Journal of Music and Human Behavior (인간행동과 음악연구)

Korean Music Therapy Education Association (한국음악치료교육학회)
권호 표지
DOI QR코드

DOI QR Code

Music as a Therapeutic Intervention for Patients with Schizophrenia: Systematic Review

조현병 환자 대상 음악중재에 대한 체계적 고찰

  • Received : 2015.09.25
  • Accepted : 2015.11.18
  • Published : 2015.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to systematically review music intervention studies for patients with schizophrenia. The researcher searched nine electronic databases for clinical trials published since 2000, using combinations of keyword related to schizophrenia and music interventions. The initial search identified 272 studies, and fifteen studies were selected by reviewing the titles, abstracts and full articles, In addition, three articles were added by examining other review articles. Thus, a total of 18 articles were analyzed in terms of their general and intervention characteristics, and the PEDro scale was used to evaluate the methodological quality of the included studies. The results demonstrated that, due to the lack of randomization and blinding, the methodological qualities of the studies with high quality music interventions were often rated low. Eight Music interventions conducted by qualified music therapists included active music-making, therapeutic relationship, and supervision systems for improving intervention quality. In conclusion, the randomization, blinding, and the therapeutic rationale of intervention are recommended in future clinical trials for patients with schizophrenia.

본 연구는 조현병환자 대상 음악중재 연구를 체계적으로 고찰하고자 실시되었다. 2000년 이후 연구를 대상으로 9개의 학술검색엔진에서 조현병과 음악중재 관련 주제어를 조합, 검색하여 272개를 우선 선택하였고, 제목 및 초록의 내용 확인 후 전문 확인의 과정을 거쳐 15개의 논문을 선택하였다. 조현병 음악치료에 대한 기존의 고찰연구에서 15개에 포함되지 않은 3개의 논문을 추가하여 전체 18개의 분석대상 논문을 최종 결정하였다. 연구의 일반적인 내용에 대해 1차 분석을 하고, 음악중재 중심으로 2차 분석을 하였다. 임상연구의 질 평가 체크리스트인 PEDro 척도를 사용하여 대상연구들의 질평가를 실시한 결과, 음악중재의 질이 더 높은 연구일지라도 무선 표집, 참여자들에 대한 검맹 여부를 명시하고 있지 않은 연구들은 중재의 질이 상대적으로 낮은 연구들에 비해 연구의 질이 저평가되었다. 음악중재자의 자격요건을 명시한 8개의 연구에서는 대부분 음악창작활동을 포함하고 있고, 참여자-음악-치료사의 상호적 관계형성의 중요성을 강조하고 있으며, 중재의 질 향상을 위한 체계적인 수퍼비전 시스템에 대하여 언급하고 있다. 결론적으로 신뢰할 수 있는 조현병 환자대상 음악중재 효과연구를 위해 검맹, 무선 표집을 연구과정에 도입할 것과 동시에 음악활동 제시에 대한 상세한 설명과 근거가 함께 고려되어야 함을 제안하는데 본 연구의 의의가 있다.

Keywords

References

  1. Abrams, B. (2010). Evidence-based music therapy practice: An integral understanding. Journal of Music Therapy, 47(4), 351-379. https://doi.org/10.1093/jmt/47.4.351
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (DSM-5(R)). Arlington, Va: American Psychiatric Publishing.
  3. Ansdell, G. (2002). Community music therapy and the winds of change. Voice, 2(2). doi:10.15845/voices.v2i2.83
  4. Antman, E. M., Lau, J., Kupelnick, B., Mosteller, F., & Chalmers, T. C. (1992). A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts: Treatments for myocardial infarction. Journal of American Medical Association, 268(2), 240-248. https://doi.org/10.1001/jama.1992.03490020088036
  5. Bloch, B., Reshef, A., Vadas, L., Haliba, Y., Ziv, N., Kremer, I., & Haimov, I. (2010). The effects of music relaxation on sleep quality and emotional measures in people living with schizophrenia. Journal of Music Therapy, 47(1), 27-52. https://doi.org/10.1093/jmt/47.1.27
  6. Bradt, J., Dileo, C., & Shim, M. (2013). Music interventions for preoperative anxiety. Cochrane Database of Systematic Reviews. 2013(6), doi: 10.1002/14651858.CD006908.pub2
  7. Bruscia, K. E. (1998). Defining music therapy. (2nd ed.). Gilsum, NH: Barcelona Publishers.
  8. Bruscia, K. E. (2014). Defining music therapy. (3rd ed.). Gilsum, NH: Barcelona Publishers.
  9. Ceccato, E., Caneva, P., & Lamonaca, D. (2006). Music therapy and cognitive rehabilitation in schizophrenic patients: A controlled study. Nordic Journal of Music Therapy, 15(2), 110-120.
  10. Chan, M. F., Wong, Z. Y., & Thayala, N. V. (2011). The effectiveness of music listening in reducing depressive symptoms in adults: A systematic review. Complementary Therapies in Medicine, 19(6), 332-348. https://doi.org/10.1016/j.ctim.2011.08.003
  11. Cho, H. A. (2013). Analysis of music therapy research in professional journals in Korea. Journal of Music and Human Behavior, 10(2), 55-77.
  12. Chong, H. J. (2015). Music therapy: Understanding and application. (2nd ed.). Seoul: Ewha Womans University Press.
  13. Crawford‐Walker, C. J., King, A., & Chan, S. (2005). Distraction techniques for schizophrenia. Cochrane Database of Systematic Reviews. 2005(1), doi: 10.1002/14651858.CD004717.pub2
  14. Davis, W., & Hadley, S. (2015). A history of music therapy. In B. Wheeler (Ed.), Music therapy handbook, 17-28. New York: The Guilford Press.
  15. Davis, W. B., Gfeller, K. E., & Thaut, M. H. (2008). An introduction to music therapy: Theory and practice. Silver Spring, MD: American Music Therapy Association.
  16. de l'Etoile, S. K. (2002). The effectiveness of music therapy in group psychotherapy for adults with mental illness. The Arts in Psychotherapy, 29(2), 69-78. https://doi.org/10.1016/S0197-4556(02)00139-9
  17. De Sousa, A., & De Sousa, J. (2010). Music therapy in chronic schizophrenia. Journal of Pakistan Psychiatric Society, 7(1), 13-17.
  18. Elestien, A. S. (2004). On the origins and development of evidence-based medicine and medical decision making. Inflammation Research, 53, S184-189.
  19. Gold, C., Heldal, T. O., Dahle, T., & Wigram, T. (2005). Music therapy for schizophrenia or schizophrenia‐like illnesses. Cochrane Database of Systematic Reviews. 2011(12), doi:10.1002/14651858.CD004025.pub3
  20. Gold, C., Mossler, K., Grocke, D., Heldal, T. O., Tjemsland, L., Aarre, T., ... Rolvsjord, R. (2013). Individual music therapy for mental health care clients with low therapy motivation: Multicentre randomised controlled trial. Psychotherapy and Psychosomatics, 82(5), 319-331. https://doi.org/10.1159/000348452
  21. Hayashi, N., Tanabe, Y., Nakagawa, S., Noguchi, M., Iwata, C., Koubuchi, Y., ...Koike, I. (2002). Effects of group musical therapy on inpatients with chronic psychoses: A controlled study. Psychiatry and Clinical Neurosciences, 56(2), 187-193. https://doi.org/10.1046/j.1440-1819.2002.00953.x
  22. Hillecke, T., Nickel, A., & Bolay, H. V. (2005). Scientific perspectives on music therapy. Annals of the New York Academy of Sciences, 1060(1), 271-282. https://doi.org/10.1196/annals.1360.020
  23. Jeong, G. S., & Kim, M. H. (2015). Effect of music therapy on anxiety, blood pressure, heart rate and glucose levels of patients undergoing surgery during spinal anesthesia. Journal of Korean Academy of Fundamentals of Nursing, 22(1), 25-34. https://doi.org/10.7739/jkafn.2015.22.1.25
  24. Jorm, A. F., Morgan, A. J., & Hetrick, S. E. (2008). Relaxation for depression. Cochrane Database of Systematic Reviews. 2008(4), doi: 10.1002/14651858.CD007142.pub2
  25. Jung, N. T., & Newton, R. (2009). Cochrane Reviews of non-medication-based psychothera peutic and other interventions for schizophrenia, psychosis, and bipolar disorder: A systematic literature review. International Journal of Mental Health Nursing, 18(4), 239-249. https://doi.org/10.1111/j.1447-0349.2009.00613.x
  26. Kim, S. Y., Park, J. E., Seo, H. J., Lee, Y. J., Jang, B. H., Son, H. J., ... Shin, C. M. (2011). NECA' guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Healthcare Collaborating Agency.
  27. Kong. E, H., & Park. M, H. (2015). Effects of music therapy on agitation in dementia: Systematic review and meta-analysis. Korean Journal of Adult Nursing, 27(1), 106-116. https://doi.org/10.7475/kjan.2015.27.1.106
  28. Kwon, M., Gang, M., & Oh, K. (2013). Effect of the group music therapy on brain wave, behavior, and cognitive function among patients with chronic schizophrenia. Asian Nursing Research, 7(4), 168-174. https://doi.org/10.1016/j.anr.2013.09.005
  29. Lee, H. J., Lee, D. B., Park, M. C., & Lee, S. Y. (2014). The effect of group music therapy on the social function and interpersonal relationship in outpatients with schizophrenia. Journal of Korean Neuropsychiatric Association, 53(1), 40-53. https://doi.org/10.4306/jknpa.2014.53.1.40
  30. Lee, J. H. (2013). Music for pediatric patients in medical settings: A systematic review of randomized controlled trials. Journal of Music and Human Behavior, 10(2), 1-33.
  31. Lu, S. F., Lo, C. H. K., Sung, H. C., Hsieh, T. C., Yu, S. C., & Chang, S. C. (2013). Effects of group music intervention on psychiatric symptoms and depression in patient with schizophrenia. Complementary Therapies in Medicine, 21(6), 682-688. https://doi.org/10.1016/j.ctim.2013.09.002
  32. Maratos, A., Gold, C., Wang, N., & Crawford, M. (2008). Music therapy for depression. Cochrane Database of Systematic Reviews. 2008(1), doi: 10.1002/14651858.CD004517.pub2
  33. Moe, T., Roesen, A., & Raben, H. (2000). Restitutional factors in group music therapy with psychiatric patients based on a modification of guided imagery and music (GIM). Nordic Journal of Music Therapy, 9(2), 36-50.
  34. Morgan, K., Bartrop, R., Telfer, J., & Tennant, C. (2011). A controlled trial investigating the effect of music therapy during an acute psychotic episode. Acta Psychiatrica Scandinavica, 124(5), 363-371. https://doi.org/10.1111/j.1600-0447.2011.01739.x
  35. Mossler, K., Chen, N., Heldal, T. O., & Gold, C. (2011). Music therapy for people with schizophrenia and schizophrenia‐like disorders. Cochrane Database of Systematic Reviews. 2011(12), doi: 10.1002/14651858.CD004025.pub3
  36. PEDro Scale (1999). http://www.pedro.org.au/english/downloads/pedro-scale/
  37. Peng, S. M., Koo, M., & Kuo, J. C. (2010). Effect of group music activity as an adjunctive therapy on psychotic symptoms in patients with acute schizophrenia. Archives of Psychiatric Nursing, 24(6), 429-434. https://doi.org/10.1016/j.apnu.2010.04.001
  38. Sackett, D. L. (2000). Evidence-based medicine. John Wiley & Sons. Ltd.
  39. Silverman, M. J. (2011). Effects of music therapy on psychiatric patients' proactive coping skills: Two pilot studies. The Arts in Psychotherapy, 38(2), 125-129. https://doi.org/10.1016/j.aip.2011.02.004
  40. Silverman, M. J. (2013a). Effects of group songwriting on depression and quality of life in acute psychiatric inpatients: A randomized three group effectiveness study. Nordic Journal of Music Therapy, 22(2), 131-148. https://doi.org/10.1080/08098131.2012.709268
  41. Silverman, M. J. (2013b). Effects of music therapy on self-and experienced stigma in patients on an acute care psychiatric unit: A randomized three group effectiveness study. Archives of Psychiatric Nursing, 27(5), 223-230. https://doi.org/10.1016/j.apnu.2013.06.003
  42. Talwar, N., Crawford, M. J., Maratos, A., Nur, U., McDermott, O. R. I. I., & Procter, S. (2006). Music therapy for in-patients with schizophrenia. Exploratory randomised controlled trial. The British Journal of Psychiatry, 189(5), 405-409. https://doi.org/10.1192/bjp.bp.105.015073
  43. Thaut, M. H. (1999). A session structure for music psychotherapy. In w. B. Davis, K. E. Gfeller, & M. H. Thaut (Eds.), An introduction to music therapy Theory and practice (2nd ed.). New York: McGraw Hill.
  44. Ulrich, G., Houtmans, T., & Gold, C. (2007). The additional therapeutic effect of group music therapy for schizophrenic patients: A randomized study. Acta Psychiatrica Scandinavica, 116(5), 362-370. https://doi.org/10.1111/j.1600-0447.2007.01073.x
  45. Vink, A., & Bruinsma, M. (2014). Evidence based music therapy. In Dialogue and Debate- Conference Proceedings of the 10th World Congress on Music Therapy (pp.1779-1806).
  46. World Health Organization (2015). What is schizophrenia? Retrieved from http://www.who.int/mental_health/management/schizophrenia/en/
  47. Yinger, O. S., & Gooding, L. F. (2015). A systematic review of music-based interventions for procedural support. Journal of Music Therapy, 52(1), 1-77. https://doi.org/10.1093/jmt/thv004
  48. Zincir, S. B., Zincir, S., Yenel, A., Kivilcim, Y., Cetin, B., Tulay, C., & Basar, U. (2014). Classical turkish music as group music therapy for inpatients with schizophrenia: Feasibility and efficacy. International Journal, 2(4), 1063-1072.

Cited by

  1. A comparison of emotion identification and its intensity between adults with schizophrenia and healthy adults: Using film music excerpts with emotional content vol.27, pp.2, 2018, https://doi.org/10.1080/08098131.2017.1405999