for the main comparison.
| Music therapy compared with standard care for schizophrenia and schizophrenia‐like disorders | ||||||
|
Patient or population: People with schizophrenia and schizophrenia‐like disorders Settings: Individual and group setting Intervention: Music therapy (in addition to standard care) Comparison: Standard care alone | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Risk with standard care | Risk difference with music therapy | |||||
|
Global state: No clinically important overall improvement (as rated by individual trials) ‐ medium term (follow‐up: 3‐6 months) |
Low risk population | RR 0.38 (0.24 to 0.59) | 133 (2 RCTs) | ⊕⊕⊝⊝ low1,2,3,4 | ||
| 300 per 1000 | 114 per 1000 (72 to 177) | |||||
| Moderate risk population | ||||||
| 655 per 1000 | 249 per 1000 (157 to 386) | |||||
| High risk population | ||||||
| 800 per 1000 | 304 per 1000 (192 to 472) | |||||
|
Mental state: specific ‐ negative symptoms ‐ average endpoint score (SANS, high score = poor) medium term (follow‐up: 3‐6 months) |
The mean mental state: specific ‐ 2. negative symptoms ‐ average endpoint score (SANS, high score = poor) in the intervention groups was 0.55 lower (0.87 lower to 0.24 lower) |
177 (3 RCTs) | ⊕⊕⊝⊝ low1, 3 | |||
| Mental state: general ‐ average endpoint score (PANSS, high score = poor) ‐ medium term, (follow‐up: 3‐6 months) | The mean mental state: general ‐ 1a. average endpoint score (PANSS, high score = poor) ‐ medium term in the intervention groups was 0.97 lower (1.31 lower to 0.63 lower) | 159 (2 RCTs) | ⊕⊕⊝⊝ low1,2,3,5 | |||
| Mental state: General ‐ average endpoint score (BPRS, high score = poor) ‐ medium term (follow‐up: 3‐6 months) | The mean mental state: general ‐ 1b. average endpoint score (BPRS, high score=poor) in the intervention groups was 1.25 lower (1.77 lower to 0.73 lower) | 70 (1 RCT) | ⊕⊕⊕⊝ moderate1,3,5 | |||
| Functioning: general ‐ average endpoint score (GAF, high score = good) medium term (follow‐up: 3‐6 months) | The mean general functioning ‐ a. average endpoint score (GAF, high score = good) in the intervention groups was 0.19 lower (0.56 lower to 0.18 higher) | 118 (2 RCTs) | ⊕⊕⊕⊝ moderate3 | |||
|
Functioning: social ‐ average endpoint score (SDSS, high score = poor) medium term, (follow‐up: 3‐6 months) |
The mean social functioning: average endpoint score (SDSS, high score = poor) ‐ medium term in the intervention groups was 0.72 lower (1.04 lower to 0.4 lower) | 160 (2 RCTs) | ⊕⊕⊕⊝ moderate1,3,5 | |||
|
Quality of life: general ‐ average endpoint score (GWB, high score = good) ‐ short term (follow‐up: less than 3 months) |
The mean quality of life: general ‐ average endpoint score (GWB, high score = good) in the intervention groups was 1.82 higher (1.27 higher to 2.38 higher) | 72 (1 RCT) | ⊕⊕⊕⊝ moderate1,3,5 | |||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk Ratio; RCT: Randomised controlled trial; SANS: Scale for the Assessment of Negative Symptoms; SDSS: Social Disability Screening Schedule; PANSS: Positive and Negative Syndrome Scale; BPRS: The Brief Psychiatric Rating Scale; GAF: Global Assessment of Functioning; GWB: General Well‐Being Schedule. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Risk of bias ‐ limitations in study design such as poorly reported randomisation, allocation concealment, blinding or unclear outcome reporting.
2 Inconsistency ‐ heterogeneity between studies was high.
3 Imprecision ‐ the optimal information size is lower than 300 events.
4 Large effect ‐ RR < 0.5
5 Large effect ‐ the effect was in the large range according to Cohen 1988.