People with schizophrenic spectrum disorders (SSDs) often exhibit both positive (hallucinations, delusions) and negative (apathy, social withdrawal, lack of affect) symptoms. Negative symptoms respond poorly to current medications, and there is a need for novel treatments that can help minimize them. 

Oxytocin is a naturally occurring hormone associated with higher levels of emotional bonding and pro-social behavior in social contexts. It’s possible that administering oxytocin within a positive social context such as a group mindfulness-based intervention might improve empathy and lessen negative symptoms.

Zierhut et al. [Journal of Psychiatric Research] conducted pilot a study to test the effects of administering oxytocin vs. placebo in patients with SSDs participating in Mindfulness-Based Group Therapy.

The researchers randomly assigned 41 German adults diagnosed with an SSD (average age = 42 years; 68% male) to oxytocin + MBGT or a placebo + MBGT. Oxytocin (and placebo) were intranasally administered 45 minutes prior to group therapy sessions.

MBGT is a mindfulness-based intervention designed for adults with SSDs. It was delivered in two 50-minute small group sessions over the course of a single week. The first session included an introduction to mindfulness, a 15-minute breath awareness exercise, and the group sharing of experiences and goals. The second session focused on engaging all the senses and included a nature walk. 

Participants were assessed before and after the week-long intervention on measures of empathy, negative symptoms, stress, affect, and mindfulness (using the Southampton Mindfulness Questionnaire). Blood oxytocin levels were also assessed at multiple time points.

The results showed the combined sample reported significant increases in self-rated empathy (d=0.56) and perspective taking (d=0.69) from pre- to post-intervention, without significant between group differences. There was no improvement in either group, however, on a measure of empathy involving inferring the mental state of people depicted in pictures on a computer screen.

The oxytocin group showed significantly greater self-rated improvements in diminished emotional range (ηp2= 0.11) and lack of motivation (ηp2= 0.11) compared to the placebo controls. Self-reported negative affect decreased (d = -0.86 and  -0.57) and positive affect increased significantly (d=0.44 and 0.69) for both group. Both groups also reported significant decreases in perceived stress.

The study shows Mindfulness-Based Group Therapy can potentially improve self-reported empathy. Adding oxytocin leads to greater improvement in self-reported negative symptoms of diminished emotional range and lack of motivation. The study is a pilot study that needs replication with a larger sample size, longer treatment duration, the inclusion of a no-treatment control, and long-term follow-up.

Reference:

Zierhut, M., Bergmann, N., Hahne, I., Wohlthan, J., Kraft, J., Braun, A., Tam Ta, T. M., Hellmann-Regen, J., Ripke, S., Bajbouj, M., Hahn, E., & Böge, K. (2024). The combination of oxytocin and mindfulness-based group therapy for empathy and negative symptoms in schizophrenia spectrum disorders – A double-blinded, randomized, placebo-controlled pilot study. Journal of Psychiatric Research. 

Link to study