Muzikoterapija za osobe oboljele od shizofrenije i shizofreniji sličnih poremećaja
Abstract
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.
PICO
Plain language summary
Terapija glazbom za shizofreniju i shizofreniji slične poremećaje
Terapija glazbom (muzikoterapija) je terapeutska metoda koja koristi glazbene doživljaje kako bi pomogla osobama s teškim mentalnim poremećajima u razvoju odnosa i rješavanju problema, što ne bi mogli uz korištenje isključivo riječi. Dosadašnje studije su proučavale učinke muzikoterapije kao dodatne terapije, uz standardnu skrb. Rezultati tih studija su pokazali kako terapija glazbom poboljšava opće stanje, uz poboljšanje mentalnog stanja i funkcioniranja ukoliko je proveden dovoljan broj seansi muzikoterapije.
