Auditory perception training program in people with schizophrenia

ISRCTN ISRCTN10712315
DOI https://doi.org/10.1186/ISRCTN10712315
Secondary identifying numbers 2016/548
Submission date
20/09/2017
Registration date
27/09/2017
Last edited
02/04/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Schizophrenia is a mental health condition that causes abnormal social behaviour and can make people be unable to understand what is real and what is not real. It is present in 1% of the world population and can cause a lot of disability. Some of the symptoms such as hallucinations and delusions can usually be controlled with pharmacological (medical) treatment. Other symptoms, such as the lack of initiative, the impoverishment of the personality, or the social disinterest or problems in the management of emotions presented by this type of patients, are treated at the present time to decrease with rehabilitation programs, without reaching get a "cure" of them at the present time. People suffering from Schizophrenia or Schizoaffective Disorder present a greater difficulty in recognizing emotions in the voices than people without this disorder. The “Voices” programme was developed to help patients with schizophrenia be able to recognise emotions. The aim of this study is examine if that programme can improve social functioning.
Who can participate?
Adults aged 18 to 60 years old who have Schizophrenia and are enrolled in psychiatric services.

What does the study involve?
Participants are randomly allocated to one of two groups. Those in the first group receive the rehabilitation programme in two 30 minute sessions twice a week for four weeks. Those in the control group do not receive any training. Participants are evaluated before and after the study with neuropsychological tests.

What are the possible benefits and risks of participating?
Participants may benefit from improving their auditory perception, which could mean better communication and better social integration. There are no direct risks with participation, other than the time the participant has spent undergoing the tests.

Where is the study run from?
This study is being run by the Hospital Universitario de A Coruña (Spain) and takes place in treatment centres in Spain.

When is the study starting and how long is it expected to run for?
October 2016 to August 2017

Who is funding the study?
Fundación Biomédica Galicia Sur (Spain)

Who is the main contact?
Miss Maria Lado Codesido

Study website

Contact information

Miss María Lado Codesido
Scientific

Hospital Universitario de A Coruña
A Coruña
15006
Spain

ORCiD logoORCID ID 0000-0003-3799-7222

Study information

Study designInterventional randomized multicenter single-blind controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet ISRCTN10712315_PIS.pdf
Scientific titleProsodic rehabilitation program in patients with schizophrenia
Study objectivesThe aim of this study is to evaluate the applicability of a pilot program dedicated to prosodic training in patients with schizophrenia to improve their recognition of basic and complex emotions, resulting, secondarily, in the simultaneous improvement of social cognition and social competencies.

Hypothesis:
Participants in this prosodic rehabilitation program have better results in prosodic tests than the ones that participate in ordinary psychosocial rehab program.
Ethics approval(s)Clinical Research Ethics Committee of Galicia (Comité Autonómico de Ética da Investigación de
Galicia), 26/01/2017, ref: EC registry code: 2016/548
Health condition(s) or problem(s) studiedSchizophrenia
InterventionThe training program "Voices" was designed by the initial selection of 100 simple phrases of neutral content. 34 of them contain two answer options in which two simple emotions are expressed, 33 of them contain three options with simple and complex emotions and the last 34 contain a selection of answers in which four complex emotions are expressed.

These phrases are later recorded by professional actors based on the emotion prompted. A Microsoft Powerpoint® presentation wass created to include these audio recordings and the corresponding answer options.

Next, the programme was tested with 20 independent testers (11 women and 9 men) and 82 phrases have been extracted and deemed valid (with over 70% agreement among testers). The new version was applied to a sample of 164 healthy control subjects, recruited in the faculty of Medicine at the University of Santiago de Compostela (with 101 women and 63 men, aged 19 – 44 years). On this occasion, answer time wass limited to 10 seconds per question. The test duration was approximately 14 minutes. On this occasion, 63 phrases were selected, which achieved a majority agreement of 79.9%.

This definitive selection that defines the Voices programme has been uploaded to a software platform suitable for patient use (e-Motional Training®), in which a personal user account and password are created. In the "Voices" programme, the various phrases are shown randomly, with the goal of selecting the correct answer of the two, three, or four options. In this selection, there is no set time limit to answer, and there exists the possibility to repeat the audio fragment. At the end of the game, points are registered and compared with the score obtained in previous games.

Participants are randomly allocated to one of two groups. In the intervention group, participants complete prosodic training, during a period of four weeks, two sessions of 30 minutes twice a week. The control group does not receive any specific training. All participants are evaluated before and after the intervention using neuropsychological tests.

Eight sessions are carried out, with a biweekly frequency lasting approximately 20-30 min/day during which time the Voices programme are applied in its entirety. In each session, the test content are randomised. The control group does not receive any specific training.

An evaluation is executed before and after the intervention applying a set of neuropsychological tests.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measureProsodic level is measured using the Spanish version of the Reading Mind in the Voices" programme at baseline and one month after the intervention.
Secondary outcome measures1. Severity of the schizophrenia is measured using the Positive and Negative Syndrome Scale (PANSS) at baseline and one month
2. Verbal and non-verbal knowledge is measured using the Intelligence Test (K-BIT) at baseline and one month
Overall study start date01/10/2016
Completion date30/08/2017

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsGiven that we do not have instruments of prosodic rehabilitation available in the literature, nor training programs similar to the one proposed here, we will use the results obtained in the validated English version of the RMV-TR test (Golan, 2007) to calculate the sample size. In our case, we hypothesise that the average difference expected between the population of the intervention group and the control population in the post-test will be analogous to the average difference between the control group without illness and the group of patients with autism in Golan’s study. For this, we use the findings of previous facial emotion recognition studies in which, through intervention, the treated group comes to demonstrate behaviour like that of the normal control group. According to it, our recruitment target is 44 participants, 22 of them participating in "Voices" rehab and 22 controls.
Key inclusion criteria1. Capacity to consent
2. Given willing consent to participate in the study, after being informed of the objectives of the study
3. Diagnosed with Schizophrenia or Schizoaffective Disorder according to the DSM-5 criteria
4. Enrolled, at the time of the study, in Psychiatric Services
5. Receiving neuroleptic pharmacological treatment
6. Within the age range of 18 - 60 years old at the time of participation in the therapy program
Key exclusion criteria1. Does not give willing consent to participate in the study
2. The patient is incapacitated
3. Suffering from a severe comorbid mental disorder or showing a history of severe brain damage or neurological disorder that could act as a confounding variable, or intellectual disability (examples: organic type associated disorder or diagnosis of limited or low intelligence quotient)
4. Demonstrates hearing problems
5. Currently participating in a program in skills to improve social adjustment
6. Practices active substance abuse
Date of first enrolment18/11/2016
Date of final enrolment01/08/2017

Locations

Countries of recruitment

  • Spain

Study participating centres

Asociación Pro-Enfermos Mentales
Avenida Cristina nº2º.
Carballo, A Coruña
15105
Spain
Hospital de Día (Hospital Nicolás Peña).
Avda. Camelias, nº109.
Vigo, Pontevedra
36211
Spain
Hospital de Día (Hospital Santa Maria Nai)
Rúa Ramón Puga, nº54.
Ourense
32005
Spain
Residencia Ceboliño
Avda. Pontevedra, nº5
Ourense
32005
Spain
Hospital de Día (Hospital Naval)
Av. da Residencia
Ferrol, A Coruña
15405
Spain
A.F.A.E.S. Porta Nova
C/Río Sil 1-3 Bajo. Piñeiros.
Narón, A Coruña.
15570
Spain

Sponsor information

Servicio Gallego de Salud (SERGAS)
Government

Edif. Admtvo. San Lázaro s/n
Santiago de Compostela
15700
Spain

Website http://www.sergas.es/
ROR logo "ROR" https://ror.org/0591s4t67

Funders

Funder type

Charity

Fundación Biomédica Galicia Sur

No information available

Results and Publications

Intention to publish date30/08/2018
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryStored in repository
Publication and dissemination planPlanned publication in a high-impact peer reviewed journal.
IPD sharing planThe datasets generated during and/or analysed during the current study will be stored in a non-publically available repository. In the repository data we are storing the results of the pre and post neuropsychological tests, in paper in the investigator center (Hospital Universitario de A Coruña). The proccess of requesting access is using the email contact that is written in the patient information sheet (Maria.Lado.Codesido@sergas.es). The results of the rehabilitation is storaged in the weblink www.e-motionaltraining.com, and all the data are anonymised. The way of contact would be the same, contacting through the same e-mail. We don´t have any other persistent link. The timing for availability will be 1 year after the publication of the study. The participants consent will be storaged in the same place as the results and the same timing.
About the anonymisation: The data will be collected in a consecutive manner in written and electronic form. For this, a database will be used in which participants’ information will be encrypted such that the variables collected will not be identified with the participating individuals. The questionnaires and recorded data from each participant will be identified only with the reference number or code. In no case will personal data be published nor revealed to individuals outside of the research or the Committee for Ethical Clinical Investigation.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 25/01/2019 Yes No
Participant information sheet 07/02/2019 No Yes
Protocol file 02/04/2019 No No

Additional files

ISRCTN10712315_PIS.pdf
Uploaded 07/02/2019
ISRCTN10712315_PROTOCOL.pdf
Uploaded 02/04/2019

Editorial Notes

02/04/2019: Uploaded protocol (not peer reviewed).
07/02/2019: The following changes were made:
1. The participant information sheet was uploaded as an additional file.
2. Publication reference added.