Music Soothes the Schizophrenic Patient

A meta-analysis in BMC Psychiatry suggests a significantly better treatment effect in schizophrenic patients who received music therapy (MT) than in those who did not, especially in those with a chronic course of the disease. This effect was consistent regardless of the duration, frequency, or numbers of MT sessions.

The therapeutic powers of music for a number of conditions—including chronic pain—have been well-documented. But for schizophrenia, the clinical evidence of music’s benefit has been mixed.

The finding is important because patients with schizophrenia often have comorbid mood symptoms, either in the form of a manic mood or depression. Many also have associated risk factors that can include violence and suicide. Music therapy has been used as adjunct therapy for decades, but most studies of MT’s impact have focused on its treatment of negative and mood symptoms only—not “positive” mood symptoms that, despite the typical use of the word, aren’t necessarily positive for patients with schizophrenia. “Positive symptoms have been proven to be highly associated with the risk of violence, which contributes to the stigmatization of patients with schizophrenia,” the study authors note.

The researchers conducted performed meta-regression analysis to evaluate the association between the treatment effect of MT. The primary outcome was disease severity rating scale, which varied in every study; they included the Brief Psychiatric Rating Scales (BPRS), the Positive And Negative Symptoms Scales (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), and the Self-rating Depression Scales (SDS) The authors gave priority to the PANSS rather than the BPRS, SANS, and SDS, because it is more specific to the setting of schizophrenia.

A total of 402 schizophrenic patients who received adjunct music therapy and 402 who did not were extracted from the 12 studies selected for review. The treatment effect in the schizophrenic patients was significantly better in those treated with adjunct music therapy than in those treated without adjunct music therapy (ES&thinsp;=&thinsp;3.25, 95 % confidence interval (CI): 2.08 to 4.42, p&thinsp;<&thinsp;0.001). After adjusting for confounding variables, the reviewers found significant improvement in treatment effect when MT was used.

“The results showed that the treatment effect of music therapy was positively associated with the ‘whole duration of illness,’” the reviewers noted. “This means that the application of music therapy for schizophrenic patients could alleviate disease severity, especially in those with chronic illness…Because music therapy is costly and complex, clinicians may be reluctant to include it in clinical practice. However, our findings show that the effect of music therapy is beneficial regardless of the frequency, length, and duration. Therefore, we suggest that clinicians should consider including adjunct music therapy into their clinical practice to provide their patients with the best outcomes possible.”