Hypnosis for schizophrenia

Schizophrenia is a serious mental disorder which can cause people to have changes in the way they understand the world and their senses. It can also cause social withdrawal. The main treatments for schizophrenia in developed countries are various antipsychotic medications although not everyone responds to these drugs. Other interventions such as talking therapies, relaxation, hypnosis and other alternative therapies have been suggested to be of help, mostly in addition to medication. This review looks at the use of hypnosis in the treatment of schizophrenia, which was compared, in the trials identified, to relaxation, listening to music and standard treatment. Three trials were identified containing a total of 149 people. All of these studies were carried out before 1983 and were relatively short (eight weeks, four weeks and one week). Due to the way the data were reported in these studies and their size, there was no conclusive evidence that hypnosis was better than the other interventions. Very few people left the trials suggesting that hypnosis, relaxation and listening to classical music (Sibelius) were at least acceptable interventions. In order to draw better informed conclusions regarding this potential treatment option in schizophrenia, well conducted trials are required, that measure well outcomes such as improvement in symptoms, functioning and quality of life of the people involved.

(Plain language summary prepared for this review by Janey Antoniou of RETHINK, UK www.rethink.org).

Authors' conclusions: 

The studies in this field are few, small, poorly reported and outdated. Hypnosis could be helpful for people with schizophrenia. If we are to find this out, better designed, conducted and reported randomised studies are required. This current update has not revealed any new studies in this area since 2003.

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Background: 

Many people with schizophrenia continue to experience symptoms despite conventional treatments being used. Alternative therapies such as hypnosis, in conjunction with conventional treatments, may be helpful.

Objectives: 

To investigate the use of hypnosis for people with schizophrenia or schizophrenia-like illnesses compared with standard care and other interventions.

Search strategy: 

We searched the Cochrane Schizophrenia Group's Register (October 2006), contacted the Cochrane Complementary Medicine Field for additional searching (January 2003), hand searched references of included or excluded studies and made personal contact with authors of relevant trials.

Selection criteria: 

We included all randomised or double blind controlled trials that compared hypnosis with other treatments or standard care for people with schizophrenia.

Data collection and analysis: 

We reliably selected studies, quality assessed them and extracted data. We excluded data where more than 50% of participants in any group were lost to follow up. For binary outcomes we calculated a fixed effects risk ratio (RR) and its 95% confidence interval (CI).

Main results: 

We included three studies (total n=149). When hypnosis was compared with standard treatment no one left the studies between 1-8 weeks (n=70, 2 RCTs, Risk Difference 0.00 CI -0.09 to 0.09). Mental state scores were unaffected (n=60, 1 RCT, MD BPRS by one week -3.6 CI -12.05 to 4.8) as were measures of movement disorders and neurocognitive function. Compared with relaxation, hypnosis was also acceptable (n=106, 3 RCTs, RR leaving the study early 2.00 CI 0.2 to 2.15) and had no discernable effect on mental state (n=60, 1 RCT, MD BPRS by one week -3.4 CI -11.4 to 4.6), movement disorders or neurocognitive function. Hypnosis was as acceptable as music (Sibelius) by four weeks (n=36, RR leaving the study early 5.0, CI 0.3 to 97.4).

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