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Ma YM, Yuan MD, Zhong BL. Efficacy and acceptability of music therapy for post-traumatic stress disorder: a systematic review and meta-analysis of randomized controlled trials. Eur J Psychotraumatol 2024; 15:2342739. [PMID: 38647566 PMCID: PMC11036901 DOI: 10.1080/20008066.2024.2342739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/04/2024] [Indexed: 04/25/2024] Open
Abstract
Background: Music therapy is increasingly examined in randomized controlled trials (RCTs) and shows potential in treating post-traumatic stress disorder (PTSD).Objective: This systematic review and meta-analysis critically evaluates the current clinical evidence supporting the efficacy and acceptability of music therapy for PTSD.Method: RCTs comparing music therapy in addition to care as usual (CAU) versus either CAU alone or CAU combined with standard psychotherapy/pharmacotherapy for PTSD were retrieved from major English - and Chinese-language databases. Standardized mean differences (SMDs) for post-treatment PTSD symptom scores and risk differences (RDs) for retention rates upon treatment completion were calculated to assess the efficacy and acceptability of music therapy, respectively. The Cochrane risk of bias (RoB) tool 2.0 and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) were used to assess the RoB of included studies and certainty of the evidence, respectively.Results: Nine studies, incorporating 527 PTSD patients, were included, all with high RoB. The post-treatment PTSD symptom scores were significantly lower in the music therapy group than the inactive control group (SMD = -1.64, P < .001), but comparable between the music therapy group and the active control group (SMD = -0.28, P = .330). The retention rates did not differ significantly between the music therapy group and both control groups (RD = 0.03, P = .769; RD = 0.16, P = .829). The GRADE rated certainty level of evidence as low.Conclusions: Although meta-analytic findings suggest that music therapy is effective in reducing post-traumatic symptoms in individuals with PTSD, with its therapeutic effect comparable to that of standard psychotherapy, the low level of certainty limits its generalizability. More methodologically stringent studies are warranted to strengthen the clinical evidence for the efficacy and acceptability of music therapy for PTSD.
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Affiliation(s)
- Yi-Ming Ma
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, People’s Republic of China
| | - Meng-Di Yuan
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, People’s Republic of China
| | - Bao-Liang Zhong
- Research Center for Psychological and Health Sciences, China University of Geosciences (Wuhan), Wuhan, People’s Republic of China
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, People’s Republic of China
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Chen P, Zhang L, Feng Y, An FR, Su Z, Cheung T, Lok KI, Ungvari GS, Jackson T, Xiang YT, Zhang Q. Prevalence and network structure of post-traumatic stress symptoms and their association with suicidality among Chinese mental health professionals immediately following the end of China's Dynamic Zero-COVID Policy: a national survey. Transl Psychiatry 2023; 13:395. [PMID: 38102131 PMCID: PMC10724192 DOI: 10.1038/s41398-023-02680-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023] Open
Abstract
Studies on post-traumatic stress symptoms (PTSS) among mental health professionals (MHPs) are limited, particularly since restrictions due to coronavirus disease (COVID-19) have been lifted such as the recent termination of China's Dynamic Zero-COVID Policy. The current study filled this gap by exploring the prevalence, correlates, and network structure of PTSS as well as its association with suicidality from a network analysis perspective. A cross-sectional, national survey was conducted using a convenience sampling method on MHPs between January 22 and February 10, 2023. PTSS were assessed using the Post-Traumatic Stress Disorder Checklist-Civilian version, while suicidality was assessed using standardized questions related to ideation, plans, and attempts. Univariate and multivariate analyses examined correlates of PTSS. Network analysis explored the structure of PTSS and suicidality. The centrality index of "Expected influence" was used to identify the most central symptoms in the network, reflecting the relative importance of each node in the network. The "flow" function was adopted to identify specific symptoms that were directly associated with suicidality. A total of 10,647 MHPs were included. The overall rates of PTSS and suicidality were 6.7% (n = 715; 95% CI = 6.2-7.2%) and 7.7% (n = 821; 95% CI = 7.2-8.2%), respectively. Being married (OR = 1.523; P < 0.001), quarantine experience (OR = 1.288; P < 0.001), suicidality (OR = 3.750; P < 0.001) and more severe depressive symptoms (OR = 1.229; P < 0.001) were correlates of more PTSS. Additionally, higher economic status (e.g., good vs. poor: OR = 0.324; P = 0.001) and health status (e.g., good vs. poor: OR = 0.456; P < 0.001) were correlates of reduced PTSS. PCL6 ("Avoiding thoughts"; EI = 1.189), PCL7 ("Avoiding reminders"; EI = 1.157), and PCL11 ("Feeling emotionally numb"; EI = 1.074) had the highest centrality, while PCL12 ("Negative belief"), PCL 16 ("Hypervigilance") and PCL 14 ("Irritability") had the strongest direct, positive associations with suicidality. A high prevalence of lingering PTSS was found among MHPs immediately after China's "Dynamic Zero-COVID Policy" was terminated. Avoidance and hyper-arousal symptoms should be monitored among at-risk MHPs after the COVID-19 pandemic and serve as potential targets for the prevention and treatment of PTSS in this population.
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Affiliation(s)
- Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ka-In Lok
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao SAR, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, WA, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia/Graylands Hospital, Perth, WA, Australia
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Xia J, Zhu L, Huang H, Fan P, Zhou M, Cai XL, He H. Relationships between childhood trauma and mental health during the COVID-19 pandemic: a network analysis. Front Psychiatry 2023; 14:1251473. [PMID: 37743981 PMCID: PMC10515217 DOI: 10.3389/fpsyt.2023.1251473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Background Childhood trauma has been found to have an important impact on mental health. However, little is known regarding the intercorrelations between childhood trauma and mental health during the COVID-19 pandemic. This study aimed to investigate such complex interplay between childhood trauma, depression, anxiety, post-traumatic stress level during the COVID-19 pandemic, and fear of COVID-19 using network analysis. Methods A total of 1,247 college students were recruited and were asked to complete a series of questionnaires, including the Childhood Trauma Questionnaire, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Post-traumatic Stress Checklist-Civilian version, and Fear of COVID-19 Scale. The Gaussian graphical model with the scores of the questionnaires as nodes was estimated. The partial correlations between nodes were calculated as edges. Moreover, network comparison tests were conducted to compare the network patterns between participants with high levels of childhood trauma and low levels of childhood trauma. Results Childhood trauma was found to be connected to depression, anxiety, and post-traumatic stress level. The node of childhood trauma exhibited the strongest strength and the highest expected influence in the network. Participants with high levels of childhood trauma and participants with low levels of childhood trauma showed comparable network structure and global strength. Conclusion Our findings revealed a complex network pattern between childhood trauma and different mental health problems, indicating that childhood trauma might be a risk factor for mental health during the COVID-19 pandemic.
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Affiliation(s)
- Jinjin Xia
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Zhu
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Huayun Huang
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Pengfei Fan
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Meifeng Zhou
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Xin-lu Cai
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Hui He
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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