This article reports on the ongoing project development and research study ‘A New Sound and Music Milieu at Aalborg University Hospital’. Based on a number of pilot studies in AUH-Psychiatry on how special playlists and sound equipment (sound pillows and portable players) can be used by hospital patients and administered by hospital staff supervised by music therapists, the new project aims to prepare the ground for a systematic application of sound and music in the hospital environment. A number of playlists have been developed, based on theoretical and empirical research in music medicine and music therapy. A special software and hardware design – ‘The Music Star’– has been developed, and installed in combination with a directional line array speaker in patient rooms in two ICUs at the AUH–Psychiatry. The aim of the project is to empower patients to choose music suited to their needs here and now. In the study we focus on how self-selected music may lead to a decrease in anxiety and pain or improved relaxation/sleep. The article describes and discusses the theory-driven development of the sound/music milieu, relevant empirical studies, the novel method of data collection, preliminary results of the project and implications for the future implementation of the model.
Objective: To investigate the efficacy of music therapy for negative symptoms in patients with schizophrenia.Methods: Randomized, participant- and assessor-blinded, multicenter, controlled trial including patients diagnosed with schizophrenia according to ICD-10 with predominantly negative symptoms, between 18 and 65 years. Participants were randomized to 25 successive weekly individual sessions (excluding holidays, including cancellation by the participant) of either music therapy conducted by trained music therapists, or music listening together with a social care worker. The primary outcome was reduction in negative symptoms as measured by The Positive and negative Syndrome Scale (PANSS) negative subscale total score, assessed by a blinded rater, utilizing mixed-effects model analysis.Results: In total, 57 participants were randomized; 39 completed the study's initial 15 weeks, and 30 completed follow-up at 25 weeks. On the primary outcome of PANSS negative subscale, no significant difference was observed between groups with a coefficient of −0.24 (95% CI −1.76 to 1.27, P = 0.754) in the intention to treat analysis, and −0.98 (95% CI −5.06 to 3.09, P = 0.625) when only analyzing completers. Both interventions showed significant reduction from baseline to 25 weeks on PANSS negative subscale. On secondary outcomes, no between group differences were observed in The Brief Negative Symptom Scale, WHOQOL-Bref (Quality of Life), The Helping Alliance Questionnaire and The Global Assessment of Functioning in the intention to treat or completers populations utilizing Mixed Effects Models.Conclusion: No difference between groups randomized to music therapy vs. musical listening was observed resulting in no clear recommendation for which intervention to use as the first choice for treatment of patients diagnosed with schizophrenia and predominantly having negative symptoms.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02942459.
Background: Three Cochrane reviews show that music therapy has a positive effect on schizophrenia concerning general functioning and positive/negative symptoms. This study aims to replicate these results in the Danish health system, a requirement for recommendation in guidelines from the Danish National Board of Health. Methods: The study is a randomized, controlled multi-site study, with a blinded design, aiming to include 90 participants who are 18–65 years in age, diagnosed according to ICD-10 with a schizophrenia diagnosis. The participants are randomized to one of two different music therapy activities for 25 weekly sessions. The study interventions are added to standard care. Outcome measures are rated at baseline, after 15 sessions and post therapy. A qualitative interview is performed as a one month follow up at the end of study. The primary intended outcome is a reduction in negative symptoms. The secondary intended outcome is progression in quality of life, alliance and psychosocial functioning. Results: As this study is still running, the results are not yet available. Conclusion: The study will investigate the direct effects of music therapy on negative symptoms as part of schizophrenia in a blinded, randomized trial. If proven effective, music therapy can be added to the small treatment armamentarium of effective therapies for negative symptoms in patients with schizophrenia.
Introduction: The objectives of the pilot study were (a) to investigate the feasibility of the research design (referral procedure, data collection procedure, measurement tools, and treatment doses/frequency); (b) to develop and evaluate the PROMT treatment manual; and (c) to test the use of flexible and or multiple interventions as part of the treatment options. Findings from this investigation aim to prepare for a future outcome study of music therapy treatments for patients with personality disorders, that are inspired by analytically oriented music psychotherapy and mentalization-based treatment. Methods: Four participants assessed and diagnosed with personality disorder received 40 sessions of individual music therapy. Pre and post measures of outcome variables looking at attachment style, helping alliance, symptom severity, interpersonal problems, and quality of life were evaluated for inclusion in the design. Interviews with clinicians were used to further evaluate the manual. Results: All participants completed treatment. Outcome measurement provided usable information and also showed some positive changes in the four cases. The research design was found to be usable for a larger study. The treatment manual was evaluated as usable, but specification on how to use mentalization-based treatment in music-based interventions is required in a future manual. Discussion: In light of the current findings, we discuss several factors relevant to a possible future outcome study, including the research design, theoretical model, and specific elements of the treatment manual. We also discuss the potential of using flexible and/or multiple interventions as part of the treatment options. We conclude that integration of mentalization-based treatment into music therapy seems promising, but further development of the treatment manual is needed.
ObjectivesExamine whether change in clinical outcomes for patients with schizophrenia and negative symptoms randomized to either Music Therapy (MT) or Music Listening (ML) is associated to moderators and mediators, with focus on alliance, attendance and dropout.MethodAn exploratory post-hoc analysis of data from an original randomized controlled trial (RCT) investigating the effect of MT vs. ML for people with schizophrenia and negative symptoms. Inclusion to the study was implemented through screening of referred patients for symptoms of schizophrenia and negative symptoms. A total of 57 patients were randomly assigned, 28 to MT and 29 to ML. Session logs and notes were included in this study. Statistical analysis investigated moderator and mediator relation to outcome variables: Negative symptoms, functioning, quality of life, and retention to treatment.ResultsOn average, participants in MT attended 18.86 sessions (SD = 7.17), whereas those in ML attended 12.26 (SD = 9.52), a statistically significant difference (p = 0.0078). Dropout at 25 weeks was predicted by intervention, with dropout being 2.65 (SE = 1.01) times more likely in ML than in music therapy (p = 0.009). Helping alliance score at weeks was explained by intervention, with mean score being 0.68 (SE = 0.32) points lower in ML than in MT (p = 0.042). The number of sessions attended was also explained by intervention, with participants in ML attending on average 6.17 (SE = 2.24) fewer sessions than those randomized to MT (p = 0.008). Though both groups improved significantly, improvements in negative symptoms, depression, and functioning tended to be higher in ML, whereas improvements in alliance and quality of life tended to be higher in MT.ConclusionThe analysis could not detect a direct link between helping alliance score and outcome variables. However, the analysis documented a stronger alliance developed in the MT group, a lower dropout rate, as well as higher attendance in treatment.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02942459.
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