Treating negative symptoms of schizophrenia

Schizophrenia is the most common psychotic disorder and the most pervasive. It is characterised by “positive” symptoms, such as hallucinations and delusions, and “negative” symptoms, such as apathy and social withdrawal. Negative symptoms contribute greatly to the functional impairment and poor psychosocial outcomes in schizophrenia. Advances in the management of schizophrenia in the past 60 years have included drug treatments, psychosocial interventions, and integrated treatment strategies.1 Interestingly, psychosocial treatments—such as cognitive behavioural therapy (CBT) and, more recently, arts therapies (music therapy, art therapy, and body movement or dance therapy)—have shown more promise than drug treatments in reducing negative symptoms and their impact, and the National Institute for Health and Clinical Excellence (NICE) has recently recommended these treatments.2 It is therefore surprising that the linked study (doi:10.1136/bmj.e846), the “Matisse trial” by Crawford and colleagues found that art therapy, as adjunctive treatment for people with schizophrenia, had little benefit over a comparator activity or treatment as usual in the treatment of negative symptoms or …