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Ethics, Medicine, and Public Health Dec 2021
PubMed: 34604490
DOI: 10.1016/j.jemep.2021.100725 -
PloS One 2019To explore possible working mechanisms of anxiety reduction in women with anxiety disorders, treated with art therapy (AT). (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To explore possible working mechanisms of anxiety reduction in women with anxiety disorders, treated with art therapy (AT).
METHODS
A RCT comparing AT versus waiting list (WL) condition on aspects of self-regulation. Stress regulation (heart rate and heart rate variability) and executive functioning (daily behavioural and cognitive performance aspects of executive functioning (EF)) were evaluated in a pre-post design. Participants were women, aged 18-65 years with moderate to severe anxiety symptoms.
RESULTS
Effectiveness of AT compared to WL was demonstrated in a higher resting HRV post treatment, improvements in aspects of self-reported daily EF (emotion control, working memory, plan/organize and task monitor), but not in cognitive performance of EF, stress responsiveness and down regulation of stress. The decrease in anxiety level was associated with improvements in self-reported daily EF.
CONCLUSIONS
AT improves resting HRV and aspects of EF, the latter was associated with art therapy-related anxiety reduction.
Topics: Adolescent; Adult; Aged; Anxiety; Anxiety Disorders; Art Therapy; Cognition; Executive Function; Female; Heart Rate; Humans; Middle Aged; Neuropsychological Tests; Stress, Psychological; Young Adult
PubMed: 31794566
DOI: 10.1371/journal.pone.0225200 -
Art therapy as an adjuvant treatment for depression in elderly women: a randomized controlled trial.Revista Brasileira de Psiquiatria (Sao... 2018There are few quantitative studies on art therapy for the treatment of depression. The objective of this study was to evaluate if art therapy is beneficial as an... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
There are few quantitative studies on art therapy for the treatment of depression. The objective of this study was to evaluate if art therapy is beneficial as an adjuvant treatment for depression in the elderly.
METHODS
A randomized, controlled, single-blind study was carried out in a sample of elderly women with major depressive disorder (MDD) stable on pharmacotherapy. The experimental group (EG) was assigned to 20 weekly art therapy sessions (90 min/session). The control group (CG) was not subjected to any adjuvant intervention. Patients were evaluated at baseline and after 20 weeks, using the Geriatric Depression Scale (GDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and cognitive measures.
RESULTS
Logistic regression analysis adjusted for age revealed that women in EG (n=31) had significant improvement in GDS (p = 0.007), BDI (p = 0.025), and BAI (p = 0.032) scores as compared with controls (n=25). No difference was found in the cognitive measures.
CONCLUSION
Art therapy as an adjunctive treatment for MDD in the elderly can improve depressive and anxiety symptoms.
CLINICAL TRIAL REGISTRATION
RBR-2YXY7Z.
Topics: Aged; Anxiety Disorders; Art Therapy; Combined Modality Therapy; Depressive Disorder, Major; Female; Geriatric Assessment; Humans; Middle Aged; Neuropsychological Tests; Psychiatric Status Rating Scales; Psychotherapy; Single-Blind Method; Socioeconomic Factors; Time Factors; Treatment Outcome
PubMed: 29412335
DOI: 10.1590/1516-4446-2017-2250 -
PloS One 2018Anxiety disorders are one of the most diagnosed mental health disorders. Common treatment consists of cognitive behavioral therapy and pharmacotherapy. In clinical...
BACKGROUND
Anxiety disorders are one of the most diagnosed mental health disorders. Common treatment consists of cognitive behavioral therapy and pharmacotherapy. In clinical practice, also art therapy is additionally provided to patients with anxiety (disorders), among others because treatment as usual is not sufficiently effective for a large group of patients. There is no clarity on the effectiveness of art therapy (AT) on the reduction of anxiety symptoms in adults and there is no overview of the intervention characteristics and working mechanisms.
METHODS
A systematic review of (non-)randomised controlled trials on AT for anxiety in adults to evaluate the effects on anxiety symptom severity and to explore intervention characteristics, benefitting populations and working mechanisms. Thirteen databases and two journals were searched for the period 1997 -October 2017. The study was registered at PROSPERO (CRD42017080733) and performed according to the Cochrane recommendations. PRISMA Guidelines were used for reporting.
RESULTS
Only three publications out of 776 hits from the search fulfilled the inclusion criteria: three RCTs with 162 patients in total. All studies have a high risk of bias. Study populations were: students with PTSD symptoms, students with exam anxiety and prisoners with prelease anxiety. Visual art techniques varied: trauma-related mandala design, collage making, free painting, clay work, still life drawing and house-tree-person drawing. There is some evidence of effectiveness of AT for pre-exam anxiety in undergraduate students. AT is possibly effective in reducing pre-release anxiety in prisoners. The AT characteristics varied and narrative synthesis led to hypothesized working mechanisms of AT: induce relaxation; gain access to unconscious traumatic memories, thereby creating possibilities to investigate cognitions; and improve emotion regulation.
CONCLUSIONS
Effectiveness of AT on anxiety has hardly been studied, so no strong conclusions can be drawn. This emphasizes the need for high quality trials studying the effectiveness of AT on anxiety.
Topics: Anxiety Disorders; Art Therapy; Controlled Clinical Trials as Topic; Humans
PubMed: 30557381
DOI: 10.1371/journal.pone.0208716 -
Trials Nov 2018Mild cognitive impairment (MCI) is a phase in cognitive decline when it is still possible to intervene to reverse the decline. Cognitive stimulation delivered through... (Randomized Controlled Trial)
Randomized Controlled Trial
Art therapy is associated with sustained improvement in cognitive function in the elderly with mild neurocognitive disorder: findings from a pilot randomized controlled trial for art therapy and music reminiscence activity versus usual care.
BACKGROUND
Mild cognitive impairment (MCI) is a phase in cognitive decline when it is still possible to intervene to reverse the decline. Cognitive stimulation delivered through psychosocial interventions provides both psychological intervention and social stimulation to improve cognition. A pilot open-label parallel-arms randomized controlled trial was undertaken to examine the effects of art therapy (AT) and music reminiscence activity (MRA) compared to the control, on the primary outcome of neurocognitive domain assessments in elderly people with MCI.
METHODS
Community-living elderly people with MCI (Petersen's criteria), assessed for study eligibility, were randomized using a web-based system with equal allocation to two intervention arms: AT (guided viewing of art pieces and production of visual arts) and MRA (listening, and recalling memories related to music) and a control arm (standard care without any intervention). Interventions were led by trained therapists weekly for 3 months, then fortnightly for 6 months. Neurocognitive domains (mean of memory, attention, and visuo-spatial abilities standardized scores), psychological wellbeing (subsyndromal depression and anxiety) and telomere length as a biological marker of cellular ageing, were assessed by intervention-blinded assessors at baseline, 3 months and 9 months.
RESULTS
In total, 250 people were screened and 68 were randomized and included in the analysis. In the AT arm, neurocognitive domains improved compared to the control arm at 3 months (mean difference (d) = 0.40; 90% CI 0.126, 0.679) and were sustained at 9 months (d = 0.31; 90% CI 0.068, 0.548). There was some improvement in depression and anxiety at 3 and 9 months and in telomere length at 9 months, but this was not significant. Similar improvements were observed in the MRA arm over the control arm, but they were not significant. There were no intervention-related adverse effects.
CONCLUSIONS
Art therapy delivered by trained staff as "art as therapy" and "art psychotherapy" may have been the significant contributor to cognitive improvements. The findings support cognitive stimulation for elderly people with cognitive decline and signal the need for larger studies and further investigation of carefully designed psycho-social interventions for this group.
TRIAL REGISTRATION
Clinical Trials.gov, NCT02854085 . Registered on 7 July 2016.
Topics: Aged; Aged, 80 and over; Art Therapy; Cognition; Cognitive Dysfunction; Female; Humans; Male; Middle Aged; Music Therapy; Neuropsychological Tests; Pilot Projects; Telomere
PubMed: 30413216
DOI: 10.1186/s13063-018-2988-6 -
The Cochrane Database of Systematic... Jul 2021Many women experience fear of childbirth (FOC). While fears about childbirth may be normal during pregnancy, some women experience high to severe FOC. At the extreme...
BACKGROUND
Many women experience fear of childbirth (FOC). While fears about childbirth may be normal during pregnancy, some women experience high to severe FOC. At the extreme end of the fear spectrum is tocophobia, which is considered a specific condition that may cause distress, affect well-being during pregnancy and impede the transition to parenthood. Various interventions have been trialled, which support women to reduce and manage high to severe FOC, including tocophobia.
OBJECTIVES
To investigate the effectiveness of non-pharmacological interventions for reducing fear of childbirth (FOC) compared with standard maternity care in pregnant women with high to severe FOC, including tocophobia.
SEARCH METHODS
In July 2020, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and reference lists of retrieved studies. We contacted researchers of trials which were registered and appeared to be ongoing.
SELECTION CRITERIA
We included randomised clinical trials which recruited pregnant women with high or severe FOC (as defined by the individual trial), for treatment intended to reduce FOC. Two review authors independently screened and selected titles and abstracts for inclusion. We excluded quasi-randomised and cross-over trials.
DATA COLLECTION AND ANALYSIS
We used standard methodological approaches as recommended by Cochrane. Two review authors independently extracted data and assessed the studies for risk of bias. A third review author checked the data analysis for accuracy. We used GRADE to assess the certainty of the evidence. The primary outcome was a reduction in FOC. Secondary outcomes were caesarean section, depression, birth preference for caesarean section or spontaneous vaginal delivery, and epidural use.
MAIN RESULTS
We included seven trials with a total of 1357 participants. The interventions included psychoeducation, cognitive behavioural therapy, group discussion, peer education and art therapy. We judged four studies as high or unclear risk of bias in terms of allocation concealment; we judged three studies as high risk in terms of incomplete outcome data; and in all studies, there was a high risk of bias due to lack of blinding. We downgraded the certainty of the evidence due to concerns about risk of bias, imprecision and inconsistency. None of the studies reported data about women's anxiety. Participating in non-pharmacological interventions may reduce levels of fear of childbirth, as measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ), but the reduction may not be clinically meaningful (mean difference (MD) -7.08, 95% confidence interval (CI) -12.19 to -1.97; 7 studies, 828 women; low-certainty evidence). The W-DEQ tool is scored from 0 to 165 (higher score = greater fear). Non-pharmacological interventions probably reduce the number of women having a caesarean section (RR 0.70, 95% CI 0.55 to 0.89; 5 studies, 557 women; moderate-certainty evidence). There may be little to no difference between non-pharmacological interventions and usual care in depression scores measured with the Edinburgh Postnatal Depression Scale (EPDS) (MD 0.09, 95% CI -1.23 to 1.40; 2 studies, 399 women; low-certainty evidence). The EPDS tool is scored from 0 to 30 (higher score = greater depression). Non-pharmacological interventions probably lead to fewer women preferring a caesarean section (RR 0.37, 95% CI 0.15 to 0.89; 3 studies, 276 women; moderate-certainty evidence). Non-pharmacological interventions may increase epidural use compared with usual care, but the 95% CI includes the possibility of a slight reduction in epidural use (RR 1.21, 95% CI 0.98 to 1.48; 2 studies, 380 women; low-certainty evidence).
AUTHORS' CONCLUSIONS
The effect of non-pharmacological interventions for women with high to severe fear of childbirth in terms of reducing fear is uncertain. Fear of childbirth, as measured by W-DEQ, may be reduced but it is not certain if this represents a meaningful clinical reduction of fear. There may be little or no difference in depression, but there may be a reduction in caesarean section delivery. Future trials should recruit adequate numbers of women and measure birth satisfaction and anxiety.
Topics: Analgesia, Epidural; Analgesia, Obstetrical; Art Therapy; Bias; Cesarean Section; Cognitive Behavioral Therapy; Counseling; Depression; Fear; Female; Humans; Midwifery; Parturition; Phobic Disorders; Pregnancy; Randomized Controlled Trials as Topic
PubMed: 34231203
DOI: 10.1002/14651858.CD013321.pub2 -
Scientific Reports Sep 2023This explorative study of patients with chronic schizophrenia aimed to clarify whether group art therapy followed by a therapist-guided picture review could influence...
This explorative study of patients with chronic schizophrenia aimed to clarify whether group art therapy followed by a therapist-guided picture review could influence patients' communication behaviour. Data on voice and speech characteristics were obtained via objective technological instruments, and these characteristics were selected as indicators of communication behaviour. Seven patients were recruited to participate in weekly group art therapy over a period of 6 months. Three days after each group meeting, they talked about their last picture during a standardized interview that was digitally recorded. The audio recordings were evaluated using validated computer-assisted procedures, the transcribed texts were evaluated using the German version of the LIWC2015 program, and the voice recordings were evaluated using the audio analysis software VocEmoApI. The dual methodological approach was intended to form an internal control of the study results. An exploratory factor analysis of the complete sets of output parameters was carried out with the expectation of obtaining typical speech and voice characteristics that map barriers to communication in patients with schizophrenia. The parameters of both methods were thus processed into five factors each, i.e., into a quantitative digitized classification of the texts and voices. The factor scores were subjected to a linear regression analysis to capture possible process-related changes. Most patients continued to participate in the study. This resulted in high-quality datasets for statistical analysis. To answer the study question, two results were summarized: First, text analysis factor called Presence proved to be a potential surrogate parameter for positive language development. Second, quantitative changes in vocal emotional factors were detected, demonstrating differentiated activation patterns of emotions. These results can be interpreted as an expression of a cathartic healing process. The methods presented in this study make a potentially significant contribution to quantitative research into the effectiveness and mode of action of art therapy.
Topics: Humans; Schizophrenia; Art Therapy; Voice; Communication; Language
PubMed: 37749186
DOI: 10.1038/s41598-023-43069-y -
Irish Journal of Medical Science Dec 2022Diabetes mellitus (DM) is a global public health issue. Type 1 diabetes (T1D) is the predominant diabetes type in children and always requires insulin therapy. The... (Review)
Review
Diabetes mellitus (DM) is a global public health issue. Type 1 diabetes (T1D) is the predominant diabetes type in children and always requires insulin therapy. The incidence rate of newly diagnosed T1D in children continues to increase in Ireland Roche et al. (Eur J Pediatr 175(12):1913-1919, 2016) and worldwide Patterson et al. (Diabetologia 62(3):408-417, 2019). The objective of this study was to conduct a literature review of the effects of various non-pharmacological therapeutic modalities on the control of diabetes in children. A literature review was performed using PubMed, Medline, Embase and Cochrane library to evaluate play, art, music and exercise therapy in the treatment of DM using the keywords: "paediatric", "diabetes", "play therapy", "art therapy", "music therapy" and "exercise therapy". These search terms initially returned 270 cases, which resulted in a total of 11 papers being reviewed after eliminating duplicate or irrelevant papers. Literature review showed that all therapies have a positive impact on the child, but there is limited research looking at the impact of therapy on quantitative measures such as HbA1c or 'time in range'.
Topics: Child; Humans; Diabetes Mellitus, Type 1; Music; Insulin; Exercise Therapy; Music Therapy
PubMed: 35037160
DOI: 10.1007/s11845-021-02889-5