Psychosocial/non-pharmacologic treatment of negative symptoms

Current best practice regarding the treatment of negative symptoms of schizophrenia supports the use of psychological interventions in addition to medication. This chapter reviews the literature evaluating different non-pharmacological approaches to treating these symptoms. Meta-analytic studies suggest that social skills training, music therapy, non-invasive brain stimulation, mindfulness, and exercise-based interventions are all effective at improving negative symptoms, relative to treatment as usual (TAU). Effect sizes for these interventions range from small to moderate. The long-term benefits of these interventions are currently unclear, and there has been some debate as to whether the impact of these interventions constitute consistent, clinically meaningful change. Evidence for other therapies such as arts therapies other than music therapy, cognitive behavioural therapies for psychosis, neurocognitive therapies, and family-based interventions is more inconsistent. As a result, primary negative symptoms of schizophrenia can still be considered an important unmet therapeutic need where more research is needed.