Music Therapy as Treatment of Negative Symptoms for Adult Patients Diagnosed with Schizophrenia—Study Protocol for a Randomized, Controlled and Blinded Study

Abstract

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.

Music Therapy vs. Music Listening for Negative Symptoms in Schizophrenia: Randomized, Controlled, Assessor- and Patient-Blinded Trial

“…Rationale and in-depth description of all study procedures were presented in a protocol publication (1).…”

“…Negative symptoms in patients with schizophrenia have been correlated with lower quality of life, lower overall social and global functioning, as well as cognitive deficits (1). Several systematic reviews have shown that adjunct music therapy treatment is beneficial, useful and viable in general (2)(3)(4) and others have shown positive effect on negative symptoms (5)(6)(7)(8)(9).…”

Music as a Psychosocial Intervention with People Suffering from Schizophrenia: Challenges in Practice and Research

“…If this is not possible, the client cannot be included in the study." [25]. So many factors could provide that the potential participant became insecure or regretted just before or during the planned screening procedure.…”

A Complex Combination Therapy for a Complex Disease–Neuroimaging Evidence for the Effect of Music Therapy in Schizophrenia

“…Similarly, the following exclusion criteria may be used: relatively recent onset of schizophrenia; clinical presentation dominated by positive symptoms; changes in medication in the prior month; recent hospitalization; history of substance abuse; history of significant adverse effects of antipsychotic therapy (extrapyramidal symptoms, sedation, etc.) ( 103 ). Meta-analytical results appear to corroborate the proposed idea of a beneficial influence of music therapy on symptom reduction, including negative symptoms, as well as on quality on life ( 104 ).…”

“…It is the view of the authors that adequate evaluation of the outcome of music therapy entails careful consideration of the following: the initial patient selection; session quality, as opposed to simply the number of sessions; deeper analysis of long-term effects of music therapy; the dose-response relationship ( 106 ). Alternatively, other authors have suggested complex therapy consisting of 25 sessions of music therapy, with improvements in general functioning and alleviation of negative symptoms having been reported ( 103 ). Still other findings suggest an optimal duration of 3 months for music therapy in order for an effect on negative symptoms to be registered ( 104 ).…”