Positive psychology interventions may be a beneficial resource for patients on the schizophrenia spectrum, with possible impacts on well-being and symptom reduction, according to a study published in the Brazilian Journal of Psychiatry. Here, lead author Isabela Pina, MD, a psychiatrist and preceptor of medical residency in psychiatry, explains the findings of the systematic review, how clinicians can use it in practice, and her and her colleagues’ ongoing work in the field.
Q: What led you and your colleagues to investigate positive psychology interventions and schizophrenia?
A: There is a lack of treatment options to treat schizophrenia negative symptoms and to effectively resocialize these patients. People with schizophrenia still suffer enormously from stigma and often have their treatment neglected. We aimed to integrate the field of positive psychology—which has grown since the first papers published by Professor Martin Seligman, PhD—with schizophrenia by researching the available scientific literature up to this moment.
Q: Please briefly describe the study method and participants.
A: We did a systematic review to synthesize and compare previous studies on positive psychology interventions. Our objective was to assess the outcome of these interventions in negative symptoms and subjective well-being.
Q: Please briefly describe the most significant finding(s).
A: There are small studies in the literature available, done as pilot studies of these interventions. Also, interventions in positive psychology were quite heterogeneous, mixing techniques from positive psychology and mindfulness.
There is also a difficulty in how to properly measure subjective well-being and quality of life in these patients. Lastly, we found positive results with reduction of negative symptoms and improvement in subjective well-being and quality of life statistically relevant results.
Q: Were any outcomes different than you expected?
A: No, there weren’t. They corresponded to our hypothesis.
Q: Are there any practical applications of your findings for clinicians treating patients with schizophrenia?
A. Yes, first I believe that our study brings hope and a new way of seeing patients with schizophrenia. Because it is a serious and very debilitating mental disorder, we have a tendency to think that we can do nothing for them. In fact, we can do a lot, mainly through rehabilitation and engagement in society and in the subjective aspects of quality of life and well-being. The study also showed that there is room for more work in this area, with a tendency to promising results.
Q: Are you conducting any more research in this area, and are there any other studies you feel are needed?
A: Yes, our group has been working with the validation of a scale, the SWN-K (subjective well being under neuroleptics–short version), for our language. With it we can better assess the subjective well-being of patients with schizophrenia. We also have other projects aimed at interventions that mix positive psychology with neuromodulation, an increasingly growing area in psychiatry.
Q: Any final thoughts pertaining to this research?
A: Despite some promising results, there is still much to be done in the research and study on interventions in positive psychology and quality of life in patients on the spectrum of schizophrenia. The data are heterogeneous and with a small number of patients. However, it is an area that has been growing a lot and as a new way of seeing our patients and looking for what is positive and best in them. Therefore, it is worthwhile to try to carry out such interventions and new studies.
Pina I, Braga CM, de Oliveira TFR, et al. Positive psychology interventions to improve well-being and symptoms in people on the schizophrenia spectrum: a systematic review and meta-analysis. Brazilian Journal of Psychiatry. 2020 December 18. [Epub ahead of print].
Isabela Pina is a psychiatrist and preceptor of medical residency in psychiatry at Hospital Das Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil. She is also a member of the Brazilian Psychiatric Association, a nonprofit organization representing 5500 Brazilian psychiatrists.