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Humour-based interventions for people with schizophrenia.

Yasushi Tsujimoto1,2,3, Yuri Nakamura4, Masahiro Banno3,5,6

  • 1Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan.

The Cochrane Database of Systematic Reviews
|October 13, 2021
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Summary

Humor-based interventions show potential for reducing depressive symptoms in schizophrenia patients but lack sufficient evidence for other outcomes. More research is needed to confirm their effectiveness as an adjunct to standard care.

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Area of Science:

  • Psychiatry and Mental Health
  • Psychological Interventions
  • Schizophrenia Research

Background:

  • Humor-based interventions utilize playfulness to address life's absurdities, aiming to promote health and wellness.
  • These interventions have been proposed as an adjunct to standard care for individuals with schizophrenia.
  • A comprehensive summary of the existing evidence for humor-based interventions in schizophrenia is currently lacking.

Purpose of the Study:

  • To systematically examine the effects of humor-based interventions when used as an add-on therapy for schizophrenia patients.
  • To synthesize the available evidence regarding the efficacy of humor-based interventions in improving outcomes for individuals with schizophrenia.

Main Methods:

  • A systematic literature search was conducted across multiple databases including CENTRAL, CINAHL, ClinicalTrials.Gov, Embase, ISRCTN, MEDLINE, PsycINFO, PubMed, and WHO ICTRP.
  • Included were randomized controlled trials comparing humor-based interventions with active controls, other psychological interventions, or standard care for schizophrenia.
  • Data extraction and quality appraisal were performed independently by two review authors, with risk of bias assessed using the Cochrane Handbook and GRADE approach.

Main Results:

  • Only two studies (n=96) provided usable data for quantitative synthesis; primary outcomes like general mental state, negative symptoms, quality of life, and adverse effects lacked sufficient data.
  • Humor-based interventions showed a potential to reduce depressive symptoms (Beck Depression Inventory: MD -6.20, 95% CI -12.08 to -0.32) compared to active controls, though evidence was of low certainty.
  • Evidence regarding effects on general mental state, positive symptoms, negative symptoms, anxiety, and study attrition was inconclusive due to very low to low certainty of evidence and small sample sizes.

Conclusions:

  • The current evidence base is insufficient to definitively support the use of humor-based interventions for individuals with schizophrenia.
  • Uncertainty remains regarding the impact of humor-based interventions on various clinical outcomes in schizophrenia.
  • Future research employing rigorous methodologies and focusing on clinically significant outcomes is warranted to clarify the role of humor-based interventions.