Effectiveness of using calligraphic activity to treat people with schizophrenia: a randomized controlled trial in Southern Taiwan

Abstract

Background: Prior research has shown preliminary evidence that calligraphy activity improves various body functions and decreases severity of psychotic symptoms in individuals with schizophrenia. However, major limitations of earlier studies include small and heterogeneous samples. The current large-scale randomized controlled trial examined effects of calligraphy activity on cognition (including attention), emotions, psychotic symptoms, quality of life, and mood in people with schizophrenia. Methods: One-hundred-and-fifty patients with schizophrenia were randomly allocated to the treatment group (receiving calligraphy activity) or the control group (receiving general activity), both of which lasted for 24 weeks (70 minutes per session; one session per week). Assessments were conducted at pretest, posttest, and three-month follow-up. The Montreal Cognitive Assessment, Chu’s Attention Test, Depression, Anxiety, and Stress Scale, Positive and Negative Syndrome Scale, World Health Questionnaire on the Quality of Life-Brief Form, and Visual Analogue Scale were used. Results: Improved cognition and attention were found in both groups, although no group effects were shown. The treatment group appeared to show lower severity of positive symptoms at follow-up than posttest, whereas the control group appeared to show the opposite pattern. Improved mood was found in the treatment group. Conclusion: This study provides evidence regarding effects of calligraphy activity on increasing cognition and potentially decreasing severity of positive symptoms in patients with schizophrenia. Calligraphy activity can be incorporated in clinical occupational therapy and may be provided to supplement medication treatment. Trial Registration: ClinicalTrials.gov NCT03882619; https://clinicaltrials.gov/ct2/show/NCT03882619

Exploring the link between cognitive deficit, self‐esteem, alexithymia, and depressive symptom of schizophrenia

“…Thus, scientists are looking for the methods of nonpsychotropic drugs to effectively improve these side effects, namely, calligraphy activity (W. Y. Huang et al, 2022), psychotherapy interventions (Roberts et al, 2021), aerobic exercise (Firth et al, 2017), and so forth. Early clinical research reported that the presence of moderate to severe depressive symptoms can occur at any point during SCZ (J.…”

“…However, in view of the lack of efficacy improvement regarding negative symptoms, metabolic syndrome, and cognitive function, the SGAs were limited in clinical application (Divac et al., 2014 ). Thus, scientists are looking for the methods of nonpsychotropic drugs to effectively improve these side effects, namely, calligraphy activity (W. Y. Huang et al., 2022 ), psychotherapy interventions (Roberts et al., 2021 ), aerobic exercise (Firth et al., 2017 ), and so forth. Early clinical research reported that the presence of moderate to severe depressive symptoms can occur at any point during SCZ (J. Huang et al., 2019 ).…”

Effects of Visual Art Therapy on Positive Symptoms, Negative Symptoms, and Emotions in Individuals with Schizophrenia: A Systematic Review and Meta-Analysis

“…The studies were published between 2005 and 2023, with sample sizes ranging from 22 to 140. Two studies were conducted in the United Kingdom [ 35 , 36 ], two in Taiwan [ 37 , 38 ], one each in Germany [ 39 ] and Turkey [ 40 ], and the remaining twenty-five in China [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ]. A total of 3037 individuals with schizophrenia participated in these studies.…”

Rasch Modeling and Differential Item Functioning of the Self-Stigma Scale-Short Version among People with Three Different Psychiatric Disorders

“…The JPC is the largest psychiatric center in Taiwan, and it provides mental health services and psychiatric treatment to people residing in southern Taiwan. Therefore, the JPC could refer to the current study a sufficient number of participants with psychiatric diagnoses of SUDs, ADHD, and SZ [ 30 , 33 , 34 ].…”