Ruddy R, Milnes D
Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds, West Yorkshire, UK, LS2 9LT.
Cochrane Database Syst Rev. 2003(2):CD003728. doi: 10.1002/14651858.CD003728.
Medication is the mainstay of treatment for schizophrenia or schizophrenia-like illnesses. Many people, however, continue to experience symptoms in spite of medication. In addition to medication, creative therapies, such as art therapy may be helpful. Art therapy allows exploration of the patient's inner world in a non-threatening way through a therapeutic relationship and the use of art materials. It was mainly developed in adult psychiatric inpatient units and was designed for use with people in whom verbal psychotherapy would be impossible.
To review the effects of art therapy as an adjunctive treatment for schizophrenia compared with standard care and other psychosocial interventions.
We searched the Cochrane Schizophrenia Group's Register (May 2002), hand searched reference lists and 'Inscape' (the Journal of the British Association of Art Therapists), and contacted relevant authors.
All randomised controlled trials that compared art therapy with standard care or other psychosocial interventions for schizophrenia.
Studies were reliably selected, quality assessed and data extracted. Data were excluded where more than 50% of participants in any group were lost to follow up. For binary outcomes we calculated a fixed effects risk ratio (RR) and its 95% confidence interval (CI).
The search identified 57 reports but only two studies (total n=137) met the inclusion criteria. Both compared art therapy plus standard care with standard care alone. Fewer people allocated to art therapy left the study before 20 weeks compared with those given standard care alone (n=47, 1 RCT, RR 0.34 CI 0.15 to 0.8, NNT 3 CI 1.5 to 7). Measures of change in mental state, interpersonal relationships and social networking were reported but the data were too problematic to interpret with confidence. Much data was lost due to poor reporting or inappropriate use of scales.
REVIEWER'S CONCLUSIONS: Randomised studies have been proven to be possible in this field. The use of art therapy for serious mental illnesses should continue to be under evaluation as its benefits, or harms, are unclear.
药物治疗是精神分裂症或精神分裂症样疾病治疗的主要手段。然而，许多人尽管接受了药物治疗，仍会出现症状。除药物治疗外，创造性疗法，如艺术疗法可能会有所帮助。艺术疗法通过治疗关系和使用艺术材料，以一种无威胁的方式让患者探索内心世界。它主要在成人精神科住院部发展起来，专为无法进行言语心理治疗的人群设计。
比较艺术疗法与标准护理及其他心理社会干预措施，作为精神分裂症辅助治疗的效果。
我们检索了Cochrane精神分裂症研究组登记册（2002年5月），手工检索参考文献列表和《Inscape》（英国艺术治疗师协会杂志），并联系了相关作者。
所有比较艺术疗法与精神分裂症标准护理或其他心理社会干预措施的随机对照试验。
可靠地选择研究、评估质量并提取数据。如果任何组中超过50%的参与者失访，则排除数据。对于二元结局，我们计算了固定效应风险比（RR）及其95%置信区间（CI）。
检索到57篇报告，但只有两项研究（共137例）符合纳入标准。两项研究均比较了艺术疗法加标准护理与单纯标准护理。与单纯接受标准护理的人相比，接受艺术疗法的人中在20周前退出研究的人数更少（n = 47，1项随机对照试验，RR 0.34，CI 0.15至0.8，NNT 3，CI 1.5至7）。报告了精神状态、人际关系和社交网络变化的测量结果，但数据问题太多，无法自信地解释。由于报告不佳或量表使用不当，许多数据丢失。
已证明在该领域进行随机研究是可行的。由于艺术疗法的益处或危害尚不清楚，其在严重精神疾病中的应用应继续接受评估。
