Dance therapy for schizophrenia

Background: Dance therapy or dance movement therapy (DMT) is defined as 'the psychotherapeutic use of movement as a process which furthers the emotional, social, cognitive, and physical integration of the individual'. It may be of value for people with developmental, medical, social, physical or psychological impairments. Dance therapy can be practiced in mental health rehabilitation units, nursing homes, day care centres and incorporated into disease prevention and health promotion programs. Objectives: To evaluate the effects of dance therapy for people with schizophrenia or schizophrenia-like illnesses compared with standard care and other interventions. Search strategy: We searched the Cochrane Schizophrenia Group Trials Register (July 2007), inspected references of all identified studies (included and excluded), and contacted first authors for additional data. Selection criteria: We included all randomised controlled trials (RCTs) comparing dance therapy and related approaches with standard care or other psychosocial interventions for people with schizophrenia. Data collection and analysis: We reliably selected, quality assessed and extracted data. We excluded data where more than 30% of participants were lost to follow-up. For continuous outcomes we calculated a weighted mean difference; for binary outcomes we calculated a fixed-effect risk ratio (RR) and their 95% confidence intervals (CI). Main results: We included one single blind study (total n=45) of reasonable quality. It compared dance therapy plus routine care with routine care alone. Most people tolerated the treatment package but about 40% were lost in each group by four months (RR 0.68 CI 0.31 to 1.51). PANSS average endpoint total scores were similar in each group (WMD -0.50 CI -11.8 to 10.8) as were the positive subscores (WMD 2.50 CI -0.67 to 5.67). At the end of treatment significantly more people in the dance therapy group had a greater than 20% reduction in PANSS negative symptom score (RR 0.62 CI 0.39 to 0.97), and overall average negative endpoint scores were lower (WMD -4.40 CI -8.15 to 0.65). There was no difference in satisfaction score (average CAT score, WMD 0.40 CI -0.78 to 1.58) and quality of life data were also equivocal (average MANSA score, WMD 0.00 CI -0.48 to 0.48). Authors' conclusions: There is no evidence to support - or refute - the use of dance therapy in this group of people. This therapy remains unproven and those with schizophrenia, their carers, trialists and funders of research may wish to encourage future work to increase high quality evidence in this area.