Intervention Review

Music therapy for people with schizophrenia and schizophrenia-like disorders

  1. Karin Mössler1,
  2. XiJing Chen2,
  3. Tor Olav Heldal3,
  4. Christian Gold4,*

Editorial Group: Cochrane Schizophrenia Group

Published Online: 7 DEC 2011

Assessed as up-to-date: 31 JAN 2011

DOI: 10.1002/14651858.CD004025.pub3


How to Cite

Mössler K, Chen X, Heldal TO, Gold C. Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD004025. DOI: 10.1002/14651858.CD004025.pub3.

Author Information

  1. 1

    University of Bergen, GAMUT, Bergen, Norway

  2. 2

    Aalborg University, Department of Communication and Psychology, Aalborg, Aalborg, Denmark

  3. 3

    Nordfjord Psychiatric Centre, Førde Health Trust, GAMUT, University of Bergen, Bergen, Norway

  4. 4

    Uni Health, Uni Research, Grieg Academy Music Therapy Research Centre (GAMUT), Bergen, Norway

*Christian Gold, Grieg Academy Music Therapy Research Centre (GAMUT), Uni Health, Uni Research, Lars Hilles gate 3, Bergen, 5015, Norway. christian.gold@uni.no.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 7 DEC 2011

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Music therapy for schizophrenia or schizophrenia-like disorders

Music therapy is a therapeutic method that uses music experiences to help people with serious mental disorders to develop relationships and to address issues they may not be able to using words alone. Studies to date have examined the effects of music therapy as an add-on treatment to standard care. The results of these studies suggest that music therapy improves global state and may also improve mental state and functioning if a sufficient number of music therapy sessions are provided.