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Morita therapy for schizophrenia

  • Review
  • Intervention




Morita therapy was founded in 1919 by Shoma Morita (1874-1938). The therapy involves a behavioural structured program to encourage an outward perspective on life and increased social functioning.


To evaluate the effects of Morita therapy for schizophrenia and schizophrenia-like psychoses.

Search methods

We searched the Cochrane Schizophrenia Groups Trials Register, the Chongqing VIP Database, and the Wanfang Database (July 2008) for all relevant references. The first author of each included study was also contacted.

We updated this search (July 2012) and added the results to the awaiting classification section of the review.

Selection criteria

We included all randomised clinical trials comparing Morita therapy with any other treatment.

Data collection and analysis

We reliably selected studies and extracted data. For homogenous dichotomous data we calculated random-effects, relative risk (RR), 95% confidence intervals (CI) and, where appropriate, numbers needed to treat (NNT) on an intention-to-treat basis. For continuous data, we calculated weighted mean differences (WMD).

Main results

We found 12 small, studies of medium-poor quality (total n=1123). The standard care versus Morita therapy comparison (total n=761 people) had very low attrition (<2%, 10 RCTs, RR 1.01 CI 0.4 to 2.8). Mental state did tend to improve with Morita therapy (n=76, 1 RCT, number of >25-30% decline in BPRS, RR 0.36 CI 0.1 to 0.9, NNT 5 CI 4 to 25). For negative symptoms data were inconsistent, with data from four short-term trials favouring Morita therapy (n=323, WMD average endpoint SANS -12.94 CI -21.6 to -4.3), but heterogeneity was considerable (I2 =97%). In medium-term studies, negative symptoms were favoured by Morita therapy (n=44, 1 RCT, RR >25% decline SANS 0.25 CI 0.1 to 0.8, NNT 3 CI 2 to 8). Morita therapy plus standard treatment did significantly improve the activities of daily living compared with standard treatment alone (n=104, 1 RCT, WMD -4.1 average endpoint ADL CI -7.7 to -0.6). Compared with a rehabilitation programme Morita therapy did not promote attrition (n=302, 2 RCTs, RR leaving early 1.00 CI 0.5 to 2.1). In two very similar studies Morita therapy showed better effect on mental state with lower BPRS score (n=278, 2 RCTs, WMD average endpoint BPRS -6.95 CI -9.3 to -4.6, I2 =0%), insight score (n=278, 2 RCTs, WMD average endpoint clinical judgement score -1.11 CI -1.3 to -0.9, I2 = 0%) and social functioning (n=278, WMD average endpoint IPROS -18.14 CI -21.3 to -15.0, I2 =0%).

Authors' conclusions

Morita therapy for schizophrenia remains an experimental intervention. New trials are justified and specific plans for the design of future studies are outlined.

[Note: the 10 citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]








すべての関連参考文献について、Cochrane Schizophrenia Groups Trials Register、Chongqing VIP DatabaseおよびWanfang Database(2008年7月)を検索した。また、各対象研究の筆頭著者に問い合わせを行った。







研究の質が中から低の小規模研究12件を同定した(n = 1123)。標準治療と森田療法を比較した結果(n = 761)、症例減少率はきわめて低かった(2%未満、RCT10件、RR 1.01 CI 0.4〜2.8)。森田療法では、精神状態の改善傾向が認められた(n=76、RCT1件、BPRSの低下が25超〜30%の数、RR 0.36 CI 0.1〜0.9、NNT 5 CI 4〜25)。森田療法の有益性を示唆する短期試験4件のデータでは、陰性症状のデータに一貫性が認められなかったが(n = 323、WMD平均エンドポイントSANS -12.94 CI -21.6〜-4.3)、異質性が顕著であった(I2 = 97%)。 中期的な試験では、森田療法による陰性症状の改善が認められた(n = 44、RCT1件、SANSの低下が25%超RR 0.25 CI 0.1〜0.8、NNT 3 CI 2〜8)。森田療法+標準治療では、標準治療単独の場合と比較して日常生活動作の有意な改善が認められた(n = 104、RCT1件、WMD -4.1平均エンドポイントADL CI -7.7~-0.6)。森田療法は、リハビリテーションプログラムと比較して消耗期の改善が認められなかった(n = 302、RCT2件、早期離脱RR 1.00 CI 0.5〜2.1)。2件のきわめて類似した研究では、森田療法は精神状態に対する効果が高く、BPRSスコア(n = 278、RCT2件、WMD平均エンドポイントBPRS -6.95 CI -9.3〜-4.6、I2 = 0%)、洞察力スコア(n = 278、RCT2件、WMD平均エンドポイント臨床評価スコア-1.11 CI -1.3〜-0.9、I2 = 0%)および社会的機能(n = 278、WMD 平均エンドポイントIPROS -18.14 CI -21.3〜- 15.0、I2 = 0%)は低値を示した。





《注意》この日本語訳は、臨床医、疫学研究者などによる翻訳のチェックを受けて公開していますが、訳語の間違いなどお気づきの点がございましたら、eJIM事務局までご連絡ください。なお、2013年6月からコクラン・ライブラリーのNew review, Updated reviewとも日単位で更新されています。eJIMでは最新版の日本語訳を掲載するよう努めておりますが、タイム・ラグが生じている場合もあります。ご利用に際しては、最新版(英語版)の内容をご確認ください。

Plain language summary

Morita therapy for schizophrenia

Schizophrenia is a long-term, chronic illness with a high disability rate and disease burden. Treatment for schizophrenia should focus on the wider social aspects of living in the community in addition to medicating the immediate symptoms of this long-term illness. Reliance on medication alone is insufficient, especially for patients with an illness which is often very debilitating. There are several kinds of intervention strategies available, often involving both the individual sufferer and the wider family unit; Morita therapy being one of these.

Morita therapy is a systematic psychotherapy based on Eastern psychology. The aim of this type of therapy is to alleviate the anxiety of sufferers and eliminate neurotic symptoms by encouraging the patient to accept anxiety as a natural state, whilst at the same time engaging them in constructive behaviours via four phases. To date the efficacy of Morita therapy for schizophrenia has not been verified systematically. In this review we analysed the effects of Morita therapy in hospital settings for people with schizophrenia or schizophrenia-like conditions.

We were only able to include 12 studies, which varied in terms of the number of treatment phases used, and duration of treatment. Six studies were not blinded and four were inadequately randomised. Results indicate Morita therapy may have some early positive effects, but there is no data to assess whether this can be sustained in the long term. This review highlights the need for better-designed studies to assess the efficacy of this therapy in the treatment of schizophrenia.







《注意》この日本語訳は、臨床医、疫学研究者などによる翻訳のチェックを受けて公開していますが、訳語の間違いなどお気づきの点がございましたら、eJIM事務局までご連絡ください。なお、2013年6月からコクラン・ライブラリーのNew review, Updated reviewとも日単位で更新されています。eJIMでは最新版の日本語訳を掲載するよう努めておりますが、タイム・ラグが生じている場合もあります。ご利用に際しては、最新版(英語版)の内容をご確認ください。