Music Therapy for Schizophrenia

(SING_R33 Trial)

Overseen By Philip R Corlett, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Yale University

Disqualifiers: Substance abuse, Head injury, IQ<70, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 6

Duration: 4 weeks

200 Participants Needed

Trial Summary

Do I need to stop my current medications for the trial?

No, you don't need to stop your current medications. You must have at least 2 weeks of stable doses of psychotropic medications before participating.

Will I have to stop taking my current medications?

The trial requires that participants have at least 2 weeks of stable doses of their current psychotropic medications, so you will not need to stop taking them. Your medication type and dose will be recorded and considered in the study analysis.

What data supports the idea that Music Therapy for Schizophrenia is an effective treatment?

The available research shows that music therapy can be an effective treatment for schizophrenia. One study found that group music activities significantly reduced the severity of psychotic symptoms in patients with acute schizophrenia. Another study showed that music therapy improved social interaction and reduced negative symptoms in patients with residual schizophrenia. Additionally, a systematic review indicated that music therapy can help manage symptoms like depression and anxiety, improve social and cognitive functioning, and enhance quality of life. Compared to other treatments, music therapy is beneficial because it has no side effects and is relatively inexpensive. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment Musical Intervention, Song-making In a Group (SING), Musical Intervention (MI) for schizophrenia?

Research shows that music therapy, including group music activities, can help reduce symptoms of schizophrenia, such as psychotic symptoms and depression, and improve social interaction and quality of life. Studies have found that both active participation in music and listening to music can be beneficial, especially when done in a group setting. ^{1 2 3 4 5}

What safety data exists for music therapy in treating schizophrenia?

The available research indicates that music therapy, including various forms such as active, receptive, and combined, has been studied for its effects on schizophrenia. The studies reviewed suggest that music therapy can improve symptoms and quality of life without side effects. A systematic review and meta-analysis found significant improvements in symptoms and quality of life, and a randomized controlled trial reported no side effects, highlighting music therapy as a safe and potentially effective adjunct treatment for schizophrenia. ^{1 2 5 6 7}

Is music therapy safe for people with schizophrenia?

Music therapy is generally considered safe for people with schizophrenia, as it has no reported side effects and can improve symptoms like social isolation and interest in external events. ^{1 2 5 6 7}

Is music therapy a promising treatment for schizophrenia?

Yes, music therapy is a promising treatment for schizophrenia. It helps reduce negative symptoms, improves social interaction, and increases interest in activities. Patients also find it relaxing and it helps them express emotions better. Plus, it has no side effects and is affordable. ^{1 4 5 8 9}

How is the music therapy treatment for schizophrenia unique compared to other treatments?

Music therapy for schizophrenia is unique because it involves active participation in group song-making, which helps reduce social isolation and improve communication without side effects, unlike standard drug treatments. ^{1 4 5 8 9}

What is the purpose of this trial?

This trial tests a musical intervention called SING for people with psychotic illnesses who hear voices and have social difficulties. The goal is to see if musical activities can help improve their symptoms by changing how their brain processes experiences. Singing has been used in language rehabilitation for decades, with various studies suggesting its potential benefits for neurological and speech disorders.

Research Team

Philip R Corlett, PhD

Principal Investigator

Yale University

Eligibility Criteria

This trial is for individuals who hear voices daily and have been diagnosed with a psychotic disorder as per the Diagnostic and Statistical Manual-V. They must exhibit moderate hallucinations, be able to give informed consent, interact well with the study team, and likely complete the study.

Inclusion Criteria

Voice hearing patients meeting diagnostic criteria for Diagnostic and Statistical Manual-V psychotic disorder

I hear voices daily.

PANSS P3 (Hallucinations item) greater than 3

Exclusion Criteria

My mental health medication dose has been stable for at least 2 weeks.

I have a serious medical condition or had a head injury with symptoms.

My IQ is below 70.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Treatment

Participants engage in the SING intervention, involving music-making activities in groups with a trained facilitator

4 weeks

4 weekly sessions

Follow-up

Participants are monitored for changes in language use, social belief updating, and conditioned hallucinations

1 week

1 visit (in-person)

Treatment Details

Interventions

• Musical Intervention

Trial Overview The SING trial tests how different forms of musical intervention affect people with schizophrenia. Participants are randomly assigned to create music, perform karaoke, listen to pop music or curate playlists. The impact on hallucinations, social learning, and language use is measured.

Participant Groups

Group I: Musical Intervention Experimental Treatment 1 Intervention

Participants will work together in a group with other voice hearers, making music with a trained facilitator for 4 weekly sessions

Musical Intervention is already approved in United States for the following indications:

Approved in United States as Musical Intervention for:

• Psychotic illnesses
• Conditioned Hallucinations
• Social Reinforcement Learning
• Language Use

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials

1,963

Recruited

3,046,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

Assisted music therapy combined with drug therapy significantly improved symptoms in chronic schizophrenia patients compared to drug therapy alone, as shown by lower scores on the SANS and BPRS scales in the experimental group.

The study analyzed 11 articles with a total of 603 patients, indicating that while short-term benefits of music therapy are evident, further research is needed to assess its long-term effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Meta-analysis of assisted music therapy for chronic schizophrenia]. You, ZY., Wang, JZ.[2006]

Music therapy, particularly when delivered in a combined format (active and receptive), significantly improves various outcomes for individuals with schizophrenia, including psychotic symptoms, depression, anxiety, and overall quality of life, based on a review of 17 studies.

The dosage of music therapy is crucial, with higher exposure times (ranging from 20 to 9,720 minutes) leading to better results, suggesting that more extended therapy sessions are more effective than shorter ones.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of Dosage and Type of Music Therapy in Symptom Management and Rehabilitation for Individuals with Schizophrenia. Chung, J., Woods-Giscombe, C.[2019]

In a study involving 80 patients with schizophrenia, those who participated in group music therapy showed significant improvements in psychiatric symptoms and depression compared to those who received usual care.

The music therapy consisted of 10 sessions, each lasting 60 minutes, and was found to be an effective and cost-efficient intervention for enhancing mental health in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of group music intervention on psychiatric symptoms and depression in patient with schizophrenia. Lu, SF., Lo, CH., Sung, HC., et al.[2013]

In a study involving 67 patients with schizophrenia, group music activity as an adjunctive therapy significantly reduced psychotic symptoms, as measured by the Brief Psychiatric Rating Scale (BPRS).

The intervention consisted of 50-minute group music sessions held five times a week for 2 weeks, demonstrating that incorporating music therapy can enhance standard care for patients in acute psychiatric settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of group music activity as an adjunctive therapy on psychotic symptoms in patients with acute schizophrenia. Peng, SM., Koo, M., Kuo, JC.[2010]

In a study of 76 in-patients with the residual subtype of schizophrenia, music therapy combined with standard medication significantly reduced negative symptoms and improved social interaction and interest in external events.

Music therapy is a safe and cost-effective intervention with no side effects, suggesting it could be beneficial for broader use in treating schizophrenia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rehabilitative effect of music therapy for residual schizophrenia. A one-month randomised controlled trial in Shanghai. Tang, W., Yao, X., Zheng, Z.[2008]

Adjunct music therapy significantly improved overall symptoms, negative symptoms, depression symptoms, and quality of life in patients with schizophrenia, based on a meta-analysis of 18 studies involving 1,212 participants.

Despite these positive findings, the quality of evidence is considered low, indicating a need for more well-designed studies with larger sample sizes to further confirm the efficacy of music therapy in treating schizophrenia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of adjunct music therapy for patients with schizophrenia: A meta-analysis. Jia, R., Liang, D., Yu, J., et al.[2021]

In a study of 60 participants experiencing acute psychotic episodes, music therapy as an adjunct to standard pharmacological treatment showed a statistically significant improvement in Brief Psychiatric Rating Scale (BPRS) scores for the treatment group compared to the control group.

Although the treatment group experienced a 9.3% reduction in hospital stay length, this finding was not statistically significant, suggesting that while music therapy may benefit some patients, its overall impact on hospitalization and other psychological assessments remains inconclusive.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A controlled trial investigating the effect of music therapy during an acute psychotic episode. Morgan, K., Bartrop, R., Telfer, J., et al.[2011]

Different types of music therapy, including listening, singing, dancing, and playing instruments, can be effectively combined to create a graduated group-centered approach for treating schizophrenia.

The study suggests that music therapy can significantly influence anxiety and activity levels in individuals with schizophrenia, promoting more appropriate communication and behavior within the group setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Possibilities for inclusion of group music therapeutic methods in the treatment of psychotic patients]. Schmuttermayer, R.[2006]

Music therapy is well-accepted by schizophrenic patients, showing no negative effects even when introduced during the post-acute phase of treatment, based on a study of 30 patients.

The therapy provides positive benefits such as relaxation, reduced anxiety, and improved emotional expression, although the duration of these effects is limited.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Music therapy evaluated by schizophrenic patients]. Reker, T.[2006]

References

1. China pubmed.ncbi.nlm.nih.gov

[Meta-analysis of assisted music therapy for chronic schizophrenia]. [2006]

2. England pubmed.ncbi.nlm.nih.gov

Influence of Dosage and Type of Music Therapy in Symptom Management and Rehabilitation for Individuals with Schizophrenia. [2019]

3. Scotland pubmed.ncbi.nlm.nih.gov

Effects of group music intervention on psychiatric symptoms and depression in patient with schizophrenia. [2013]

4. United States pubmed.ncbi.nlm.nih.gov

Effect of group music activity as an adjunctive therapy on psychotic symptoms in patients with acute schizophrenia. [2010]

5. England pubmed.ncbi.nlm.nih.gov

Rehabilitative effect of music therapy for residual schizophrenia. A one-month randomised controlled trial in Shanghai. [2008]

6. Ireland pubmed.ncbi.nlm.nih.gov

The effectiveness of adjunct music therapy for patients with schizophrenia: A meta-analysis. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

A controlled trial investigating the effect of music therapy during an acute psychotic episode. [2011]

8. Germany pubmed.ncbi.nlm.nih.gov

[Possibilities for inclusion of group music therapeutic methods in the treatment of psychotic patients]. [2006]

9. Germany pubmed.ncbi.nlm.nih.gov

[Music therapy evaluated by schizophrenic patients]. [2006]