40-Hz Audiovisual Stimulation in Schizophrenia Spectrum Disorders

Effects of 40-Hz Binaural Beat Music Combined With Rhythmic Photic Stimulation on Psychological Distress, Anxiety, Cognitive Function, and Electroencephalographic Spectral Activity in Patients With Schizophrenia Spectrum Disorders: A Sham-Controlled Randomized Trial

This randomized, sham-controlled trial evaluated the effects of 40-Hz binaural beat music (BBM) combined with 40-Hz rhythmic photic stimulation (RPS) in adults with schizophrenia spectrum disorders. A total of 55 participants with schizophrenia or schizoaffective disorder were randomly assigned to either the BBM plus RPS group or a sham control group. Participants received 20-minute sessions three times per week for 12 consecutive weeks, for a total of 36 sessions. The primary outcome was anxiety measured using the Beck Anxiety Inventory (BAI). Secondary outcomes included psychological distress measured using the Five-item Brief Symptom Rating Scale (BSRS-5) and global cognitive function measured using the Mini-Mental State Examination (MMSE). Electroencephalographic (EEG) relative power across delta, theta, alpha, beta, and gamma frequency bands was also assessed as an exploratory physiological outcome.

Inclusion Criteria:

1. Diagnosis of schizophrenia or schizoaffective disorder according to DSM-5 criteria, made by a board-certified psychiatrist at least 1 year prior to enrollment.
2. Age 20 to 60 years.
3. Stable psychiatric symptoms, with no adjustment of major psychotropic medications for at least 2 consecutive months.
4. No severe hearing impairment.

4. Current participation in a day-care program, community rehabilitation center, or rehabilitation ward.

Exclusion Criteria:

1. Acute illness episode or unstable physical condition.
2. History of epilepsy or risk of seizures.
3. Substance abuse.
4. Impaired or disturbed consciousness.