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Stone T, Short A. Can Music Therapy Help Adults with Schizophrenia Improve Their Cognitive Skills? A Scoping Review. Issues Ment Health Nurs 2024; 45:55-65. [PMID: 37956438 DOI: 10.1080/01612840.2023.2266851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Cognitive impairment associated with schizophrenia can lead to functional disability and poor quality of life. Established cognitive remediation programs have variable results for adults with schizophrenia, with some participants receiving little or no benefit. This scoping review investigates the efficacy of music therapy as cognitive remediation for adults with schizophrenia. Literature was identified using electronic databases, reference list searching and citation tracking. A total of 13 studies met the criteria for inclusion. Results demonstrated that music therapy improved attention, executive function, language, memory, and processing speed. However, more research is required to better understand and develop cognitively beneficial music therapy programs for adults with schizophrenia.
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Affiliation(s)
- Tina Stone
- School of Humanities and Communication Arts, Western Sydney University, Penrith, Australia
| | - Alison Short
- School of Humanities and Communication Arts, Western Sydney University, Penrith, Australia
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2
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Fram NR. Music in the Middle: A Culture-Cognition-Mediator Model of Musical Functionality. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1178-1197. [PMID: 36649305 DOI: 10.1177/17456916221144266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Music is both universal, appearing in every known human culture, and culture-specific, often defying intelligibility across cultural boundaries. This duality has been the source of debate within the broad community of music researchers, and there have been significant disagreements both on the ontology of music as an object of study and the appropriate epistemology for that study. To help resolve this tension, I present a culture-cognition-mediator model that situates music as a mediator in the mutually constitutive cycle of cultures and selves representing the ways individuals both shape and are shaped by their cultural environments. This model draws on concepts of musical grammars and schema, contemporary theories in developmental and cultural psychology that blur the distinction between nature and nurture, and recent advances in cognitive neuroscience. Existing evidence of both directions of causality is presented, providing empirical support for the conceptual model. The epistemological consequences of this model are discussed, specifically with respect to transdisciplinarity, hybrid research methods, and several potential empirical applications and testable predictions as well as its import for broader ontological conversations around the evolutionary origins of music itself.
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Affiliation(s)
- Noah R Fram
- Center for Computer Research in Music and Acoustics, Department of Music, Stanford University
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN
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3
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van Alphen R, Stams GJJM, Hakvoort L. Musical Attention Control Training for Psychotic Psychiatric Patients: An Experimental Pilot Study in a Forensic Psychiatric Hospital. Front Neurosci 2019; 13:570. [PMID: 31231183 PMCID: PMC6566130 DOI: 10.3389/fnins.2019.00570] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/20/2019] [Indexed: 01/04/2023] Open
Abstract
Poor attention skills constitute a major problem for psychiatric patients with psychotic symptoms, and increase their chances of treatment drop-out. This study investigated possible benefits of musical attention control training (MACT). To examine the effect of MACT on attention skills of psychiatric patients with psychotic features a randomized controlled trial (RCT) was conducted in a forensic psychiatric clinic. Participants (N = 35, age M = 34.7, 69% male) were pair matched (on age, gender, and educational level), and randomly assigned to an experimental and control group. The experimental group received a 30-min MACT training once a week over 6 weeks' time, whereas the controls received treatment as usual without attention training. Single blind pre- and post-neuropsychological assessments were performed to measure different attention levels. The experimental MACT group outperformed the control group in selective, sustained and alternating attention. In addition, overall attendance of MACT participants was high (87.1%). This result suggests that in this experimental pilot study MACT was effective for attention skills of psychiatric patients with psychotic features. To obtain larger intervention effects additional research is necessary, with a larger sample and a more specific MACT intervention.
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Affiliation(s)
- R. van Alphen
- Inforsa, Forensic Psychiatric Hospital, Amsterdam, Netherlands
| | - G. J. J. M. Stams
- Social and Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - L. Hakvoort
- Department of Music Therapy, ArtEZ University of the Arts, Enschede, Netherlands
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4
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Mansouri FA, Acevedo N, Illipparampil R, Fehring DJ, Fitzgerald PB, Jaberzadeh S. Interactive effects of music and prefrontal cortex stimulation in modulating response inhibition. Sci Rep 2017; 7:18096. [PMID: 29273796 PMCID: PMC5741740 DOI: 10.1038/s41598-017-18119-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 12/06/2017] [Indexed: 12/30/2022] Open
Abstract
Influential hypotheses propose that alterations in emotional state influence decision processes and executive control of behavior. Both music and transcranial direct current stimulation (tDCS) of prefrontal cortex affect emotional state, however interactive effects of music and tDCS on executive functions remain unknown. Learning to inhibit inappropriate responses is an important aspect of executive control which is guided by assessing the decision outcomes such as errors. We found that high-tempo music, but not low-tempo music or low-level noise, significantly influenced learning and implementation of inhibitory control. In addition, a brief period of tDCS over prefrontal cortex specifically interacted with high-tempo music and altered its effects on executive functions. Measuring event-related autonomic and arousal response of participants indicated that exposure to task demands and practice led to a decline in arousal response to the decision outcome and high-tempo music enhanced such practice-related processes. However, tDCS specifically moderated the high-tempo music effect on the arousal response to errors and concomitantly restored learning and improvement in executive functions. Here, we show that tDCS and music interactively influence the learning and implementation of inhibitory control. Our findings indicate that alterations in the arousal-emotional response to the decision outcome might underlie these interactive effects.
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Affiliation(s)
- Farshad Alizadeh Mansouri
- Department of Physiology, Cognitive Neuroscience Laboratory, Monash Biomedicine Discovery Institute, Monash University, Victoria, 3800, Australia. .,ARC Centre of Excellence in Integrative Brain Function, Monash University, Victoria, Australia.
| | - Nicola Acevedo
- Department of Physiology, Cognitive Neuroscience Laboratory, Monash Biomedicine Discovery Institute, Monash University, Victoria, 3800, Australia
| | - Rosin Illipparampil
- Department of Physiology, Cognitive Neuroscience Laboratory, Monash Biomedicine Discovery Institute, Monash University, Victoria, 3800, Australia
| | - Daniel J Fehring
- Department of Physiology, Cognitive Neuroscience Laboratory, Monash Biomedicine Discovery Institute, Monash University, Victoria, 3800, Australia.,ARC Centre of Excellence in Integrative Brain Function, Monash University, Victoria, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Monash University, Victoria, 3199, Australia
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5
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Lim J, Chong HJ, Kim AJ. A comparison of emotion identification and its intensity between adults with schizophrenia and healthy adults: Using film music excerpts with emotional content. NORDIC JOURNAL OF MUSIC THERAPY 2017. [DOI: 10.1080/08098131.2017.1405999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jeehyo Lim
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul, Korea
| | - Hyun Ju Chong
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul, Korea
| | - Aimee Jeehae Kim
- Department of Music Therapy, Graduate School, Ewha Womans University, Seoul, Korea
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6
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Geretsegger M, Mössler KA, Bieleninik Ł, Chen X, Heldal TO, Gold C. Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database Syst Rev 2017; 5:CD004025. [PMID: 28553702 PMCID: PMC6481900 DOI: 10.1002/14651858.cd004025.pub4] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Music therapy is a therapeutic approach that uses musical interaction as a means of communication and expression. Within the area of serious mental disorders, the aim of the therapy is to help people improve their emotional and relational competencies, and address issues they may not be able to using words alone. OBJECTIVES To review the effects of music therapy, or music therapy added to standard care, compared with placebo therapy, standard care or no treatment for people with serious mental disorders such as schizophrenia. SEARCH METHODS We searched the Cochrane Schizophrenia Group's Trials Study-Based Register (December 2010 and 15 January, 2015) and supplemented this by contacting relevant study authors, handsearching of music therapy journals and manual searches of reference lists. SELECTION CRITERIA All randomised controlled trials (RCTs) that compared music therapy with standard care, placebo therapy, or no treatment. DATA COLLECTION AND ANALYSIS Review authors independently selected, quality assessed and data extracted studies. We excluded data where more than 30% of participants in any group were lost to follow-up. We synthesised non-skewed continuous endpoint data from valid scales using a standardised mean difference (SMD). We employed a fixed-effect model for all analyses. If statistical heterogeneity was found, we examined treatment dosage (i.e. number of therapy sessions) and treatment approach as possible sources of heterogeneity. MAIN RESULTS Ten new studies have been added to this update; 18 studies with a total 1215 participants are now included. These examined effects of music therapy over the short, medium, and long-term, with treatment dosage varying from seven to 240 sessions. Overall, most information is from studies at low or unclear risk of biasA positive effect on global state was found for music therapy compared to standard care (medium term, 2 RCTs, n = 133, RR 0.38 95% confidence interval (CI) 0.24 to 0.59, low-quality evidence, number needed to treat for an additional beneficial outcome NNTB 2, 95% CI 2 to 4). No binary data were available for other outcomes. Medium-term continuous data identified good effects for music therapy on negative symptoms using the Scale for the Assessment of Negative Symptoms (3 RCTs, n = 177, SMD - 0.55 95% CI -0.87 to -0.24, low-quality evidence). General mental state endpoint scores on the Positive and Negative Symptoms Scale were better for music therapy (2 RCTs, n = 159, SMD -0.97 95% CI -1.31 to -0.63, low-quality evidence), as were average endpoint scores on the Brief Psychiatric Rating Scale (1 RCT, n = 70, SMD -1.25 95% CI -1.77 to -0.73, moderate-quality evidence). Medium-term average endpoint scores using the Global Assessment of Functioning showed no effect for music therapy on general functioning (2 RCTs, n = 118, SMD -0.19 CI -0.56 to 0.18, moderate-quality evidence). However, positive effects for music therapy were found for both social functioning (Social Disability Screening Schedule scores; 2 RCTs, n = 160, SMD -0.72 95% CI -1.04 to -0.40), and quality of life (General Well-Being Schedule scores: 1 RCT, n = 72, SMD 1.82 95% CI 1.27 to 2.38, moderate-quality evidence). There were no data available for adverse effects, service use, engagement with services, or cost. AUTHORS' CONCLUSIONS Moderate- to low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state (including negative and general symptoms), social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders. However, effects were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcome measures in relation to music therapy.
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Affiliation(s)
- Monika Geretsegger
- Uni ResearchGAMUT ‐ The Grieg Academy Music Therapy Research Centre, Uni Research HealthLars Hilles gate 3BergenNorway5015
| | - Karin A Mössler
- Uni ResearchGAMUT ‐ The Grieg Academy Music Therapy Research Centre, Uni Research HealthLars Hilles gate 3BergenNorway5015
| | - Łucja Bieleninik
- Uni ResearchGAMUT ‐ The Grieg Academy Music Therapy Research Centre, Uni Research HealthLars Hilles gate 3BergenNorway5015
| | - Xi‐Jing Chen
- Institute of Psychology, Chinese Academy of ScienceCAS Key Laboratory of Mental HealthBeijingChina
| | - Tor Olav Heldal
- Stryn MunicipalityHome Care Health and Social ServicesTonningsgata 4StrynNorway
| | - Christian Gold
- Uni ResearchGAMUT ‐ The Grieg Academy Music Therapy Research Centre, Uni Research HealthLars Hilles gate 3BergenNorway5015
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7
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Chung J, Woods-Giscombe C. Influence of Dosage and Type of Music Therapy in Symptom Management and Rehabilitation for Individuals with Schizophrenia. Issues Ment Health Nurs 2016; 37:631-641. [PMID: 27192343 DOI: 10.1080/01612840.2016.1181125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The purpose of this systematic review was to investigate the influence of dosage, type (active, receptive, or combined), and format (individual or group) of music therapy for individuals with schizophrenia. With the terms "music*" and "schizophreni*," six research databases were searched: CINAHL, EMBASE, Music Index, PsycInfo, Pubmed, and RILM. The search was limited to studies written in English, peer-reviewed, and published between 1991 and 2015. Seventeen articles met the stated criteria. Dosage of music therapy ranged from 20 to 9,720 minutes. Three types of music therapy were delivered: active, receptive, or combined, and therapy was implemented via individual or group format. Depending on the dosage, type, and format, music therapy improved psychotic symptom management, depression and anxiety management, social and cognitive functioning, behavior, and quality of life of the participants. Dosage had a greater impact on the effects of music therapy compared to type and format. Studies that implemented a combination of active and receptive music therapy were more likely to produce significant improvements in outcomes compared to the studies that implemented the other types of music therapy. However, studies using combined type provided higher dosage of the intervention (e.g., more minutes of intervention exposure). This systematic review can be used to guide future research on and clinical applications for music therapy in this population. Future studies might also investigate the interaction of demographic characteristics or severity of illness with dosage and type on effects of music therapy.
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Affiliation(s)
- Jeehae Chung
- a The University of North Carolina at Chapel Hill, School of Nursing , Chapel Hill , North Carolina , USA
| | - Cheryl Woods-Giscombe
- a The University of North Carolina at Chapel Hill, School of Nursing , Chapel Hill , North Carolina , USA
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8
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Iyendo TO. Exploring the effect of sound and music on health in hospital settings: A narrative review. Int J Nurs Stud 2016; 63:82-100. [PMID: 27611092 DOI: 10.1016/j.ijnurstu.2016.08.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/13/2016] [Accepted: 08/14/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sound in hospital space has traditionally been considered in negative terms as both intrusive and unwanted, and based mainly on sound levels. However, sound level is only one aspect of the soundscape. There is strong evidence that exploring the positive aspect of sound in a hospital context can evoke positive feelings in both patients and nurses. Music psychology studies have also shown that music intervention in health care can have a positive effect on patient's emotions and recuperating processes. In this way, hospital spaces have the potential to reduce anxiety and stress, and make patients feel comfortable and secure. This paper describes a review of the literature exploring sound perception and its effect on health care. DATA SOURCES AND REVIEW METHODS This review sorted the literature and main issues into themes concerning sound in health care spaces; sound, stress and health; positive soundscape; psychological perspective of music and emotion; music as a complementary medicine for improving health care; contradicting arguments concerning the use of music in health care; and implications for clinical practice. Using Web of Science, PubMed, Scopus, ProQuest Central, MEDLINE, and Google, a literature search on sound levels, sound sources and the impression of a soundscape was conducted. The review focused on the role and use of music on health care in clinical environments. In addition, other pertinent related materials in shaping the understanding of the field were retrieved, scanned and added into this review. RESULTS The result indicated that not all noises give a negative impression within healthcare soundscapes. Listening to soothing music was shown to reduce stress, blood pressure and post-operative trauma when compared to silence. Much of the sound conveys meaningful information that is positive for both patients and nurses, in terms of soft wind, bird twitter, and ocean sounds. CONCLUSIONS Music perception was demonstrated to bring about positive change in patient-reported outcomes such as eliciting positive emotion, and decreasing the levels of stressful conditions. Whilst sound holds both negative and positive aspects of the hospital ecosystem and may be stressful, it also possesses a soothing quality that induces positive feelings in patients. Conceptualizing the nature of sound in the hospital context as a soundscape, rather than merely noise can permit a subtler and socially useful understanding of the role of sound and music in the hospital setting, thereby creating a means for improving the hospital experience for patients and nurses.
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Affiliation(s)
- Timothy Onosahwo Iyendo
- Department of Architecture, Eastern Mediterranean University, Gazimağusa, North Cyprus, Via Mersin 10, Turkey.
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9
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Chung YK, Chong HJ, Kim SJ. Perception of complexity, interest level, and preference for harmonic progression of music for adults with schizophrenia. ARTS IN PSYCHOTHERAPY 2016. [DOI: 10.1016/j.aip.2015.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Bodner E, Assa Polansky E. The attitudes of music therapy students and professionals regarding the emotional valence of improvisations in music therapy. NORDIC JOURNAL OF MUSIC THERAPY 2015. [DOI: 10.1080/08098131.2015.1067248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Blackburn R, Bradshaw T. Music therapy for service users with dementia: a critical review of the literature. J Psychiatr Ment Health Nurs 2014; 21:879-88. [PMID: 25303405 DOI: 10.1111/jpm.12165] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2014] [Indexed: 11/27/2022]
Abstract
Dementia is an organic mental health problem that has been estimated to affect over 23 million people worldwide. With increasing life expectancy in most countries, it has been estimated that the prevalence of dementia will continue to significantly increase in the next two decades. Dementia leads to cognitive impairments most notably short-term memory loss and impairments in functioning and quality of life (QOL). National policy in the UK advocates the importance of early diagnosis, treatment and social inclusion in maintaining a good QOL. First-line treatment options often involve drug therapies aimed at slowing down the progression of the illness and antipsychotic medication to address challenging behaviours. To date, research into non-pharmacological interventions has been limited. In this manuscript, we review the literature that has reported evaluations of the effects of music therapy, a non-pharmacological intervention. The results of six studies reviewed suggest that music therapy may have potential benefits in reducing anxiety, depression and agitated behaviour displayed by elderly people with dementia as well as improving cognitive functioning and QOL. Furthermore, music therapy is a safe and low-cost intervention that could potentially be offered by mental health nurses and other carers working in residential settings.
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Affiliation(s)
- R Blackburn
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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12
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Solanki MS, Zafar M, Rastogi R. Music as a therapy: role in psychiatry. Asian J Psychiatr 2013; 6:193-9. [PMID: 23642975 DOI: 10.1016/j.ajp.2012.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 09/22/2012] [Accepted: 12/05/2012] [Indexed: 01/07/2023]
Abstract
Music is popularly believed to usher in bliss and serenity, and healing is considered its natural quality. It has an emotionally charging charisma of its own, that we all as listeners might have experienced at times. Music has been there with mankind since the beginning of history, but where does it stand as a therapy? Is there any evidence base? How this therapy came into being and how it has evolved, and what the old and current research says about its role in psychiatric disorders. This review tries to explore these questions and arrives at a conclusion that music certainly promises more than just entertainment, and evidence so far suggests music therapy can be beneficial in the treatment of psychiatric disorders, as a cost effective noninvasive adjunct to standard therapy in a variety of settings and patient groups, yet more validated scientific research is still required to establish it as a sole quantified therapy.
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Affiliation(s)
- Madhusudan Singh Solanki
- Department of Psychiatry, Safdarjung Hospital and Vardhman Mahavir Medical College, New Delhi 110029, India.
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13
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Mössler K, Chen X, Heldal TO, Gold C. Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database Syst Rev 2011:CD004025. [PMID: 22161383 DOI: 10.1002/14651858.cd004025.pub3] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Music therapy is a therapeutic method that uses musical interaction as a means of communication and expression. The aim of the therapy is to help people with serious mental disorders to develop relationships and to address issues they may not be able to using words alone. OBJECTIVES To review the effects of music therapy, or music therapy added to standard care, compared with 'placebo' therapy, standard care or no treatment for people with serious mental disorders such as schizophrenia. SEARCH METHODS We searched the Cochrane Schizophrenia Group Trials Register (December 2010) and supplemented this by contacting relevant study authors, handsearching of music therapy journals and manual searches of reference lists. SELECTION CRITERIA All randomised controlled trials (RCTs) that compared music therapy with standard care, placebo therapy, or no treatment. DATA COLLECTION AND ANALYSIS Studies were reliably selected, quality assessed and data extracted. We excluded data where more than 30% of participants in any group were lost to follow-up. We synthesised non-skewed continuous endpoint data from valid scales using a standardised mean difference (SMD). If statistical heterogeneity was found, we examined treatment 'dosage' and treatment approach as possible sources of heterogeneity. MAIN RESULTS We included eight studies (total 483 participants). These examined effects of music therapy over the short- to medium-term (one to four months), with treatment 'dosage' varying from seven to 78 sessions. Music therapy added to standard care was superior to standard care for global state (medium-term, 1 RCT, n = 72, RR 0.10 95% CI 0.03 to 0.31, NNT 2 95% CI 1.2 to 2.2). Continuous data identified good effects on negative symptoms (4 RCTs, n = 240, SMD average endpoint Scale for the Assessment of Negative Symptoms (SANS) -0.74 95% CI -1.00 to -0.47); general mental state (1 RCT, n = 69, SMD average endpoint Positive and Negative Symptoms Scale (PANSS) -0.36 95% CI -0.85 to 0.12; 2 RCTs, n=100, SMD average endpoint Brief Psychiatric Rating Scale (BPRS) -0.73 95% CI -1.16 to -0.31); depression (2 RCTs, n = 90, SMD average endpoint Self-Rating Depression Scale (SDS) -0.63 95% CI -1.06 to -0.21; 1 RCT, n = 30, SMD average endpoint Hamilton Depression Scale (Ham-D) -0.52 95% CI -1.25 to -0.21 ); and anxiety (1 RCT, n = 60, SMD average endpoint SAS -0.61 95% CI -1.13 to -0.09). Positive effects were also found for social functioning (1 RCT, n = 70, SMD average endpoint Social Disability Schedule for Inpatients (SDSI) score -0.78 95% CI -1.27 to -0.28). Furthermore, some aspects of cognitive functioning and behaviour seem to develop positively through music therapy. Effects, however, were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided. AUTHORS' CONCLUSIONS Music therapy as an addition to standard care helps people with schizophrenia to improve their global state, mental state (including negative symptoms) and social functioning if a sufficient number of music therapy sessions are provided by qualified music therapists. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcomes measures in relation to music therapy.
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Affiliation(s)
- Karin Mössler
- GAMUT, University of Bergen, Lars Hilles Gt. 3, Bergen, Norway
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14
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Gold C, Solli HP, Krüger V, Lie SA. Dose-response relationship in music therapy for people with serious mental disorders: systematic review and meta-analysis. Clin Psychol Rev 2009; 29:193-207. [PMID: 19269725 DOI: 10.1016/j.cpr.2009.01.001] [Citation(s) in RCA: 182] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Revised: 01/06/2009] [Accepted: 01/12/2009] [Indexed: 12/19/2022]
Abstract
Serious mental disorders have considerable individual and societal impact, and traditional treatments may show limited effects. Music therapy may be beneficial in psychosis and depression, including treatment-resistant cases. The aim of this review was to examine the benefits of music therapy for people with serious mental disorders. All existing prospective studies were combined using mixed-effects meta-analysis models, allowing to examine the influence of study design (RCT vs. CCT vs. pre-post study), type of disorder (psychotic vs. non-psychotic), and number of sessions. Results showed that music therapy, when added to standard care, has strong and significant effects on global state, general symptoms, negative symptoms, depression, anxiety, functioning, and musical engagement. Significant dose-effect relationships were identified for general, negative, and depressive symptoms, as well as functioning, with explained variance ranging from 73% to 78%. Small effect sizes for these outcomes are achieved after 3 to 10, large effects after 16 to 51 sessions. The findings suggest that music therapy is an effective treatment which helps people with psychotic and non-psychotic severe mental disorders to improve global state, symptoms, and functioning. Slight improvements can be seen with a few therapy sessions, but longer courses or more frequent sessions are needed to achieve more substantial benefits.
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