Evidence for Treatment Methods for Schizophrenia
Music Therapy
Music therapy is sometimes the therapy of choice for schizophrenia and schizophrenia-like disorders.
Because it is a non-verbal method, it is sometimes preferred. However, is there any evidence for this method? The following is a paper on this topic.
The study
Eighteen studies with a total of 1215 participants are currently included.
These have looked at the effects of music therapy over the short, medium and long term, with treatment doses varying from 7 to 240 sessions.
Overall, most of the information comes from studies with a low or unclear risk of bias.found a positive effect of music therapy on overall state compared to standard treatment. There were no binary data available for other outcomes.
Medium-term continuous data identified a positive effect of music therapy on negative symptoms using a negative symptom rating scale.Endpoint scores for general mental status on the positive and negative symptom scales were better for music therapy.The medium-term mean endpoint scores using the Global Assessment of Functioning did not show an effect of music therapy on general functioning.
However, positive effects of music therapy were found for both social functioning and quality of life.There were no available data on adverse effects, service use, service engagement, or costs.
Conclusion.
Moderate to low quality evidence suggests that music therapy as an addition to standard treatment improves overall status, mental status (including negative and general symptoms), social functioning, and quality of life in people with schizophrenia or schizophrenia-like disorders. However, the effects were not consistent across studies and depended on the number of music therapy sessions and the quality of music therapy provided. Further research should specifically address the long-term effects of music therapy, dose-response relationships, and the relevance of outcome measures related to music therapy.
Geretsegger M, MösslerKA, BieleninikŁ, Chen XJ, Heldal TO, Gold C. Music therapy for people with schizophrenia and schizophrenia-like disorders.Cochrane Database of Systematic Reviews 2017. Issue 5. art. No.: CD004025. doi: 10.1002 / 14651858.CD004025.pub4.
Avatar Therapy
What is avatar therapy? Avatar means a character that serves as your alter ego in games or on the Internet.It uses this technology to create a virtual person, using their face, voice and other sensory input to create an interactive environment.
Some schizophrenic patients suffer from auditory hallucinations.
There is a therapy called avatar therapy, in which an avatar is used to create and interact with the subject of the auditory hallucinations and to approach the auditory hallucinations.
Contents of the study
This review covers three short-term studies with 195 participants.
Avatar therapy was compared to usual care and counseling therapies.
The results from these studies are not of high quality as evidence.
There were some reports of positive effects, but these effects cannot be confirmed because they are too equivocal to make sense as front-line care, and there is a high risk of bias in each result.The risk of Avatar therapy causing problems for patients cannot be ignored.
More trials are needed to establish this therapy, more cooperation from patients and stakeholders is needed, and studies need to be designed to select results that mean something in daily life and provide clear information over months or years to those who are interested.
In case of comparison with regular therapy, there is no significant difference, and there are some experiments that have shown some significant results with avatar therapy slightly in comparison with counseling therapy.
Reviewer's Conclusion
Analysis of the available data indicates that there are very few, if any, consistent effects of avatar therapy on people with schizophrenia experiencing auditory hallucinations. Any effect or suggestion of an effect is uncertain because the risk of bias and clinical implications are unclear. The theory behind avatar therapy is compelling, but the practice needs to be tested in large, lengthy, well-designed, and well-reported randomized trials with the help of, but not under the direction of, the pioneers of avatar therapy.
Aali G, Kariotis T, Shokraneh F. Avatar therapy for people with schizophrenia or related disorders. Cochrane Database of Systematic Reviews 2020, No. 5. Art. No.: CD011898. doi: 10.1002 /14651858.CD011898.pub2.
Testosterone replacement therapy.
There has been a lot of interest in administering sex hormones to treat schizophrenia.Since sex hormones have also received a lot of attention for other reasons, is this a good content for people who have schizophrenia and want to expect a testosterone booster? Here are the conclusions of those research papers.
The Research
Three relevant, small, short trials were found. (total n = 126)
The mean total PANSS score was not significantly different between the DHEA and antipsychotic group and the group that received antipsychotics and placebo. Positive PANSS scores were ambiguous.For negative symptoms, the binary SANS scale data favored the DHEA and antipsychotic groups.
PANSS negative scores were not significantly different between the comparison groups. About 17% of the participants left both groups early.
St. Hans rating scale data for extrapyramidal symptoms favored the DHEA plus antipsychotic group, but ratings for akathisia were ambiguous.
Conclusion.
The results are inconclusive, with most producing insignificant or contradictory results. Currently, adjunctive DHEA should remain an experimental treatment for schizophrenic patients.
Elias A, Kumar A. Testosterone in schizophrenia. Cochrane Database of Systematic Reviews 2007, Issue 3. No.: CD006197. doi: 10.1002 / 14651858.CD006197.pub2.
Chinese herbal medicine
In China, there is a treatment method using Chinese herbal medicine called Wendan Decoction (WDD). This treatment is also used for other conditions besides schizophrenia, but while medication can have benefits, it can also have unexpected side effects.
When it comes to herbal medicines, etc., the number of major adverse effects reported is drastically reduced, but some people may prefer these.
Research
We included 15 randomized trials of WDD for schizophrenia (1437 participants).
There was a high risk of performance bias within trials, but overall, a low risk of selection, attrition, and reporting bias.The data showed that WDD improved participants' short-term overall status compared to placebo or no treatment.
WDD is often used as an add-on intervention along with antipsychotics.
When WDD + antipsychotics was compared to antipsychotics alone, the overall condition was better in the combination group.
When WDD + low-dose antipsychotics were compared with regular-dose antipsychotics alone, the combination again showed effects on short-term global status.For all comparisons, we found no data on outcomes that directly report quality of life, use of hospital services, and economic efficiency.
Conclusion.
The limited evidence suggests that WDD may have some positive short-term overall antipsychotic effects compared with placebo or no treatment. However, when WDDs were compared with other antipsychotics, there was no effect on overall or mental status, but WDDs were associated with fewer side effects. when WDDs were combined with antipsychotics, there were positive effects on overall and mental status, with few negative effects of the combination. The available evidence is of high quality. The available evidence is not of high quality. More well-designed and larger studies are needed to fully and fairly test the effects of WDD on schizophrenic patients.
Deng H, Xu J. Wendan decoction (traditional Chinese herbal medicine), schizophrenia.Cochrane Database of Systematic Reviews 2017, Issue 6. art. No.: CD012217. doi: 10.1002 / 14651858.CD012217.pub2.
Cognitive Behavioral Therapy
Based on the conclusions of the experiments conducted to confirm the therapeutic effects, it seems that the therapeutic effects of cognitive behavioral therapy cannot be proven.
The studies were
The study was based on a review of 60 clinical trials involving 5,922 patients, and included randomly assigned trials of cognitive behavioral therapy and standard treatment.Cognitive-behavioral therapy is designed to help people reevaluate themselves, to tolerate their behavior, and to reduce their distress.
The results of these trials showed that symptom recurrence was possible even with long-term interventions, and that the long-term effects were less durable when compared to standard treatment.
The reviewer's comments were.
Currently, the available evidence on the effects of adding CBT to standard treatment for patients with schizophrenia is unclear and insufficient to draw definite conclusions.
Jones C, Hacker D, Xia J, Meaden A, Irving CB, Zhao S, Chen J, Shi C. Cognitive behavioural therapy plus standard care versus standard care for people with schizophrenia. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD007964. DOI: 10.1002/14651858.CD007964.pub2
