The following article is a part of conference coverage from the American Psychiatric Association Annual Meeting 2021, held virtually from May 1 to 3, 2021. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the APA 2021.
Art therapy or psychotherapy produces both short-term and sustained improvements in elder patients with mild neurocognitive disorders (NCDs), according to the results of a pilot randomized control trial (RCT) in Singapore, which was presented at the American Psychiatric Association annual meeting held virtually from May 1 to May 3, 2021.
Within 3 years of diagnosis, approximately half of patients with mild NCD will progress to major NCD. Cognitive stimulation interventions are being explored to slow this progression, as pharmacotherapy is not recommended for cases of mild NCD. Study authors presented their findings from an RCT that examined the cognitive effects of an art therapy (AT) program delivered over the course of 9 months to community-living seniors screened with Petersen’s criteria. Of the 250 patients screened, 68 patients were randomly assigned (mean age 71.1; 57 women; and 5.4 years of schooling) to AT or the control group (CG).
The AT intervention sessions involved viewings of preselected artworks at the National Art Gallery and the National University Art Museum, alternated with sessions for the creation of artworks inspired by identified themes using a range of supplies and techniques. All sessions were led by trained therapists, who guided participants in discussions of the museum works and the participants’ presentation and discussion of their own creations. These sessions took place every week for 3 months, then every 2 weeks for 6 months in small group sessions. Assessments of neurocognitive domains took place at baseline, then at 3 months and 9 months.
When compared with the CG, the AT group showed improvements at 3 months in neurocognitive domains (d=0.40; 90% CI, 0.126-0.679), for List Learning (d=0.542; 90% CI, 0.105-0.810; P =.042), and Digit Span Forward (d=0.991; 90% CI, 0.251-1.730; P =.028).
Beneficial effects that were not statistically significant (P >.05) were also observed for Block Design, Delayed Recall, Color Trails 2, and Recognition Trials. The mean number of domains with a Z-score <-1.5 at 3 months was lower for the AT group compared with CG (d=-0.314; 90% CI, -0.629 to 0.000; P =.100). The beneficial effects of AT were sustained for participants at 9 months (d=0.31; 90% CI, 0.068-0.548; P =.035).
The study investigators concluded, “This pilot RCT supports the effectiveness of AT, delivered as ‘art as therapy’ and ‘art psychotherapy,’ in older persons with mild NCD. Both short-term gains and sustained improvements at 9 months of the intervention were found. [Although] the study sample was small and was not statistically strong to determine effectiveness or generalizability, this study indicates scope for a substantive study on AT and also to explore other variables such as socialization.”
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Mahendran R, Lee R, Heok KE. Art therapy as a cognitive stimulating activity for older adults with a mild neurocognitive disorder. Presented at: APA annual meeting May 1-3, 2021. Abstract/Poster 5157.