Music therapy for depression

Globally, it is documented that the number of individuals living with depression is more than 300 million people and it is predicted to become the most prominent cause of disability by the year 2020 (World Health Organization, 2017). This has an impact on both the individuals living with depression and their families and health and social care providers. The global prevalence of depression highlights a need to explore different treatment options to improve the quality of life for individuals living with the often persistent and disabling functional and nonfunctional symptoms of depression. These can include diminished concentration, sleep disturbance, psychomotor changes and feelings of reduced self-worth and guilt (American Psychiatric Association, 2013) Common to other psychiatric disorders, the etiology of depression appears to involve environmental and genetic elements, with literature indicating a complex synthesis between neurotransmitter availability and receptor control within the brain (Palazidou, 2012). Two widely utilized classification systems, the WHO International Classification of Disease (World Health Organization, 1992) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013), are utilized to diagnose a major depressive disorder. In both systems, diagnosis requires the presence of at least one core symptom for most of the day, almost every day, for the duration of at least 2 weeks. Music therapy is an intervention used in medical, educational, and everyday environments with individuals and groups to bestow the participant, their family and the wider community with feelings of physical and mental wellbeing. It is reported that individuals who receive music therapy may experience increased motivation, self-image and ability to develop heightened coping mechanisms (Juslin, Liljestrom, Vastfjall, self-esteem; quality of life; cost (not addressed by any of the identified studies); lack of acceptability or intolerance to treatment causing individuals to leave the project; anxiety; and satisfaction with treatment (not addressed by any of the identified studies). Studies were identified through a search of the Cochrane Common Mental Disorders Group specialized RCT register, the Wiley/Cochrane Library, Thomson Reuters/Web of Science, Ebsco/PsycInfo, Ebsco/CINAHL, Embase.com, PubMed, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, the National Guideline Clearing House, OpenGrey, Digital Access to Research Theses-Europe E-theses Portal, Open Access Theses and Dissertation and the ProQuest Dissertations and Theses Database. The terms “depression” or “mood disorders” or “affective disorders” and “music” and “RCTs” were used. Nine studies were identified for inclusion in the meta-analysis, with a total of 421 participants. Of these, one was a CCT and eight were RCTs. All studies measured depressive symptoms. A significant, short-term improvement in depression symptoms (using both clinician and patient-reported scales), level of functioning and anxiety was identified for participants using music therapy together with treatment as usual when compared with only treatment as usual. No significant differences were found between the use of music therapy and psychological therapy, or between active music therapy compared with receptive music therapy when using a physician or patient-reported measures. Adverse events were reported by only a single RCT; this indicated no significant link between music therapy and adverse events when compared with treatment as usual. No significant differences were found in the quality of life or numbers of participants leaving the study early between those undergoing music therapy plus treatment as usual versus treatment as usual, between those undergoing music therapy compared with psychological therapy, or those using active music therapy compared with receptive music therapy. In addition, no significant differences were found in the only study to examine self-esteem, in this instance comparing levels for those receiving music therapy plus treatment as usual, versus treatment as usual. The review demonstrated that a significant, short-term improvement in depressive symptoms, level of functioning and anxiety can be seen in individuals undertaking music therapy together with usual treatment when compared with a group undergoing treatment as usual. There is no significant difference in depressive symptoms between individuals undertaking music therapy when compared with psychological therapy. The number of adverse events for those having music therapy alongside their usual treatment was not significantly different from those only having treatment as usual. As a useful adjunct to treatment as usual in managing depression, music therapy offers the potential to reduce symptoms and improve anxiety and the ability to function. There is no significant risk of adverse events documented. Nurses working in partnership with their patients and families can be instrumental in identifying strategies and approaches that are most relevant to the individual. This may include a combination of treatment as usual, including psychotherapy, medication, collaborative care, occupational therapy and/or recreative activities, together with music therapy. The use of music therapy together with standard treatment options has the potential to reduce the significant impact of depression due to the resulting reduction in symptoms. The Mission of Cochrane Nursing (CN) is to support Cochrane's work by increasing the use of their library and provide an international evidence base for nurses and related healthcare professionals involved in delivering, leading or researching nursing care. The CN produces “Cochrane Corner” columns (summaries of recent nursing-care-relevant Cochrane reviews) that are regularly published in the group's collaborating nursing-care-related journals. The original authors and full citations of the Cochrane reviews are noted in each published column. These published summaries reach a much wider group of nurses and related healthcare agencies internationally and allow direct access to highly relevant evidence outcomes that frontline healthcare workers might not otherwise have access to. Information on the processes this group has developed can be accessed at: http://cncf.cochrane.org/evidence-transfer-program-review-summaries