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17 May 2006
Body–oriented psychological therapy (BPT) may be effective for the treatment of persistent negative symptoms in patients with schizophrenia, exploratory trial data show.
"The approach of body-oriented interventions is based on phenomenological findings and the assumption that movement and emotional experiences are biologically and experientially associated," note Frank Röhricht (Newham Centre for Mental Health, London, UK) and Stefan Priebe (Barts and The London Queen Mary's School of Medicine and Dentistry, UK).
"This is supported by close anatomical and functional links between the limbic system, particularly the extended amygdala, and the basal ganglia."
The researchers investigated the potential for such therapy to reduce negative symptoms in 24 outpatients with schizophrenia. To control for the influence of non-specific attention and structured group activities, BPT was compared with supportive counseling, which was received by 21 schizophrenia patients.
The aims of BPT were to overcome communication barriers through non-verbal techniques; refocus cognitive and emotional awareness towards the body; stimulate activity and emotional responsiveness; promote exploration of self-potentials, focusing on body strength and capability; modify dysfunctional self-perception; and address common psychopathological features.
Each participant received 20 sessions of therapy in addition to treatment as usual.
Patients undergoing BPT attended more sessions than those assigned to supportive counseling, and had significantly lower negative symptoms scores on the Positive and Negative Symptom scale at the end of the trial.
Indeed, 50% of patients receiving BPT achieved a 20% or greater reduction in negative symptoms from baseline, compared with just 21% of those receiving supportive counseling.
"The findings did not suggest an influence of potentially confounding factors, ie, antipsychotic medication, extrapyramidal symptoms, improvement of positive symptoms, on the different treatment effect in the two groups," the investigators report in the journal Psychological Medicine.
Patients' assessment of treatment was broadly positive and their rating of the therapeutic relationship generally appreciative, with no significant differences between the two treatments.
"BPT was accepted by patients and associated with a favorable effect," Röhricht and co-workers comment. "The effect size was substantial and at least as high as those reported in the literature for antipsychotic medication and cognitive-behavioral therapy."
The team says further detailed studies to explore the therapeutic mechanisms involved in BPT are warranted.
Source: Psychol Med 2006; 36: 669–678
©2006 Current Medicine Group Ltd
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