Group art therapy as an adjunctive treatment for people with schizophrenia: a randomised controlled trial (MATISSE).

Crawford, Mike; Killaspy, Helen; Barnes, Thomas R. E.; Barrett, Barbara; Byford, Sarah; Clayton, Katie; Dinsmore, John; Floyd, Sian; Hoadley, Angela; Johnson, Tony; Kalaitzaki, Eleftheria; King, Michael; Leurent, Baptiste; Maratos, Anna; O'Neill, F. Anthony; Osborn, David; Patterson, Sue; Soteriou, Tony; Tyrer, Peter; Waller, Diane

doi:10.3310/hta16080

Cited by 51 publications

(79 citation statements)

References 71 publications

(22 reference statements)

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“…8 In this study, no significant improvements in either negative symptoms or any of the secondary outcomes were found in the art therapy group, relative to either the active control group or standard care. The MATISSE trial 8 was designed as a pragmatic trial with the aim of testing the impact of group art therapy delivered in current clinical practice, meaning that one specific model of therapy was not evaluated. Consequently, the type of treatment provided was not consistently applied, which has been criticised by some art therapists, who have suggested that what was evaluated is not what is routinely delivered in the UK.…”

Section: Schizophrenia and Arts Therapiescontrasting

confidence: 50%

“…This could be considered relatively high and compares favourably with a similar trial in art therapy on this patient sample. 8 In this study, 8 participants typically reported a long duration of illness (median 11 years, IQR = 7-18), with multiple hospital admissions (median 3, IQR = 1-5) and moderate negative symptoms (PANSS negative 23.2, SD = 4.3). Overall, the participant characteristics of the sample should be considered to be both representative of the schizophrenia population in secondary care in the UK and the types of patients who would be considered appropriate for focused treatments for negative symptoms.…”

Section: Discussionmentioning

confidence: 92%

“…Following the MATISSE trial, 8 a second important issue is that it is not currently clear whether any lack of effectiveness in the treatment of negative symptoms is specific to the art therapy that was delivered in this context or endemic to all 'arts therapies' as a whole. In recognition of this, the MATISSE 8 trial research recommendations suggest that 'Data from exploratory trials of other creative therapies, including music therapy and body movement therapy, have shown promising results and randomised trials examining the clinical effectiveness and cost-effectiveness of offering these interventions to people with schizophrenia should be conducted' (p. xii).…”

Section: Schizophrenia and Arts Therapiesmentioning

confidence: 99%

“…In recognition of this, the MATISSE 8 trial research recommendations suggest that 'Data from exploratory trials of other creative therapies, including music therapy and body movement therapy, have shown promising results and randomised trials examining the clinical effectiveness and cost-effectiveness of offering these interventions to people with schizophrenia should be conducted' (p. xii). 8 Therefore, research on other arts therapies modalities might help to assess whether the lack of efficacy of art therapy on negative symptoms is particular to this type of psychotherapy or is indicative of arts therapies as a whole.…”

Section: Schizophrenia and Arts Therapiesmentioning

confidence: 99%

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Clinical effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia: a multicentre randomised controlled trial

Priebe

Savill

Wykes

et al. 2016

Health Technol Assess

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BackgroundThe negative symptoms of schizophrenia significantly impact on quality of life and social functioning, and current treatment options are limited. In this study the clinical effectiveness and cost-effectiveness of group body psychotherapy as a treatment for negative symptoms were compared with an active control.DesignA parallel-arm, multisite randomised controlled trial. Randomisation was conducted independently of the research team, using a 1 : 1 computer-generated sequence. Assessors and statisticians were blinded to treatment allocation. Analysis was conducted following the intention-to-treat principle. In the cost-effectiveness analysis, a health and social care perspective was adopted.ParticipantsEligibility criteria: age 18–65 years; diagnosis of schizophrenia with symptoms present at > 6 months; score of ≥ 18 on Positive and Negative Syndrome Scale (PANSS) negative symptoms subscale; no change in medication type in past 6 weeks; willingness to participate; ability to give informed consent; and community outpatient. Exclusion criteria: inability to participate in the groups and insufficient command of English.SettingsParticipants were recruited from NHS mental health community services in five different Trusts. All groups took place in local community spaces.InterventionsControl intervention: a 10-week, 90-minute, 20-session group beginners’ Pilates class, run by a qualified Pilates instructor. Treatment intervention: a 10-week, 90-minute, 20-session manualised group body psychotherapy group, run by a qualified dance movement psychotherapist.OutcomesThe primary outcome was the PANSS negative symptoms subscale score at end of treatment. Secondary outcomes included measures of psychopathology, functional, social, service use and treatment satisfaction outcomes, both at treatment end and at 6-month follow-up.ResultsA total of 275 participants were randomised (140 body psychotherapy group, 135 Pilates group). At the end of treatment, 264 participants were assessed (137 body psychotherapy group, 127 Pilates group). The adjusted difference in means of the PANSS negative subscale at the end of treatment was 0.03 [95% confidence interval (CI) –1.11 to 1.17], showing no advantage of the intervention. In the secondary outcomes, the mean difference in the Clinical Assessment Interview for negative symptoms expression subscale at the end of treatment was 0.62 (95% CI –1.23 to 0.00), and in extrapyramidal movement disorder symptoms –0.65 (95% CI –1.13 to –0.16) at the end of treatment and –0.58 (95% CI –1.07 to –0.09) at 6 months’ follow-up, showing a small significant advantage of body psychotherapy. No serious adverse events related to the interventions were reported. The total costs of the intervention were comparable with the control, with no clear evidence of cost-effectiveness for either condition.LimitationsOwing to the absence of a treatment-as-usual arm, it is difficult to determine whether or not both arms are an improvement over routine care.ConclusionsIn comparison with an active control, group body psychotherapy does not have a clinically relevant beneficial effect in the treatment of patients with negative symptoms of schizophrenia. These findings conflict with the review that led to the current National Institute for Health and Care Excellence guidelines suggesting that arts therapies may be an effective treatment for negative symptoms.Future workDetermining whether or not this lack of effectiveness extends to all types of art therapies would be informative.Trial registrationCurrent Controlled Trials ISRCTN842165587.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 11. See the NIHR Journals Library website for further project information.

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Section: Schizophrenia and Arts Therapiescontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 92%

Section: Schizophrenia and Arts Therapiesmentioning

confidence: 99%

Section: Schizophrenia and Arts Therapiesmentioning

confidence: 99%

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Clinical effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia: a multicentre randomised controlled trial

Priebe

Savill

Wykes

et al. 2016

Health Technol Assess

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“…• • Art therapy is included in the UK NICE clinical guideline on the treatment and management of psychosis and schizophrenia in adults (NICE, 2014), but RCT evidence is inconclusive (Crawford, 2012). • • Music therapy has a long history in schizophrenia and recent trials support its efficacy in social domains and quality of life (Grocke et al, 2009(Grocke et al, , 2014Mössler et al, 2011).…”

Section: Emerging Psychological and Psychosocial Therapiesmentioning

confidence: 99%

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Galletly

Castle

Dark

et al. 2016

Aust N Z J Psychiatry

641

672

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Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. Methods:The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. RANZCP GuidelinesGalletly et al. 411 Australian & New Zealand Journal of Psychiatry, 50(5)Results: The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. Conclusions:This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.

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Positive Clinical Psychology and the Promotion of Happiness, Compassion, and Autonomy in People with Psychosis

Hutton¹

2016

The Wiley Handbook of Positive Clinical Psychology

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Group art therapy as an adjunctive treatment for people with schizophrenia: a randomised controlled trial (MATISSE).

Cited by 51 publications

References 71 publications

Clinical effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia: a multicentre randomised controlled trial

Clinical effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia: a multicentre randomised controlled trial

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

Positive Clinical Psychology and the Promotion of Happiness, Compassion, and Autonomy in People with Psychosis

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