[Music therapy for negative symptoms in patients with schizophrenia: five systemic N-of-1 trials in a high-security psychiatric hospital]. / Muziektherapie voor negatieve symptomen bij schizofrenie: vijf n=1-studies in een tbs-kliniek.

BACKGROUND Negative symptoms hamper treatment progress of patients with schizophrenia. AIM This study evaluates the effect of a music therapy module on negative symptoms, composed of activating music therapy as usual, augmented by elements of neurologic music therapy on negative symptoms. METHOD A pre- and posttreatment measurement with the Dutch version of the Brief Negative Symptom Scale has been taken from five forensic psychiatric patients and their personal nurses. During the module, sociotherapist scored the Negative Symptom Scale three times a week. Applying the reliable change index and simulation modeling analysis, the quantitative change in negative symptoms was analyzed for each patient, supported by a qualitative analysis of the medical files. RESULTS Four out of five patients showed reduction in negative symptoms. CONCLUSION Music therapy seems to have a positive effect on the reduction of negative symptoms and regaining of activity and treatment motivation in forensic psychiatric patients, who prior to the study were long-lasting inactive and difficult to motivate. Adjusting the music therapy to individual needs, personalized treatment, is in line with the complexity of the target group.

Theta/SMR Neurofeedback Training Works Well for Some Forensic Psychiatric Patients, But Not for Others: A Sham-Controlled Clinical Case Series.

Electroencephalographic (EEG) neurofeedback could be a promising treatment for forensic psychiatric patients. Increasing evidence shows some patients are unable to regulate cortical activity. Before neurofeedback can be applied successfully, research is needed to investigate the interpersonal mechanisms responsible for patients' ability to respond to neurofeedback. A single-case experimental design allows for close monitoring of individual patients, providing valuable information about patients' response to the intervention and the time frame in which changes in clinical symptoms can be observed. Four patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) substance use disorder and various comorbidities participated in a sham-controlled clinical case study. Self-report level of impulsivity and craving were assessed. Results indicate that one patient showed more improvements on behavioral measures after the neurofeedback training than did the others. This patient reported less impulsivity and reduced levels of self-reported craving. However, these findings could not be attributed to the neurofeedback intervention. The findings suggest that there is insufficient evidence for the beneficial effects of a theta/sensorimotor rhythm (SMR) neurofeedback intervention on measures of impulsivity and craving, and that there may be great interindividual differences in patients' ability to regulate cortical activity.