Intervention Review

Drama therapy for schizophrenia or schizophrenia-like illnesses

  1. Rachel Ruddy1,*,
  2. Kim Dent-Brown2

Editorial Group: Cochrane Schizophrenia Group

Published Online: 24 JAN 2007

Assessed as up-to-date: 13 NOV 2006

DOI: 10.1002/14651858.CD005378.pub2


How to Cite

Ruddy R, Dent-Brown K. Drama therapy for schizophrenia or schizophrenia-like illnesses. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD005378. DOI: 10.1002/14651858.CD005378.pub2.

Author Information

  1. 1

    University of Leeds, Academic Unit of Psychiatry & Behavioural Sciences, Leeds, UK

  2. 2

    Sheffield Centre for Health and Related Research, Sheffield, UK

*Rachel Ruddy, Academic Unit of Psychiatry & Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds, LS2 9LT, UK. R.A.Ruddy@leeds.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 24 JAN 2007

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Medication is the mainstay of treatment for schizophrenia or schizophrenia-like illnesses, but many people continue to experience symptoms in spite of medication (Johnstone 1998). In addition to medication, creative therapies, such as drama therapy may prove beneficial. Drama therapy is a form of treatment that encourages spontaneity and creativity. It can promote emotional expression, but does not necessarily require the participant to have insight into their condition or psychological-mindset.

Objectives

To review the effects of drama therapy and related approaches as an adjunctive treatment for schizophrenia compared with standard care and other psychosocial interventions.

Search methods

We searched the Cochrane Schizophrenia Group's Register (October 2006), hand searched reference lists, hand searched Dramatherapy (the journal of the British Association of Dramatherapists) and Arts in Psychotherapy and contacted relevant authors.

Selection criteria

We included all randomised controlled trials that compared drama therapy, psychodrama and related approaches with standard care or other psychosocial interventions for schizophrenia.

Data collection and analysis

We reliably selected, quality assessed and extracted data from the studies. We excluded data where more than 50% of participants in any group were lost to follow up. For continuous outcomes we calculated a weighted mean difference and its 95% confidence interval. For binary outcomes we calculated a fixed effects risk ratio (RR), its 95% confidence interval (CI) and a number needed to treat (NNT).

Main results

The search identified 183 references but only five studies (total n=210) met the inclusion criteria. All of the studies were on inpatient populations and compared the intervention with standard inpatient care. One study had drama therapy as the intervention, one had role-playing, one had a social drama group and two used psychodrama. Two of the included studies were Chinese and it is difficult to know whether psychodrama and indeed inpatient psychiatric care in China is comparable with the drama interventions and inpatient care in the other included studies. There were no significant findings about the value of drama interventions for keeping inpatients engaged in treatment. Due to poor reporting very little data from the five studies could be used and there were no conclusive findings about the harms or benefits of drama therapy for inpatients with schizophrenia.

Authors' conclusions

Randomised studies are possible in this field. The use of drama therapy for schizophrenia and schizophrenia-like illnesses should continue to be under evaluation as its benefits, or harms, are unclear.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Drama therapy for schizophrenia or schizophrenia-like illnesses

Drama therapy is one of the creative therapies suggested to be of value as an adjunctive treatment for people with schizophrenia or schizophrenia-like illnesses. Randomised studies have been successfully conducted in this area but poor study reporting meant that no conclusions could be drawn from them. The benefits or harms of the use of drama therapy in schizophrenia are therefore unclear and further large, high quality studies are required to determine the true value of drama therapy for schizophrenia or schizophrenia-like illnesses.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

精神分裂或類精神分裂疾病的戲劇治療

要務是精神分裂或類精神分裂疾病的唯一治療,但許多患者在藥物治療下仍持續有精神症狀(Johnstone 1998)。除了藥物治療以外,創造性的治療,如戲劇治療,也許能證明其效益。戲劇治療是一種鼓勵自發與創造性的治療。它能夠促進情緒表達,但不需要參與者對她們的狀況具有病識感或心理感知。

目標

回顧針對精神分裂患者以戲劇治療及相關取向作為附屬治療的效果,與標準照護或其他心理社會介入措施相比較。

搜尋策略

我們搜尋Cochrane Schizophrenia Group的臨床登錄(2006年10月),徒手搜尋文獻清單,戲劇治療(the journal of the British Association of Dramatherapists),以及心理治療中的藝術,並且聯絡相關的作者。

選擇標準

我們搜尋所有針對精神分裂患者的戲劇治療、心理劇,及相關取向,與標準照護或其他心理社會介入措施相比較的隨機試驗。

資料收集與分析

我們從研究中有效地選擇、有品質地評估與取出資料。只要任何一個團體在追蹤時期有超過50%的參與者無法追蹤,我們便排除此筆資料。我們更近一步計算出加權平均值差異,及95%信賴區間。我們計算了固定效果的風險值(RR),95%的信賴區間,以及必須治療的數目(NNT)。

主要結論

本研究找到了183篇文獻,但只有5個研究符合納入標準(總樣本數210)。所有的研究都是以住院病人為主體,以接受標準照護程序的病人為對照組。一個研究以戲劇治療介入,一個是角色扮演,一個是社會劇,另外兩個是心理劇。納入標準中的兩個研究是中文的,很難知道在中國的心理劇住院患者的精神科照顧,的確能夠與其他研究的戲劇治療介入及住院患者的兆互相比較。由於這5個研究能用的資料太少,並未發現以戲劇治療住院的精神分裂患者具有傷害性或效益存在。

作者結論

在這個領域中,隨機研究是可行的。對精神分裂及類精神分裂疾病採取戲劇治療,其效益或傷害性仍不清楚,需要繼續評估。

翻譯人

本摘要由彰化基督教醫院陳美貴翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

戲劇治療是一種創造性治療,在精神分裂與類精神分裂症患者的附屬治療上是有益的。在這個領域可成功地實施隨機研究,但只有很少的研究顯示出有意義的結論。因此對精神分裂症患者進行戲劇治療的效益或損害並不清楚,需要未來更高品質的研究來確定對對精神分裂及類精神分裂患者採取戲劇治療的真正效果。