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Overcoming Disembodiment: The Effect of Movement Therapy on Negative Symptoms in Schizophrenia-A Multicenter Randomized Controlled Trial.

Martin LA, Koch SC, Hirjak D, Fuchs T - Front Psychol (2016)

Bottom Line: Changes in negative symptom scores on the Scale for the Assessment of Negative Symptoms (SANS) were analyzed using Analysis of Covariance (ANCOVA) with Simpson-Angus Scale (SAS) scores as covariates in order to control for side effects of antipsychotic medication.Effect sizes were moderate and mean symptom reduction in the treatment group was 20.65%.RESULTS strongly suggest that BPT/DMT should be embedded in the daily clinical routine.

View Article: PubMed Central - PubMed

Affiliation: Department of Educational Science and Psychology, Free University BerlinBerlin, Germany; Department of Arts Therapies and Therapy Science, Alanus University AlfterAlfter, Germany.

ABSTRACT

Objective: Negative symptoms of patients with Schizophrenia are resistant to medical treatment or conventional group therapy. Understanding schizophrenia as a form of disembodiment of the self, a number of scientists have argued that the approach of embodiment and associated embodied therapies, such as Dance and Movement Therapy (DMT) or Body Psychotherapy (BPT), may be more suitable to explain the psychopathology underlying the mental illness and to address its symptoms. Hence the present randomized controlled trial (DRKS00009828, http://apps.who.int/trialsearch/) aimed to examine the effectiveness of manualized movement therapy (BPT/DMT) on the negative symptoms of patients with schizophrenia.

Method: A total of 68 out-patients with a diagnosis of a schizophrenia spectrum disorder were randomly allocated to either the treatment (n = 44, 20 sessions of BPT/DMT) or the control condition [n = 24, treatment as usual (TAU)]. Changes in negative symptom scores on the Scale for the Assessment of Negative Symptoms (SANS) were analyzed using Analysis of Covariance (ANCOVA) with Simpson-Angus Scale (SAS) scores as covariates in order to control for side effects of antipsychotic medication.

Results: After 20 sessions of treatment (BPT/DMT or TAU), patients receiving movement therapy had significantly lower negative symptom scores (SANS total score, blunted affect, attention). Effect sizes were moderate and mean symptom reduction in the treatment group was 20.65%.

Conclusion: The study demonstrates that embodied therapies, such as BPT/DMT, are highly effective in the treatment of patients with schizophrenia. RESULTS strongly suggest that BPT/DMT should be embedded in the daily clinical routine.

No MeSH data available.


Related in: MedlinePlus

Interaction of the factors Group and Time for the variable SANS-TS. Error bars represent standard errors. Contrasts comparing SANS-TS of treatment and control group independently for the two testing times, reveal significant differences between the groups at T1, which even out at T2. Contrasts analyzing treatment and control group over time show an insignificant increase of negative symptoms in the control group and a significant reduction of negative symptoms in the treatment group. SANS-TS, Scale for the Assessment of Negative Symptoms Total Score; T1/T2, Measuring Time 1/Measuring Time 2.
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Figure 2: Interaction of the factors Group and Time for the variable SANS-TS. Error bars represent standard errors. Contrasts comparing SANS-TS of treatment and control group independently for the two testing times, reveal significant differences between the groups at T1, which even out at T2. Contrasts analyzing treatment and control group over time show an insignificant increase of negative symptoms in the control group and a significant reduction of negative symptoms in the treatment group. SANS-TS, Scale for the Assessment of Negative Symptoms Total Score; T1/T2, Measuring Time 1/Measuring Time 2.

Mentions: Detailed results of the Mixed Model ANCOVA of the SANS total score (SANS-TS) are presented in Table 5 and Figure 2. The covariate SAS-CS, representing the amount of extrapyramidal side effects of participants, was significantly related to the amount of overall negative symptoms. It was therefore considered necessary to take SAS-CS into account as a confounding variable in all following analyses. Controlling for extrapyramidal side effects, the ANCOVA of patient's total scores revealed a highly significant effect of the treatment on the severity of overall negative symptoms: While the main effects of the two factors Group and Time were not significant, their interaction was significant at a level of 0.01. Contrasts, analyzing the two groups over time, displayed a non-significant increase of overall negative symptoms in the control group and a significant reduction of overall negative symptoms in the treatment group (see Table 6). Effect sizes of the interaction effect as well as the reduction in the treatment group depict moderate and therefore clinically substantial effects. Mean symptom reduction of the treatment group accounts for about 20.65% of the baseline symptom score. When the ANCOVA of SANS-TS was repeated with baseline scores as additional covariates, changes in overall negative symptom severity remained significant at a significance level of 0.05 [F(1, 60.01) = 4.73, p = 0.03, r = 0.27], notwithstanding a Bonferroni correction for multiple testing.


Overcoming Disembodiment: The Effect of Movement Therapy on Negative Symptoms in Schizophrenia-A Multicenter Randomized Controlled Trial.

Martin LA, Koch SC, Hirjak D, Fuchs T - Front Psychol (2016)

Interaction of the factors Group and Time for the variable SANS-TS. Error bars represent standard errors. Contrasts comparing SANS-TS of treatment and control group independently for the two testing times, reveal significant differences between the groups at T1, which even out at T2. Contrasts analyzing treatment and control group over time show an insignificant increase of negative symptoms in the control group and a significant reduction of negative symptoms in the treatment group. SANS-TS, Scale for the Assessment of Negative Symptoms Total Score; T1/T2, Measuring Time 1/Measuring Time 2.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4815039&req=5

Figure 2: Interaction of the factors Group and Time for the variable SANS-TS. Error bars represent standard errors. Contrasts comparing SANS-TS of treatment and control group independently for the two testing times, reveal significant differences between the groups at T1, which even out at T2. Contrasts analyzing treatment and control group over time show an insignificant increase of negative symptoms in the control group and a significant reduction of negative symptoms in the treatment group. SANS-TS, Scale for the Assessment of Negative Symptoms Total Score; T1/T2, Measuring Time 1/Measuring Time 2.
Mentions: Detailed results of the Mixed Model ANCOVA of the SANS total score (SANS-TS) are presented in Table 5 and Figure 2. The covariate SAS-CS, representing the amount of extrapyramidal side effects of participants, was significantly related to the amount of overall negative symptoms. It was therefore considered necessary to take SAS-CS into account as a confounding variable in all following analyses. Controlling for extrapyramidal side effects, the ANCOVA of patient's total scores revealed a highly significant effect of the treatment on the severity of overall negative symptoms: While the main effects of the two factors Group and Time were not significant, their interaction was significant at a level of 0.01. Contrasts, analyzing the two groups over time, displayed a non-significant increase of overall negative symptoms in the control group and a significant reduction of overall negative symptoms in the treatment group (see Table 6). Effect sizes of the interaction effect as well as the reduction in the treatment group depict moderate and therefore clinically substantial effects. Mean symptom reduction of the treatment group accounts for about 20.65% of the baseline symptom score. When the ANCOVA of SANS-TS was repeated with baseline scores as additional covariates, changes in overall negative symptom severity remained significant at a significance level of 0.05 [F(1, 60.01) = 4.73, p = 0.03, r = 0.27], notwithstanding a Bonferroni correction for multiple testing.

Bottom Line: Changes in negative symptom scores on the Scale for the Assessment of Negative Symptoms (SANS) were analyzed using Analysis of Covariance (ANCOVA) with Simpson-Angus Scale (SAS) scores as covariates in order to control for side effects of antipsychotic medication.Effect sizes were moderate and mean symptom reduction in the treatment group was 20.65%.RESULTS strongly suggest that BPT/DMT should be embedded in the daily clinical routine.

View Article: PubMed Central - PubMed

Affiliation: Department of Educational Science and Psychology, Free University BerlinBerlin, Germany; Department of Arts Therapies and Therapy Science, Alanus University AlfterAlfter, Germany.

ABSTRACT

Objective: Negative symptoms of patients with Schizophrenia are resistant to medical treatment or conventional group therapy. Understanding schizophrenia as a form of disembodiment of the self, a number of scientists have argued that the approach of embodiment and associated embodied therapies, such as Dance and Movement Therapy (DMT) or Body Psychotherapy (BPT), may be more suitable to explain the psychopathology underlying the mental illness and to address its symptoms. Hence the present randomized controlled trial (DRKS00009828, http://apps.who.int/trialsearch/) aimed to examine the effectiveness of manualized movement therapy (BPT/DMT) on the negative symptoms of patients with schizophrenia.

Method: A total of 68 out-patients with a diagnosis of a schizophrenia spectrum disorder were randomly allocated to either the treatment (n = 44, 20 sessions of BPT/DMT) or the control condition [n = 24, treatment as usual (TAU)]. Changes in negative symptom scores on the Scale for the Assessment of Negative Symptoms (SANS) were analyzed using Analysis of Covariance (ANCOVA) with Simpson-Angus Scale (SAS) scores as covariates in order to control for side effects of antipsychotic medication.

Results: After 20 sessions of treatment (BPT/DMT or TAU), patients receiving movement therapy had significantly lower negative symptom scores (SANS total score, blunted affect, attention). Effect sizes were moderate and mean symptom reduction in the treatment group was 20.65%.

Conclusion: The study demonstrates that embodied therapies, such as BPT/DMT, are highly effective in the treatment of patients with schizophrenia. RESULTS strongly suggest that BPT/DMT should be embedded in the daily clinical routine.

No MeSH data available.


Related in: MedlinePlus