This pilot study aimed to evaluate the feasibility of an assessor-blind,
randomised controlled trial of psychodynamic art therapy for the treatment of
patients with schizophrenia, and to generate preliminary data on the efficacy
of this intervention during acute psychotic episodes. Fifty-eight inpatients
with DSM-diagnoses of schizophrenia were randomised to either 12 twice-weekly
sessions of psychodynamic group art therapy plus treatment as usual or to
standard treatment alone. Primary outcome criteria were positive and negative
psychotic and depressive symptoms as well as global assessment of functioning.
Secondary outcomes were mentalising function, estimated with the Reading the
mind in the eyes test and the Levels of emotional awareness scale, self-
efficacy, locus of control, quality of life and satisfaction with care.
Assessments were made at baseline, at post-treatment and at 12 weeks' follow-
up. At 12 weeks, 55% of patients randomised to art therapy, and 66% of
patients receiving treatment as usual were examined. In the per-protocol
sample, art therapy was associated with a significantly greater mean reduction
of positive symptoms and improved psychosocial functioning at post-treatment
and follow-up, and with a greater mean reduction of negative symptoms at
follow-up compared to standard treatment. The significant reduction of
positive symptoms at post-treatment was maintained in an attempted intention-
to-treat analysis. There were no group differences regarding depressive
symptoms. Of secondary outcome parameters, patients in the art therapy group
showed a significant improvement in levels of emotional awareness, and
particularly in their ability to reflect about others' emotional mental
states. This is one of the first randomised controlled trials on psychodynamic
group art therapy for patients with acute psychotic episodes receiving
hospital treatment. Results prove the feasibility of trials on art therapy
during acute psychotic episodes and justify further research to substantiate
preliminary positive results regarding symptom reduction and the recovery of
mentalising function