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精神分裂症的舞蹈疗法。

Dance therapy for schizophrenia.

作者信息

Xia Jun, Grant Tessa Jane

机构信息

Cochrane Schizophrenia Group, Bridge House, Balm House, Leeds, UK, LS10 2TP.

出版信息

Cochrane Database Syst Rev. 2009 Jan 21(1):CD006868. doi: 10.1002/14651858.CD006868.pub2.

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 programs.

OBJECTIVES

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

SEARCH STRATEGY

We searched the Cochrane Schizophrenia Group Trials Register (July 2007), inspected references of all identified studies (included and excluded), and contacted first authors for additional data.

SELECTION CRITERIA

We included all randomised controlled trials (RCTs) 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. We excluded data where more than 30% of participants were lost to follow-up. For continuous outcomes we calculated a weighted mean difference; for binary outcomes we calculated a fixed-effect risk ratio (RR) and their 95% confidence intervals (CI).

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 about 40% were lost in each group by four months (RR 0.68 CI 0.31 to 1.51). PANSS average endpoint total scores were similar in each group (WMD -0.50 CI -11.8 to 10.8) as were the positive subscores (WMD 2.50 CI -0.67 to 5.67). At the end of treatment significantly more people in the dance therapy group had a greater than 20% reduction in PANSS negative symptom score (RR 0.62 CI 0.39 to 0.97), and overall average negative endpoint scores were lower (WMD -4.40 CI -8.15 to 0.65). There was no difference in satisfaction score (average CAT score, WMD 0.40 CI -0.78 to 1.58) and quality of life data were also equivocal (average MANSA score, WMD 0.00 CI -0.48 to 0.48).

AUTHORS' CONCLUSIONS: 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.

摘要

背景

舞蹈治疗或舞动治疗(DMT)被定义为“将动作作为一种心理治疗手段,以此促进个体在情感、社交、认知和身体方面的整合”。对于患有发育、医学、社会、身体或心理障碍的人群而言,它可能具有价值。舞蹈治疗可在心理健康康复机构、养老院、日间护理中心开展,并纳入疾病预防和健康促进项目。

目的

评估与标准护理及其他干预措施相比,舞蹈治疗对精神分裂症或类精神分裂症患者的效果。

检索策略

我们检索了Cochrane精神分裂症研究组试验注册库(2007年7月),查阅了所有已识别研究(包括纳入和排除的研究)的参考文献,并联系第一作者获取更多数据。

选择标准

我们纳入了所有比较舞蹈治疗及相关方法与标准护理或其他针对精神分裂症患者的心理社会干预措施的随机对照试验(RCT)。

数据收集与分析

我们可靠地选择、评估质量并提取数据。若超过30%的参与者失访,我们将排除相关数据。对于连续性结局,我们计算加权平均差;对于二分结局,我们计算固定效应风险比(RR)及其95%置信区间(CI)。

主要结果

我们纳入了一项质量尚可的单盲研究(共45例)。该研究比较了舞蹈治疗加常规护理与单纯常规护理。大多数人能耐受该治疗方案,但每组约40%的人在四个月时失访(RR 0.68,CI 0.31至1.51)。每组的PANSS平均终点总分相似(加权平均差 -0.50,CI -11.8至10.8),阳性子分数也相似(加权平均差2.50,CI -0.67至5.67)。治疗结束时,舞蹈治疗组中PANSS阴性症状评分降低超过20%的人数显著更多(RR 0.62,CI 0.39至0.97),且总体平均阴性终点评分更低(加权平均差 -4.40,CI -8.15至0.65)。满意度评分无差异(平均CAT评分,加权平均差0.40,CI -0.78至1.58),生活质量数据也不明确(平均MANSA评分,加权平均差0.00,CI -0.48至0.48)。

作者结论

没有证据支持或反驳在这类人群中使用舞蹈治疗。这种治疗方法仍未得到证实,精神分裂症患者及其护理人员、试验者和研究资助者可能希望鼓励未来开展工作,以增加该领域的高质量证据。

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