Estudio de una nueva tecnica psicoterapeutica grupal para la esquizofrenia basada en el uso del cine de ficcionEfectos sobre sintomas positivos

Resum

ABSTRACT. Background Schizophrenia is a mental disorder that originates a great amount of suffering and limitations in those who suffer from it. The treatment of the disease is far from being solved satisfactorily. Fiction films have an extraordinary ability to trigger mental processes and brain responses in viewers, but its therapeutic potential in patients with schizophrenia has not been studied in an experimental and systematical way. Objectives To test the effectiveness of a new group psychotherapeutic technique in patients with schizophrenia and other psychotic disorders, that uses fiction films and is inspired by film analysis. Methods 48 patients with schizophrenia participated in a multicentric randomized controlled clinical trial in parallel groups. The effects of the new group psychotherapeutic technique (which uses films as a cognitive support and is inspired by film analysis) is compared to a more unspecific group technique that also uses films. Thirteen episodes of the first season of the television series "The Sopranos" were used. Both groups completed a total of 26 sessions and saw each episode twice. The primary outcome measures were the changes obtained on the subscales of the PANSS, according to the five-factor model of Wallwork, between baseline and post-treatment. Cognitive outcome measures were measured by scales of general cognition (MCCB) and social cognition (MSCEIT , FEIT and FBS) before and after treatment. Results A statistically significant improvement in the experimental group versus control group was found in positive symptoms [p=0.01, d=0.82 (0.2-1.43)], negative symptoms [p=0.005, d=0.89 (0.26-1.51)] and disorganized symptoms [p=0.013, d=0.49 (0.11-1.09)]. In the "post hoc" analysis of the positive factor a statistically significant improvement in the experimental group compared to the control was also found in delusions [p=0.01, d=0.82 (0.2-1.4)]. No significant differences were found between the two groups after the intervention in any of the cognitive domains. Conclusions The use of the new group psychotherapeutic technique in which the film sequence analysis is performed, can serve to improve the positive symptoms of schizophrenia patients, especially delusional beliefs. It can also improve the negative or disorganized symptoms.