ABSTRACT
BACKGROUND: Patients with schizophrenia frequently undergo a disturbance of body experience. This can occur during an acute psychotic phase or during a period of remission. AIM: To investigate the scientific evidence of the effects of introducing body-directed techniques into psychomotor therapy for patients with schizophrenia. METHOD: PubMed, PEDro, CINAHL, psycINFO and SPORTDiscus were searched form 1 January, 2000, tot 1 January 2011, for reports of randomised controlled trials, controlled clinical trials and for studies wit a different design. The Tijdschrift voor Psychiatrie (the Dutch Journal of Psychiatry), the Tijdschrift voor Vaktherapie (The Journal for Special therapies) and Actuele Themata (Actual Themes) in psychomotor therapy were also screened. The quality of the methodology was assessed with the help of a checklist. Evidence for the efficacy of the interventions was summarised on the basis of a best-evidence synthesis. RESULT: Eleven studies satisfied our inclusion and exclusion criteria. There was a strong evidence for the reduction of psychiatric symptoms after yoga and reduced feelings of anxiety and stress after progressive muscle relaxation. There is limited evidence for yoga in reducing feelings of anxiety and stress and for body-directed group techniques in reducing negative symptoms. Qualitative research reported that mindfulness and massage-techniques were able to considerably reduce feelings of stress. There is no evidence for the beneficial effects of dancing techniques. CONCLUSION: A body-directed approach can be effective an deserves to be included in the multidisciplinary treatment of schizophrenia.
Subject(s)
Psychotherapy/methods , Schizophrenia/therapy , Schizophrenic Psychology , Combined Modality Therapy , Exercise Therapy , Humans , Interdisciplinary Communication , YogaABSTRACT
BACKGROUND: It may be possible to improve the prognosis of psychotic disorders by the timely recognition and treatment of the early stages of these disorders. Since the first psychotic episode is often preceded by a period of non-specific symptoms and functional decline, it could be worthwhile investigating whether this early phase can be detected. AIM: To review existing diagnostic approaches and clinical instruments that are currently used for prospective identification of the prodromal phase. METHOD: We searched the literature between 1995 and 2009 using the search terms 'prodromal' or 'ultra high risk' in combination with 'psychosis' or 'schizophrenia' and 'assessment'. RESULTS: In international literature we found four diagnostic approaches to ultra high risk of psychosis: the attenuated positive symptom approach, the basic symptom approach, the clinical high risk approach and the strictly phenomenological approach. Within each of these approaches specific screening instruments had been developed and tested with regard to their ability to correctly predict a first psychotic episode. CONCLUSION: None of the current diagnostic approaches produces a sufficiently reliable prediction of the risk of a first psychotic episode. Within the group of persons assumed, based on screening, to be at very high risk, only a small percentage will actually develop a psychotic disorder.
Subject(s)
Behavioral Symptoms/physiopathology , Early Diagnosis , Psychotic Disorders/diagnosis , Behavioral Symptoms/psychology , Humans , Psychiatric Status Rating Scales , Psychotic Disorders/epidemiology , Psychotic Disorders/psychology , Risk Assessment , Risk FactorsABSTRACT
BACKGROUND: Only about 25% of people with schizophrenia follow the public health recommendations for a minimum of 150 minutes per week of moderate physical exercise. In their leisure time people diagnosed with schizophrenia take considerably less exercise than their healthy counterparts. AIM: To collect scientific evidence of movement-related interventions in patients with schizophrenia. METHOD: PubMed, PEDro, CINAHL, PsychINFO and Sport Discus were searched for the period from 2003 up to April 2009 for reports of randomised controlled trials (RCTs) on the basis of the search terms 'schizophrenia', 'exercise' and 'physical activity'. Relevant literature was also traced by means of the reference lists for selected articles. RESULTS: Eight RCTs were selected. Physical exercise was reported to bring about significant improvements in cardiovascular and metabolic parameters and in psychiatric symptomatology. A physical exercise also has social advantages; it helps patients to cope with stress and improves their quality of life. CONCLUSION: Physical exercise as part of psychomotor therapy should play an important role within the multidisciplinary treatment of schizophrenia. More research is needed into the effect of physical activity on cognitive functioning.
