November 01, 2006

Music Therapy May Help Reduce Schizophrenia Symptoms

A small study, published in the November 2006 (Vol 189) issue of the British Journal of Psychiatry, found that adding music therapy to standard treatment for acutely ill inpatients with schizophrenia provided additional benefit over standard therapy alone.

Britian's Royal College of Psychiatrists reported that Music therapy for psychiatric in-patients with schizophrenia can improve some of the symptoms of the disorder, a new study has found.

Whereas the effects of listening to music and singing have been examined among people with long-term mental health problems, the effects of ‘co-improvisational music therapy’ among people with acute schizophrenia, have not been evaluated.

The aims of this exploratory study, published in the November issue of the British Journal of Psychiatry, were to examine the feasibility of a randomised trial of music therapy for in-patients with schizophrenia, and to explore its effects on mental health.

81 in-patients at one of four hospitals in central and inner London were randomised to receive music therapy or standard care alone. Those receiving music therapy received up to 12 sessions, once a week, for up to 45 minutes.

During sessions, patients were given access to a range of musical instruments, and encouraged to use them to express themselves. All sessions were digitally recorded.

The focus of the therapy was on creating improvised music together with the therapist, with talking used to guide, interpret or enhance the musical experience.

Initially the therapist listens carefully to the patient’s music and accompanies them closely, seeking to meet their emotional state in musical terms. Then the therapist offers opportunities to extend or vary the nature of the musical interaction.

Supervision of music therapists involves reflection on the meaning of the interaction between therapist and patient, and close examination of the co-improvisations by listening to recordings of the sessions.

Most of the people had not been to a group or other therapeutic activity in the two weeks before the study, but those randomised to music therapy attended an average of 8 sessions over the following 12 weeks.

Positive and negative symptoms of schizophrenia were measured, and it was found that changes in total scores among those patients receiving music therapy were significantly greater than in those receiving standard care.

The authors of the study comment that the results showed that such a trial is feasible, and that the majority of the patients offered music therapy will accept it.

Referral for music therapy was associated with short-term reductions in general symptoms (depression) and negative symptoms of schizophrenia, although variations in baseline characteristics of the study sample may have been responsible for these apparent differences.

The researchers believe that the study provides sufficient evidence to justify a larger explanatory randomised trial of music therapy for people with schizophrenia, designed to explore the effects and cost-effectiveness of this kind of therapy.

A podcast interview with the lead research on this project can be found here:
Dr Mike Crawford, Department of Psychological Medicine, Imperial College London, talks to Dr Persaud about music therapy for in-patients with schizophrenia.


Read the story at Reuters Health News - Music may ease symptoms of schizophrenia: study

Research Journal Article/Abstract: Music therapy for in-patients with schizophrenia - An Exploratory randomised controlled trial


Further Reading:
In 2005, a team of Cochrane Review Authors found four studies that met their stringent inclusion criteria showing that:

  • Patients receiving music therapy did better than those getting standard care alone
  • The effects of music therapy seemed to be strongly linked to the number of therapy sessions
  • There was no need for the client to have any particular musical ability or prior experience
  • Specific techniques of music therapy included musical improvisation and discussion of personal issues related to the musical process
  • Specialized training for the therapist was required
That article can be found at: Music therapy can help people with schizophrenia on Medical News Today.

More about schizophrenia and music therapy:
Music therapy may help people with schizophrenia
Recent Cochrane Reviews


Comments

I know that just playing music loudly helps some children & adolescents cope with the hallucinatory voices and sounds they would otherwise be hearing.

I know this does not have to do with music therapy, but although I read articles about people with schizophrenia that also are musicians, sadly, some musicians lose their music after becoming acutely psychotic. I wonder what the difference is between those two groups.

-Naomi

Posted by: Naomi_njw at November 1, 2006 10:37 AM

i don't think it's a matter of 'losing' musicality. i think it is in the movie about schizophrenia called 'I'm Still Here' distributed by Jannsen, about a famous jazz musician who got schizophrenia, and he and his wife explain that it is the negative symptoms that interfere with him continuing to create music, perform, etc. due to negative symptoms he just sits around and does nothing, it causes him to become very lethargic and disinterested. i have a friend who was a brilliant guitarist before becoming ill, and simply lost interest when he became ill, he never got any treatment, and i know a number of musicians who are working professionally and got treatment and continue to be very productive. i think it depends on how severe the illness is and how adequately it is treated.

Posted by: slc2 at November 1, 2006 11:27 AM

Maybe, too, frustration factors in... even after adequate treatment, I would imagine that it would be frustrating to pick up an instrument after being away from it for years and trying to play it again.

A musical family member of mine quit music after slowly recovering, but did turn to other forms of art - albeit nothing with the previous passion of her music.

I also wonder if Art Therapy would have had the same positive effect on symptoms as the Music Therapy. Or Dance Therapy, for that matter. It will be interesting to see future comparative studies. Perhaps it is the mere fact of getting intensely involved in something creative & expressive that enhanced the outcome in the studied patients.

-Naomi

Posted by: Naomi_njw at November 1, 2006 12:54 PM

I have found that music helps me a lot most of the time. But, I just wanted to say that when very ill, some music might be too powerful to deal with. For instance, some lyrics can become very poignant with meaning and can be taken very personally and can cause fear. But, I think it's just making the right choice of music when severely ill. I have a very eclectic taste usually but when severely psychotic I got to a point where I could only listen to Bach harpsicord because there weren't any disturbing lyrics or sometimes too much of dynamic range which can be quite emotional. But as I get better, I listen to more and more of everything that I used to like. Just something to keep in mind.

-P4r4

Posted by: P4r4 Enator at November 2, 2006 09:07 AM

Music therapy as an addition to standard care helps people with schizophrenia to improve their global state and may also improve mental state and functioning if a sufficient number of music therapy sessions are provided. Further research should address the dose-effect relationship and the long-term effects of music therapy.

Posted by: Vicodin Detox at November 4, 2006 11:14 AM

Respected sir/madam

what is schizophrenia and depression same .....

I'm ist yrs.student of psycology,thanking u

Posted by: pooja at November 11, 2006 08:16 AM

My wife is ill of schizophrehia. What can I do to help her and to protect her? PLEASE HELP ME! sEND ME MESSAGES AT mstfufi@personal.ro.

Thanks a lot!

Posted by: JULIUS ANDREOTTI at November 19, 2006 06:20 AM

I listen to music and it makes me crazy. I just want to jump on the furniture and take a whiz all over the place. Anyone else experienced this symptom?

Posted by: Hank at November 19, 2006 05:04 PM

hey my mom has it what shouldi do when she coems to me acting all like shes someone else

Posted by: martha at November 22, 2006 09:39 AM

Can I suggest a hypothetical model of the mind?

What if there are two parts to the mind, one possessing the constructs to make us conscious (focus and language), and the other, the subconscious (triggered sequences based on stimuli), that actually runs the body? Furthermore, the conscious mind is capable of communicating externally (to others), and can also communicate somewhat directly to the subconscious. However, the subconscious is normally mute and communicates to the conscious part by emotional feedback. This relationship is similar to the one we can see when learning a new language: while a student's understanding vocabulary (passive) can be large enough to allow comprehension, his/her speaking vocabulary (active) may be poor at best and doesn't allow much (any?) effective communication. Normally, if the subconscious can communicate somewhat effectively through emotional feeback, there is no need to pursue an active vocabulary.

What would happen if a portion of the mechanisms in the conscious part of the mind (focus and language mostly), were to take root in the subconscious? Would it then try to speak directly to the conscious part? Yes, and these would be the voices of schizophrenia. What might be a fix for such a problem? Perhaps two: the conscious part needs to pay attention to the emotional feedback and not to the voices; and two, try to swamp the conscious 'tumour' within the subconscious by introducing emotional sequences to occupy the subconscious. Music is the most readily available, though poetry may also help.

Posted by: Joe Egerszegi at September 27, 2007 06:08 AM

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Posted by: tabs and lyrics at November 21, 2007 09:01 PM

Martha - if your Mom is coming to you, acting "all like she's somebody else", are you certain her diagnosis is schizophrenia?

Hank - you really aren't SERIOUS, are you?

Julius Andreotti - I strongly suggest you ask your wife's doctor this question - that 's why s/he's there! Also, contact your local Schizophrenia Society chapter.

Pooja - as a 1st year psych student, you really should know the differences between depression and schizophrenia! You MUST have taken Psych 101/102 by now!

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