Study challenges guidelines on art therapy for people with schizophrenia

The findings challenge national treatment guidelines which recommend that doctors consider referring all people with schizophrenia for arts therapies.

Schizophrenia is a severe mental disorder which affects as many as one in 100 people at some point in their lives. While antipsychotic medication can reduce symptoms, many people continue to experience poor mental health and social functioning.

Art therapy has been used as an additional treatment for people with schizophrenia, and is recommended in national treatment guidelines, but few studies have examined its clinical effects.

So a team of UK researchers set out to examine the impact of group art therapy for people with schizophrenia compared with an active control treatment and standard care alone.

The study involved 417 people aged 18 or over with a diagnosis of schizophrenia. Participants were split into three groups: 12 months of weekly group art therapy plus standard care; 12 months of weekly activity groups plus standard care; or standard care alone.

Art therapy patients were given access to a range of art materials and encouraged to use these to express themselves freely. Activity group patients were encouraged to take part in activities such as playing board games, watching and discussing DVDs, and visiting local cafes. The use of art materials was prohibited.

Outcome measures included global functioning (ability to carry out usual daily activities), mental health symptoms, social functioning and satisfaction with care. Levels of attendance at both art therapy and activity groups were low.

No differences in global functioning and mental health symptoms were found between the three groups, and no differences in social functioning and satisfaction with care were found between art therapy and standard care groups.

The authors conclude: "While we cannot rule out the possibility that group art therapy benefits a minority of people who are highly motivated to use this treatment, we did not find evidence that it leads to improved patient outcomes when offered to most people with schizophrenia."

However, they add that studies of other creative therapies for people with schizophrenia, such as music therapy and body movement therapy, are more promising, and that it may be only when such activities are combined with other interventions that benefits are seen.

In an accompanying editorial, Tim Kendall, Director at the National Collaborating Centre for Mental Health, suggests that art therapy is unlikely to be of clinical benefit for people suffering from schizophrenia, but it still has great potential for success in the treatment of negative symptoms.

Provided by British Medical Journal