Centre for Mental Health, Department of Medicine, Imperial College London, Claybrook Centre, London W6 8LN, UK.
BMJ. 2012 Feb 28;344:e846. doi: 10.1136/bmj.e846.
To evaluate the clinical effectiveness of group art therapy for people with schizophrenia and to test whether any benefits exceed those of an active control treatment.
Three arm, rater blinded, pragmatic, randomised controlled trial.
Secondary care services across 15 sites in the United Kingdom.
417 people aged 18 or over, who had a diagnosis of schizophrenia and provided written informed consent to take part in the study.
Participants, stratified by site, were randomised to 12 months of weekly group art therapy plus standard care, 12 months of weekly activity groups plus standard care, or standard care alone. Art therapy and activity groups had up to eight members and lasted for 90 minutes. In art therapy, members were given access to a range of art materials and encouraged to use these to express themselves freely. Members of activity groups were offered various activities that did not involve use of art or craft materials and were encouraged to collectively select those they wanted to pursue.
The primary outcomes were global functioning, measured using the global assessment of functioning scale, and mental health symptoms, measured using the positive and negative syndrome scale, 24 months after randomisation. Main secondary outcomes were levels of group attendance, social functioning, and satisfaction with care at 12 and 24 months.
417 participants were assigned to either art therapy (n=140), activity groups (n=140), or standard care alone (n=137). Primary outcomes between the three study arms did not differ. The adjusted mean difference between art therapy and standard care at 24 months on the global assessment of functioning scale was -0.9 (95% confidence interval -3.8 to 2.1), and on the positive and negative syndrome scale was 0.7 (-3.1 to 4.6). Secondary outcomes did not differ between those referred to art therapy or those referred to standard care at 12 or 24 months.
Referring people with established schizophrenia to group art therapy as delivered in this trial did not improve global functioning, mental health, or other health related outcomes.
Current Controlled Trials ISRCTN46150447.
评估团体艺术治疗对精神分裂症患者的临床疗效，并检验其疗效是否优于对照治疗。
三臂、设盲评估、实用、随机对照试验。
英国 15 个地点的二级护理服务。
417 名年龄在 18 岁及以上的患者，经诊断患有精神分裂症，并书面同意参与研究。
参与者按地点分层，随机分配接受为期 12 个月的每周团体艺术治疗加标准护理、12 个月的每周活动小组加标准护理或单独标准护理。艺术治疗和活动小组的成员人数最多为 8 人，每次治疗时长为 90 分钟。在艺术治疗中，成员可以使用各种艺术材料，并被鼓励自由表达自己。活动小组的成员则被提供各种不涉及艺术或手工艺品的活动，并被鼓励共同选择他们想参与的活动。
主要结局指标是全球功能，使用功能总体评估量表进行测量；次要结局指标是心理健康症状，使用阳性和阴性症状量表进行测量，测量时间为随机分组后 24 个月。主要次要结局指标是团体出勤率、社会功能和对护理的满意度，分别在 12 个月和 24 个月进行测量。
417 名参与者被分配到艺术治疗组（n=140）、活动小组组（n=140）或标准护理组（n=137）。三组主要结局指标没有差异。在功能总体评估量表上，24 个月时艺术治疗与标准护理之间的调整平均差异为-0.9（95%置信区间-3.8 至 2.1），在阳性和阴性症状量表上的差异为 0.7（-3.1 至 4.6）。在 12 个月或 24 个月时，接受艺术治疗或标准护理的患者的次要结局指标没有差异。
将患有精神分裂症的患者转介至本试验中提供的团体艺术治疗，并未改善其总体功能、心理健康或其他健康相关结局。
当前对照试验 ISRCTN46150447。
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