High-Frequency vs. Low-Frequency Music Therapy in Psychiatric Inpatients: A Randomized Controlled Trial

IntroductionMusic therapy is an evidence-based clinical intervention with demonstrated efficacy in reducing anxiety and depression and in neuromodulation that promotes well-being. Sessions are usually delivered weekly. Psychiatric hospital stays are progressively shorter, requiring interventions to be delivered in brief intensive schemes. Our objective was to evaluate the effectiveness of a high-frequency intervention music therapy (5 sessions/week) compared to a low-frequency (1 session/week) control group. Materials and methodsThis is a randomized controlled clinical trial in patients with mental disorders under in-hospital psychiatric treatment. A computer-based random generator created a random allocation sequence to guarantee equal group assignment probability. The primary outcome was symptoms in the Depression/Anxiety/Stress Scale of 21 items (DAS-21). Secondary outcomes were the impact of music therapy sessions on adult patients measured with the CISMA questionnaire (CISMA by Spanish acronyms), and global life satisfaction with the single item for measuring overall life satisfaction (SWLS). To mitigate risks associated with the interventions, at least one healthcare professional will attend each session, alongside a certified music therapist. The Shapiro-Wilk test was used to test the distribution of variables. We used the Mann-Whitney U test to prove differences between groups and the Wilcoxon signed-rank test differences within groups. Spearmans test was performed to determine the correlation between continuous variables. Statistical analysis was performed with Jamovi (version 2.6, 2024). ResultsPatients in the intervention group had a significant stress level reduction compared to the control group (p=0.033). Both groups experienced significant improvements in anxiety, depression, and global life satisfaction. In addition, positive expectations towards music therapy were associated with greater symptom reduction (r=-0.33, p=0.004). DiscussionTo the best of our knowledge, this study is the first randomized controlled trial comparing high-frequency and low-frequency music therapy for psychiatric inpatients. Although both groups demonstrated significant improvement in all the outcomes measured, only the high-frequency group demonstrated greater benefit for stress symptoms. Changes in physiological stress have been reported previously, concordant with our psychological findings. Music therapy had a probable suggestive effect on symptom reduction. These findings highlight the potential of music therapy for stress management in psychiatric hospitals but emphasize the need for further research to standardize session intensity and treatment duration. Trial Registration: ISRCTN registry: ISRCTN87861817 (https://www.isrctn.com/ISRCTN87861817)