title: Pilot study evaluating the effect of massage therapy on stress, anxiety and aggression in a young adult psychiatric inpatient unit.
abstract: OBJECTIVE
  The aim of the present pilot study was to examine the effectiveness of a relaxation massage therapy programme in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit.
  
  
  METHODS
  This was a prospective, non-randomized intervention study comparing treatment as usual (TAU) with TAU plus massage therapy intervention (MT) over consecutive 7 week blocks (May-August 2006). MT consisted of a 20 min massage therapy session offered daily to patients during their period of hospitalization. The Kennedy Nurses' Observational Scale for Inpatient Evaluation (NOSIE), the Symptom Checklist-90-Revised (SCL-90-R), the State-Trait Anxiety Inventory (STAI) and stress hormone (saliva cortisol) levels were used to measure patient outcomes at admission and discharge from the unit. The Staff Observation Aggression Scale-Revised (SOAS-R) was used to monitor the frequency and severity of aggressive incidents on the unit.
  
  
  RESULTS
  There was a significant reduction in self-reported anxiety (p < 0.001), resting heart rate (p < 0.05) and cortisol levels (p < 0.05) immediately following the initial and final massage therapy sessions. Significant improvements in hostility (p = 0.007) and depression scores (p < 0.001) on the SCL-90-R were observed in both treatment groups. There was no group x time interaction on any of the measures. Poor reliability of staff-reported incidents on the SOAS-R limited the validity of results in this domain.
  
  
  CONCLUSIONS
  Massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients. Study limitations preclude any definite conclusions on the effect of massage therapy on aggressive incidents in an acute psychiatric setting. Randomized controlled trials are warranted.
authors.affiliation: ORYGEN Research Centre, Parkville, Vic., Australia. belinda.garner@mh.org.au
authors.forename: Belinda
authors.initials: B
authors.lastname: Garner
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Phillips
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Schmidt
authors.forename: Connie
authors.initials: C
authors.lastname: Markulev
authors.forename: Jenny
authors.initials: J
authors.lastname: O'Connor
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wood
authors.forename: Gregor E
authors.initials: GE
authors.lastname: Berger
authors.forename: Peter
authors.initials: P
authors.lastname: Burnett
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006339:Heart Rate; D006791:Hostility; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008405:Massage / Q000523:psychology*; D010865:Pilot Projects; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital; D011569:Psychiatric Status Rating Scales; D012463:Saliva / Q000378:metabolism; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014754:Violence / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D006854:Hydrocortisone