In the depressive phase, patients should not hear cheerful and gay music. Entertainment often deepens the depressive state because of the contrast, and the awareness of their own problem, which prevents enjoyment.
Schizophrenia literally means splitting of the mind. It is a group of conditions in which the usual harmonious blending of emotions, intellect, and drive are disorganized into a seeming inactivity and resultant apathy. In the simple type the patient becomes uninterested in his environment and responsibilities. This result is seen in the vagrant and the delinquent.
In the type known as catatonic there are phases of excitement or stupor. In the stuporous state the attitude of the patient resembles that of an automaton. In this state it is difficult to make any contact with the patient who refuses to co-operate or even move. Catatonic excitement sometimes follows the stupor and is evidenced by the same purposeless absence of emotion, but may include unexpected acts of destructiveness.
There is another type called paranoid in which the patient develops false beliefs of persecution, and a hebephrenic type in which the patient becomes even more inaccessible and inattentive.
Schizophrenia, once thought incurable, is now considered amenable to treatment and about one fourth of the stricken recover completely after the first attack.
In treating these patients an attempt is often made to promote an interest in real things and social consciousness. It is necessary to stimulate attention and redirect it to things outside the patient. Music has a more important place in this disease than in any other mental condition, and this disease may account for more than half the population of many mental hospitals.
Altshuler and Shebesta[4] tried music in the treatment of four excited female schizophrenics in conjunction with hydrotherapy. To have some basis for evaluation of effect, the amount of vocal productions and head movements were recorded for thirty minute periods. This combination is referred to as “output”. Observations were made for a six week period, five days a week for two to three hours a day. Two patients were given continuous baths and two were given cold wet sheet packs during the observation periods. A violinist played behind a screen for the first thirty minutes. During the first ten to twenty minutes of playing no changes were noted, and the patients seemed more or less inattentive to the music. Soon it was found that familiar tunes were most effective in centering and keeping their attention. Thus, very noisy and upset patients might begin to sing a familiar song with the violin, keeping their output of energy at the same level but changing from irrelevant purposeless activity to the directed activity of singing or humming a tune. It was also noted that the effect of familiar tunes extended far beyond the termination of the music, as manifested by continued singing after the music stopped. Familiar waltzes were found to be the best type of music to use in quieting the patients, but these were more effective when preceded by more lively tunes which secured their attention.
As a control, patients were placed in dry sheets and after twenty to thirty minutes of music the output diminished in the same degree (50%) that was observed with patients in wet packs. This showed that possibly the music alone may have been responsible for the quieting effect.
These authors conclude that musical accompaniment tends to prevent the feeling that hydriatic measures are punitive and that the return of real memories is a natural substitute for states of phantasy and excitement.
Julia Eby[29] feels that