Dance therapy for schizophrenia

Abstract

Background: Dance therapy or dance movement therapy (DMT) is defined as 'the psychotherapeutic use of movement as a process which furthers the emotional, social, cognitive, and physical integration of the individual'. It may be of value for people with developmental, medical, social, physical or psychological impairments. Dance therapy can be practiced in mental health rehabilitation units, nursing homes, day care centres and incorporated into disease prevention and health promotion programmes.

Objectives: To evaluate the effects of dance therapy for people with schizophrenia or schizophrenia-like illnesses compared with standard care and other interventions.

Search methods: We updated the original July 2007 search of the Cochrane Schizophrenia Group' register in July 2012. We also searched Chinese main medical databases.

Selection criteria: We included one randomised controlled trial (RCT) comparing dance therapy and related approaches with standard care or other psychosocial interventions for people with schizophrenia.

Data collection and analysis: We reliably selected, quality assessed and extracted data. For continuous outcomes, we calculated a mean difference (MD); for binary outcomes we calculated a fixed-effect risk ratio (RR) and their 95% confidence intervals (CI). We created a 'Summary of findings' table using the GRADE approach.

Main results: We included one single blind study (total n = 45) of reasonable quality. It compared dance therapy plus routine care with routine care alone. Most people tolerated the treatment package but nearly 40% were lost in both groups by four months (1 RCT n = 45, RR 0.68 95% CI 0.31 to 1.51, low quality evidence). The Positive and Negative Syndrome Scale (PANSS) average endpoint total scores were similar in both groups (1 RCT n = 43, MD -0.50 95% CI -11.80 to 10.80, moderate quality evidence) as were the positive sub-scores (1 RCT n = 43, MD 2.50 CI -0.67 to 5.67, moderate quality evidence). At the end of treatment, significantly more people in the dance therapy group had a greater than 20% reduction in PANSS negative symptom score (1 RCT n = 45, RR 0.62 CI 0.39 to 0.97, moderate quality evidence), and overall, average negative endpoint scores were lower (1 RCT n = 43, MD -4.40 CI -8.15 to -0.65, moderate quality evidence). There was no difference in satisfaction score (average Client's Assessment of Treatment Scale (CAT) score, 1 RCT n = 42, MD 0.40 CI -0.78 to 1.58, moderate quality evidence) and quality of life data were also equivocal (average Manchester Short Assessment of Quality of life (MANSA) score, 1 RCT n = 39, MD 0.00 CI -0.48 to 0.48, moderate quality evidence).

Authors' conclusions: Based on predominantly moderate quality data, there is no evidence to support - or refute - the use of dance therapy in this group of people. This therapy remains unproven and those with schizophrenia, their carers, trialists and funders of research may wish to encourage future work to increase high quality evidence in this area.

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Dance therapy

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Study flow diagram to show trial selection

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Methodological quality summary: review authors' judgements about each methodological quality item for the included study.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

1.1. Analysis

Comparison 1 DANCE THERAPY vs STANDARD CARE, Outcome 1 Leaving the study early.

1.2. Analysis

Comparison 1 DANCE THERAPY vs STANDARD CARE, Outcome 2 Mental state: 1. Total ‐ average score (PANSS total endpoint, high = poor).

1.3. Analysis

Comparison 1 DANCE THERAPY vs STANDARD CARE, Outcome 3 Mental state: 2. Positive symptoms ‐ average score (PANSS positive endpoint, high = poor).

1.4. Analysis

Comparison 1 DANCE THERAPY vs STANDARD CARE, Outcome 4 Mental state: 3a. Negative symptoms ‐ average score (PANSS negative endpoint, high = poor).

1.5. Analysis

Comparison 1 DANCE THERAPY vs STANDARD CARE, Outcome 5 Mental state: 3b. Negative symptoms ‐ not improved (PANSS negative symptom reduction less than 20% ‐ 40%).

1.6. Analysis

Comparison 1 DANCE THERAPY vs STANDARD CARE, Outcome 6 Satisfaction with care: 1. Average endpoint score (CAT, high = good).

1.7. Analysis

Comparison 1 DANCE THERAPY vs STANDARD CARE, Outcome 7 Quality of life: 1. Average endpoint score (MANSA, high = good).