziale Psichiatrico Ospedale-Territorio, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Giampiero De Marzi
- Department of Mental Health, Azienda Sanitaria Locale (ASL) TO1, Turin, Italy
| | - Antonio Macrì
- Department of Mental Health, Azienda Sanitaria Locale (ASL) TO1, Turin, Italy
| | - Rosellina Piterà
- Department of Mental Health, Azienda Sanitaria Locale (ASL) TO1, Turin, Italy
| | - Cristiana Montemagni
- Department of Neuroscience and Mental Health Struttura Semplice Complessa a Valenza Dipartimentale (SSCVD), Coordinamento Assistenziale Psichiatrico Ospedale-Territorio, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Paola Rocca
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Department of Neuroscience and Mental Health Struttura Semplice Complessa a Valenza Dipartimentale (SSCVD), Coordinamento Assistenziale Psichiatrico Ospedale-Territorio, AOU Città della Salute e della Scienza di Torino, Turin, Italy
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Lynch S, Holttum S, Huet V. The experience of art therapy for individuals following a first diagnosis of a psychotic disorder: a grounded theory study. INTERNATIONAL JOURNAL OF ART THERAPY 2018. [DOI: 10.1080/17454832.2018.1475498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Sancassiani F, Cocco A, Cossu G, Lorrai S, Trincas G, Floris F, Mellino G, Machado S, Nardi AE, Fabrici EP, Preti A, Carta MG. "VelaMente?!" - Sailin in a Crew to Improve Self-Efficacy in People with Psychosocial Disabilities: A Randomized Controlled Trial. Clin Pract Epidemiol Ment Health 2017; 13:200-212. [PMID: 29238396 PMCID: PMC5712647 DOI: 10.2174/1745017901713010200] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/11/2017] [Accepted: 10/15/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION It has been proposed that sailing can improve quality of life, personal and social skills of people with severe psychosocial disabilities. This study aimed to assess the efficacy of a psychosocial rehabilitative intervention focused on sailing on quality of life, self-efficacy and sense of coherence in people with severe psychosocial disabilities. METHODS The study was a randomized, with parallel groups, waiting-list controlled trial. Participants were 51 people with severe psychosocial disabilities. The intervention was a structured course to learn sailing in a crew lasting three months. A randomized group began the sailing course immediately after a pre-treatment assessment; the waitlist group began the sailing course after a three months period of treatments as usual. Participants were assessed before and after the sailing course, or the waiting list period, on the General Self-Efficacy scale (GSES), Sense Of Coherence scale (SOC) and Health Survey-short form (SF-12). RESULTS Self-efficacy significantly increased after the sailing course and decreased after treatment as usual (p=0.015). Sense of coherence and the levels of quality of life tended to improve after the sailing course, albeit below levels of statistical significance. CONCLUSION When compared to more traditional psychosocial rehabilitative activities, an intervention focused on sailing in a crew positively impacts the sense of coherence and the levels of quality of life and significantly improves self-efficacy of people with severe psychosocial disabilities. Further longitudinal research is required.
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Affiliation(s)
- Federica Sancassiani
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Alessio Cocco
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Giulia Cossu
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Stefano Lorrai
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Giuseppina Trincas
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Francesca Floris
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Gisa Mellino
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Sergio Machado
- Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, (RJ), Brazil
- Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program - Salgado de Oliveira University, Niterói, Brazil
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, (RJ), Brazil
| | | | - Antonello Preti
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
- Center of Liaison Psychiatry and Psychosomatic, University Hospital, Cagliari, Italy
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Sex differences in emotion recognition ability: The mediating role of trait emotional awareness. MOTIVATION AND EMOTION 2017. [DOI: 10.1007/s11031-017-9648-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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41
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Donges US, Suslow T. Associations between trait emotional awareness and automatic emotion processing. NORDIC PSYCHOLOGY 2017. [DOI: 10.1080/19012276.2017.1381036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Uta-Susan Donges
- Department of Psychosomatic Medicine, University of Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Gropius Krankenhaus, Eberswalde, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine, University of Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
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42
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Nan JKM, Ho RTH. Effects of clay art therapy on adults outpatients with major depressive disorder: A randomized controlled trial. J Affect Disord 2017; 217:237-245. [PMID: 28433887 DOI: 10.1016/j.jad.2017.04.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 04/06/2017] [Accepted: 04/10/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Depression has become a critical global health problem, affecting millions of people. Cost-effective nonpharmacological treatment in community settings has been proposed to complement medical treatment. Short-term clay art therapy (CAT) is an alternative treatment that promotes the enhancement of various aspects of mental health for depressed individuals. METHODS One-hundred and six adults with depression were randomized into a CAT group or visual art (VA) control group for six 2.5-h weekly sessions. Intervention effects were measured using the Beck Depression Inventory, 12-Item General Health Questionnaire (Chinese version), Body-Mind-Spirit Well-Being Inventory, and 20-Item Toronto Alexithymia Scale (Chinese version) at baseline, immediately postintervention (T1), and 3-weeks postintervention (T2). RESULT Multivariate analysis of covariance results indicated a more significant time × group effect for CAT than for VA on depressive signs, general health, and body-mind-spirit well-being (all p<0.05). Significant within-groups changes were observed in these three aspects after treatment and at T2 (all p<0.001) and in alexithymia at T2 (p<0.01) in the CAT group, but the change was nonsignificant in the VA group at T1 and T2. LIMITATIONS The homogeneity of the participants affected the generalizability of the study findings. The short-term postintervention follow-up (3 weeks) presented difficulties in demonstrating the long-term effects of CAT. CONCLUSIONS CAT can aid emotion regulation and benefit various aspects of mental health in adults. The short duration of the intervention suggests additional application value in treating depression. Further investigation is warranted regarding the potential effect of CAT on alleviating physical symptoms and improving social function.
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Affiliation(s)
- Joshua K M Nan
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong; Centre on Behavioral Health, The University of Hong Kong, Hong Kong.
| | - Rainbow T H Ho
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong; Centre on Behavioral Health, The University of Hong Kong, Hong Kong
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The customer is always right? Subjective target symptoms and treatment preferences in patients with psychosis. Eur Arch Psychiatry Clin Neurosci 2017; 267:335-339. [PMID: 27194554 DOI: 10.1007/s00406-016-0694-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
Clinicians and patients differ concerning the goals of treatment. Eighty individuals with schizophrenia were assessed online about which symptoms they consider the most important for treatment, as well as their experience with different interventions. Treatment of affective and neuropsychological problems was judged as more important than treatment of positive symptoms (p < 0.005). While most individuals had experience with Occupational and Sports Therapy, only a minority had received Cognitive-Behavioral Therapy, Family Therapy, and Psychoeducation with family members before. Patients appraised Talk, Psychoanalytic, and Art Therapy as well as Metacognitive Training as the most helpful treatments. Clinicians should carefully take into consideration patients' preferences, as neglect of consumers' views may compromise outcome and adherence to treatment.
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Lutgens D, Gariepy G, Malla A. Psychological and psychosocial interventions for negative symptoms in psychosis: systematic review and meta-analysis. Br J Psychiatry 2017; 210:324-332. [PMID: 28302699 DOI: 10.1192/bjp.bp.116.197103] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 12/10/2016] [Accepted: 01/27/2017] [Indexed: 01/15/2023]
Abstract
BackgroundNegative symptoms observed in patients with psychotic disorders undermine quality of life and functioning. Antipsychotic medications have a limited impact. Psychological and psychosocial interventions, with medication, are recommended. However, evidence for the effectiveness of specific non-biological interventions warrants detailed examination.AimsTo conduct a meta-analytic and systematic review of the literature on the effectiveness of non-biological treatments for negative symptoms in psychotic disorders.MethodWe searched for randomised controlled studies of psychological and psychosocial interventions in psychotic disorders that reported outcome on negative symptoms. Standardised mean differences (SMDs) in values of negative symptoms at the end of treatment were calculated across study domains as the main outcome measure.ResultsA total of 95 studies met our criteria and 72 had complete quantitative data. Compared with treatment as usual cognitive-behavioural therapy (pooled SMD -0.34, 95% CI -0.55 to -0.12), skills-based training (pooled SMD -0.44, 95% CI -0.77 to -0.10), exercise (pooled SMD -0.36, 95% CI -0.71 to -0.01), and music treatments (pooled SMD -0.58, 95% CI -0.82 to -0.33) provide significant benefit. Integrated treatment models are effective for early psychosis (SMD -0.38, 95% CI -0.53 to -0.22) as long as the patients remain in treatment. Overall quality of evidence was moderate with a high level of heterogeneity.ConclusionsSpecific psychological and psychosocial interventions have utility in ameliorating negative symptoms in psychosis and should be included in the treatment of negative symptoms. However, more effective treatments for negative symptoms need to be developed.
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Affiliation(s)
- Danyael Lutgens
- Danyael Lutgens, MSc, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, Quebec; Genevieve Gariepy, PhD, McGill University, Institute for Health and Social Policy, Montréal, Quebec; Ashok Malla, MD, FRCPC, McGill University, Douglas Mental Health University Institute, Montréal, Quebec, Canada
| | - Genevieve Gariepy
- Danyael Lutgens, MSc, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, Quebec; Genevieve Gariepy, PhD, McGill University, Institute for Health and Social Policy, Montréal, Quebec; Ashok Malla, MD, FRCPC, McGill University, Douglas Mental Health University Institute, Montréal, Quebec, Canada
| | - Ashok Malla
- Danyael Lutgens, MSc, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montréal, Quebec; Genevieve Gariepy, PhD, McGill University, Institute for Health and Social Policy, Montréal, Quebec; Ashok Malla, MD, FRCPC, McGill University, Douglas Mental Health University Institute, Montréal, Quebec, Canada
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Wright T, Andrew T. Art therapy in a Crisis Resolution/Home Treatment Team: report on a pilot project. INTERNATIONAL JOURNAL OF ART THERAPY 2017. [DOI: 10.1080/17454832.2017.1306572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Thomas Z. Breaking Through to the Other Side: A Resident Explores the Benefits of Time-Limited Psychodynamic Therapy for Patients with Schizophrenia. Psychodyn Psychiatry 2017; 45:59-77. [PMID: 28248562 DOI: 10.1521/pdps.2017.45.1.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article recounts the case of a patient with schizophrenia engaged in time-limited psychodynamic psychotherapy with a psychiatry resident-the first case history of its type to the author's knowledge. This patient suffered from chronically debilitating schizophrenia with persistent positive and negative symptoms at the time of treatment, despite usual psychiatric management. He benefited significantly from 18 weekly sessions of weekly dynamic therapy, achieving symptom reduction, increased social involvement, and improved functioning-gains that were sustained at 9-month follow-up. The author narrates the patient's therapeutic progress from a clinician-in-training's perspective, commenting on technical aspects of his treatment. The author examines how the time-limited nature of the therapy may have infused the transference and influenced the patient's outcome. The author also reviews the evidence base for psychodynamic treatment of patients with schizophrenia, focusing on short-term therapy specifically. The author invites greater inquiry into time-limited therapeutic approaches with such patients.
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Affiliation(s)
- Zoë Thomas
- Psychiatry Resident, Department of Psychiatry, McGill University, Montreal, Canada
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Abstract
Art therapy is used as a complementary treatment to antipsychotics in schizophrenia. However, its effectiveness is not clear. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple databases. We identified five systematic reviews including 20 studies overall, of which four were randomized trials. We extracted data and prepared summary of findings tables using the GRADE method. We concluded it is not clear whether art therapy leads to clinical improvement in schizophrenia because the certainty of the evidence is very low.
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Affiliation(s)
- María Isabel Ruiz
- Departamento de Psiquiatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, Proyecto Epistemonikos, Santiago, Chile. . Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 476, Santiago Centro, Chile
| | - David Aceituno
- Departamento de Psiquiatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, Proyecto Epistemonikos, Santiago, Chile
| | - Gabriel Rada
- Proyecto Epistemonikos, Santiago, Chile, Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Attard A, Larkin M. Art therapy for people with psychosis: a narrative review of the literature. Lancet Psychiatry 2016; 3:1067-1078. [PMID: 27528095 DOI: 10.1016/s2215-0366(16)30146-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 06/06/2016] [Accepted: 06/13/2016] [Indexed: 12/15/2022]
Abstract
Art therapy enables individuals to use art to creatively express themselves and communicate differently with themselves, others, and their reality. The National Institute for Health and Clinical Excellence guidelines for psychosis and schizophrenia suggest that arts therapies, which include art therapy, are considered to improve negative symptoms of psychosis. We examined the effectiveness of art therapy for people with psychosis and explored whether art therapy is a meaningful and acceptable intervention in this Review. Seven electronic databases were searched for empirical papers that concerned the use of art therapy for adults with psychosis that were published from 2007 onwards. The search identified 18 papers. High-quality quantitative articles provided inconclusive evidence for the effectiveness of art therapy in adults with psychosis. However, high-quality qualitative articles indicated that therapists and clients considered art therapy to be a beneficial, meaningful, and acceptable intervention, although this conclusion was based on a small number of studies. In this Review, we discuss the theoretical, clinical, and methodological issues in light of the development of more robust research, which is needed to corroborate individuals' experiences and guide evidence-based practice.
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Affiliation(s)
- Angelica Attard
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Michael Larkin
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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Van Lith T. Art therapy in mental health: A systematic review of approaches and practices. ARTS IN PSYCHOTHERAPY 2016. [DOI: 10.1016/j.aip.2015.09.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Segredou I, Christodoulou C, Samakouri M, Antoniadou O, Poulis E, Therapou K, Livaditis M. Psychodynamically Oriented Supportive Group Therapy With Psychotic Patients. SMALL GROUP RESEARCH 2016. [DOI: 10.1177/1046496415626283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This pilot study investigates the contribution of supportive psychodynamically oriented group psychotherapy to the clinical characteristics and functioning of psychotic patients. After a year of group psychotherapy using an intermediary object, the drawings of a number of psychotic patients were inspected separately so as to ascertain the improvement of psychopathological elements depicted. Two groups of 38 patients each, with similar psychopathology, clinical and demographic data were assessed before and after 1 year. One group participated in group psychotherapy, with or without an intermediary object; the other group received standard care. The study demonstrated improvement in functioning, quality of life, positive/negative symptoms, and relapses of hospitalizations for patients participating in group psychotherapy. Moreover, elements that indicate psychopathology declined in the drawings of the group in therapy with an intermediary object. Psychodynamically oriented group psychotherapy, with or without an intermediary object, could be an additional treatment option for psychotic patients.
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Affiliation(s)
| | | | - Maria Samakouri
- Democritus University of Thrace, Alexandroupolis, Greece
- University General Hospital of Alexandroupolis, Evros, Greece
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