Psychosocial Rehabilitation Effects of Music Therapy in Chronic Schizophrenia

Abstract

SUMMARY This study examines the use of music as an adjunct therapy to medication. Seventy chronic schizophrenic patients with social disability were randomly assigned to an experimental group (n=40) and a control group (n=30). Individual and group music therapy combined with antipsychotic medications were given to the experimental group, while the control group received only neuroleptic therapy. All patients were evaluated with PSE, SANS, BPRS and SDSI. Videotaping was used to assess the changes from beginning to end. The results suggested a more positive effect of music therapy combined with medication on negative symptoms and social disability than medication alone. As reflected by the score on sluggishness, blunted affect, and poverty of thought, the improvement of negative symptoms was significant. There was also a significant difference in the reduction of severity in psychiatric disability three months after the music therapy. Key words: psychosocial rehabilitation, music therapy, schizophrenia INTRODUCTION The goal of psychiatric rehabilitation is to restore social functioning associated with mental disability. Although conventional antipsychotic drugs are effective in the treatment of positive symptoms in schizophrenia, negative symptom of chronic schizophrenia are more resistant to drug treatment (Liberman, 1958). It is believed that psychosocial rehabilitation methods when combined judicially with medication, can improve the negative symptoms of chronic schizophrenia. Music therapy can be regarded as one form of psychosocial rehabilitation because it can enhance social coheresiveness, and can affect individual's psychological and physiological well being, so as cognitive functioning and emotional expression. Recent suds have found that music therapy have a positive influence an self-perception and it can strengthen the ego of schizophrenic patients. Music therapy was also found to be effective in reducing negative symptoms by increasing patients' ability to convene with others and their interest in external events. This study examines the effectiveness of such therapy in reducing negative symptoms and social disabilities of chronic schizophrenic inpatients METHODOLOGY SELECTION OF SUBJECTS Al subjects were chronic schizophrenic inpatients who met CCMD-2 diagnostic criteria for schizophrenia (Wang, 1987). Besides, they all demonstrated social disability with the following characteristics: The duration of illness was greater than two years; They had received antipsychotic drugs in sufficient dose during the past six months; but symptoms had not been fully remitted. They did not have any physical disease. Seventy-two patients were recruited initially and they were randomly assigned to an experimental group and a control group. One subject from each group dropped out before completion of the study, leaving behind a total number of 70 patients with 41 males acid 29 females. Their ages ranged from 21 to 55 years with a mean of 35.6 years. The duration of illness ranged from 2 to 26 years with a mean of 12.6 years. They had at least two relapses which required readmission. The experimental group was given must therapy combined with neuroleptic medication (n=40) while the control group was given neuroleptic medication alone (n=30). Dose of antipsychotic drugs was unchanged from the beginning of the music therapy to the end of the study. The distribution of age, sex and education in the two groups is shown in Table 1. ASSESSMENT INSTRUMENTS The severity of symptoms and social functioning were assessed by two psychiatrists using the SANS, BPRS, PSE and SDSI (Social Disability Schedule for In-patient). The bests were performed at the beginning and the end of the study to compare the changes between the two groups. The inter-rater reliability was found to be satisfactory, with correlation coefficients for SANS, BPRS and SDSI all over 0. …