How theatre can improve the mental health of people with neurodegenerative diseases

Going to a concert by a favourite performer or to the theatre to see a moving play often cause feelings of pleasure, well-being and satisfaction that transcend the moment and spill over into our lives, lifting our mood. For this reason, the arts are considered by the World Health Organization to be an effective tool for improving the emotional well-being of the population. But are they beneficial for everyone? What about people with neurodegenerative diseases? Can they serve as non-medical therapy to influence their mental health?

These are some of the questions that will be tackled by the research project Dramatizing health: the role of theatre in emotional, social and cognitive well-being, promoted by Universitat Oberta de Catalunya (UOC) researchers in association with the Teatre Lliure and the Hospital de la Santa Creu i Sant Pau. The aim is to evaluate the emotional and cognitive benefits of a theatrical arts programme in patients with Parkinson's disease.

"It's not art therapy, because we're not going to treat the symptoms of the disease directly, but Arts in Health is an indirect way of providing benefits to people through participatory activities, such as going to the theatre, and participatory workshops that will be given by experts in coaching actors," said Marco Calabria, researcher at the eHealth Center's NeuroAdas Lab and member of the Faculty of Health Sciences at the UOC.

Arts in Health

The project, which has been selected in the "la Caixa" Foundation Social Observatory's Connecta funding call, is based on a previous pilot study carried out last year by UOC researchers, also in association with the Teatre Lliure and the Hospital de la Santa Creu i Sant Pau, in which they studied the effects of therapeutic intervention based on the performing arts. These new tools, called "arts in health", use forms of art, such as theatre, dance or the visual arts, to generate emotional and cognitive benefits.

The new project will seek to establish a theoretical framework that explains the relationship between the enjoyment of the moment and an improvement in the spectator's emotional state and how this is transferred to mental health.

"We want to see if this well-being produced by the arts has a domino effect that has an impact on the real lives of patients," said Calabria, the principal investigator. He pointed out that, unlike other experiences, this project "was created with a clear research focus. Many interventions involving the arts are intended to have an impact on health, but their effectiveness hasn't been studied."

"We're delighted to continue working with the UOC and the Hospital de Sant Pau on this project, which links the arts and health; the pilot test enabled us to obtain some initial positive results and see the development of the participants," explained Alícia Gorina, head of the Teatre Lliure's Educational Programme. Violeta Sugranyes, the theatre's project coordinator, added: "We want to continue working to develop a method that can be applied in other social contexts and strengthen the argument for prescribing the arts as part of the health system in the future."

Parkinson's, the second most prevalent neurodegenerative disease

The project focuses on patients with Parkinson's because it is the second most prevalent neurodegenerative disease in society and its incidence is expected to increase considerably over the next 20 years. In addition to problems with movement, sufferers have cognitive difficulties, especially in terms of attention and working memory; they also tend to suffer from apathy, anxiety and even depression. Moreover, there is still a stigma attached to the condition, which leads to a reduction in social relationships.

Participants will be recruited with the assistance of the Movement Disorder Unit at the Hospital de la Santa Creu i Sant Pau. For its part, the Teatre Lliure will be in charge of designing activities together with the UOC researchers, selecting the plays that the participants will see and organizing the workshops.

According to Carmen García, neuropsychologist with the Neurology Service at the Hospital de la Santa Creu i Sant Pau, "the therapeutic approach to Parkinson's disease is complex and requires a combination of pharmacological and non-pharmacological treatments. We're very happy to be participating in this project, which offers an opportunity to contribute to our knowledge of the efficacy of non-pharmacological therapeutic options applying the necessary scientific rigour. The project combines performance activities and has the therapeutic advantage of being carried out in the context of a group of people with the same disease, which is very beneficial psychologically".

A total of 50 volunteers will participate, divided into two groups: 25 will participate in theatre activities and another 25 will be limited to doing cognitive stimulation, attention and memory activities from home with materials that will be supplied to them. In both groups, the emotional and cognitive state of the participants will be evaluated before and after the intervention.

In a second phase, they will repeat the theatre activity but online, with the aim of breaking down barriers for people who do not live near cultural facilities. "We'll try to determine whether remote participation brings the same benefits as face-to-face participation. Here, the key element will be the role played by the group factor", Calabria commented.

The emotional and cognitive alterations of neurodegenerative diseases have a negative impact on the quality of life of those affected and their environment, with a progressive worsening throughout the disease. We therefore need to investigate new approaches to treating these alterations in combination with pharmacological therapy. Arts in Health could be an innovative methodology to meet this need to improve well-being.

This project supports United Nations Sustainable Development Goals (SDGs) 3, Good Health and Well-being; 5, Gender Equality; 10, Reduced Inequalities, and 16, Peace, Justice and Strong Institutions.

UOC R&I

The UOC's research and innovation (R&I) is helping overcome pressing challenges faced by global societies in the 21st century by studying interactions between technology and human & social sciences with a specific focus on the network society, e-learning and e-health.

Over 500 researchers and more than 50 research groups work in the UOC's seven faculties, its eLearning Research programme and its two research centres: the Internet Interdisciplinary Institute (IN3) and the eHealth Center (eHC).

The university also develops online learning innovations at its eLearning Innovation Center (eLinC), as well as UOC community entrepreneurship and knowledge transfer via the Hubbik platform.

Open knowledge and the goals of the United Nations 2030 Agenda for Sustainable Development serve as strategic pillars for the UOC's teaching, research and innovation. More information: research.uoc.edu.