Impaired musical ability in people with schizophrenia

Impaired musical ability in people with schizophrenia

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J Psychiatry Neurosci 2013; 39(2):118-26

Sanae Hatada, OTR, MED; Ken Sawada, MD, PhD; Masanori Akamatsu, MD; Erina Doi, MD; Masayoshi Minese, MD; Motoshi Yamashita, MD, PhD; Allen E. Thornton, PhD; William G. Honer, MD; Shimpei Inoue, MD, PhD

Hatada — Department of Occupational Therapy, Tosa Rehabilitation College, Kochi, Japan; Hatada, Akamatsu — Department of Neuropsychiatry, Kochi University, Kochi, Japan; Inoue — Department of Neuropsychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan; Sawada, Honer — Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; Sawada, Doi, Minese — Kochi Prefectural Aki General Hospital, Kochi, Japan; Yamashita — Kochi Health Sciences Center, Kochi, Japan; Thornton — Department of Psychology, Simon Fraser University, Burnaby, BC, Canada


Background: Assessment of the musical ability of people with schizophrenia has attracted little interest despite the diverse and substantive findings of impairments in sound perception and processing and the therapeutic effect of music in people with the illness. The present study investigated the musical ability of people with schizophrenia and the association with psychiatric symptoms and cognition.

Methods: We recruited patients with chronic schizophrenia and healthy controls for participation in our study. To measure musical ability and cognitive function, we used the Montreal Battery of Evaluation of Amusia (MBEA) and the Brief Assessment of Cognition in Schizophrenia (BACS). We carried out a mediation analysis to investigate a possible pathway to a deficit in musical ability.

Results: We enrolled 50 patients and 58 controls in the study. The MBEA global score in patients with schizophrenia was significantly lower than that in controls (p < 0.001), and was strongly associated with both the composite cognitive function score (r = 0.645, p < 0.001) and the negative symptom score (r = –0.504, p < 0.001). Further analyses revealed direct and indirect effects of negative symptoms on musical ability. The indirect effects were mediated through cognitive impairment. Limitations: The relatively small sample size did not permit full evaluation of the possible effects of age, sex, education, medication and cultural influences on the results.

Conclusion: Examining the associations between musical deficits, negative symptoms and cognitive imapirment in patients with schizophrenia may identify shared biological mechanisms.

Submitted Oct. 22, 2012; Revised Apr. 15, June 12, June 18, 2013; Accepted June 25, 2013.

Acknowledgments: We are grateful for the cooperation of all study participants and the assistance of Dr. Yasuhiko Sudo, Dr. Yoichiro Takasaka, and all the staff of Tosa Hospital, Hosogi Unity Hospital and Aki General Hospital. This work was supported by the Kochi Medical School Alumni Association.

Competing interests: A.E. Thornton has a grant from the Mind Foundation of the British Columbia Schizophrenia Society and has received consulting fees from the Provincial Health Services Authority. W.G. Honer has a grant from the Canadian Institutes of Health Research and has received consulting fees from MDH Consulting, Novartis, Roche, Lundbeck, Rush University, the Korean Society for Schizophrenia Research, the Centre for Addiction and Mental Health, the British Columbia Schizophrenia Society, the Fraser Health Authority, the Vancouver Coastal Health Authority, the Provincial Health Services Authority and the Canadian Agency for Drugs and Technology in Health. He is also on the board of In Silico Biosciences. No other competing interests declared.

Contributors: K. Sawada designed the study. S. Hatada, K. Sawada, M. Akamatsu, E. Doi, M. Minese and M. Ramashita acquired the data, which K. Sawada, A.E. Thornton, W.G. Honer and S. Inoue ana lyzed. S. Hatada, K. Sawada, W.G. Honer and S. Inoue wrote the article, which all authors reviewed and approved for publications.

DOI: 10.1503/jpn.120207

Correspondence to: K. Sawada, Department of Psychiatry, University of British Columbia, Vancouver, BC;