Tree drawing test as an auxiliary tool for evaluating schizophrenia treatment outcomes

TL;DR

This study shows that tree drawing tests can track schizophrenia treatment progress over time.

Contribution

The study introduces tree drawing metrics as a novel tool for objectively evaluating schizophrenia treatment outcomes.

Findings

Tree drawing indicators like crown and trunk measurements improved significantly over 37 weeks in schizophrenia patients.

Patients with shorter disease duration showed greater improvements during early treatment phases.

Schizophrenia patients differed significantly from healthy controls in multiple tree drawing metrics at Week 13.

Abstract

This study aimed to investigate the changes in quantitative indicators of the Tree Drawing Projection Test across different treatment stages in patients with schizophrenia, in order to provide an objective basis for evaluating treatment efficacy.

A self-controlled study design was employed. Sixty patients with schizophrenia underwent the Tree Drawing Projection Test at three time points: Week 1, Week 13, and Week 37. Differences in drawing indicators were analyzed across these time points.

Among patients with schizophrenia, the values of crown area, crown height, crown width, trunk area, and trunk height gradually increased from Week 1 to Week 37, showing observable differences (p <0.05). In patients with a disease course of less than 10 years, the changes in trunk area, trunk height, and trunk width during the acute treatment period (Week 1 to Week 13: 5.66 ± 0.55, 2.18 ± 0.20, 0.68 ± 0.08, respectively) were significantly greater than those in patients with a disease course exceeding 10 years (p <0.05). At Week 13, schizophrenia patients showed significant differences compared with healthy controls in crown area (99.67 ± 10.89), crown width (11.99 ± 2.15), trunk area (23.94 ± 4.23), trunk width (4.33 ± 0.92), root area (6.43 ± 1.61), and root height (0.76 ± 0.07) (p <0.05).

In schizophrenia patients, quantitative indicators of the Tree Drawing Projection Test—specifically crown area, crown height, and crown width—demonstrated steady increases across Week 1, Week 13, and Week 37, with these changes being statistically significant. These findings suggest that the Tree Drawing Projection Test can serve as a useful tool for assessing clinical treatment efficacy in schizophrenia.

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