The Effects of Music Therapy on Anxiety and Depression of Cancer Patients

Effectiveness of music therapy in enhancing empathy and emotional recognition in adolescents with intellectual disabilities

Music therapy has demonstrated efficacy in alleviating symptoms of mental disorders, prompting an investigation into its impact on emotion regulation and empathy levels in adolescents with mild intellectual disabilities. This study involved 120 adolescents diagnosed with mild intellectual disabilities, divided into experimental and control groups. The research evaluated empathy levels and the ability to recognize emotions using photographs and pictograms before and after the experiment. Significant improvements were noted in the experimental group, particularly in empathy towards elderly individuals (p ≤ 0.05), strangers (p ≤ 0.05), cartoon and video characters (p ≤ 0.05), and animals (p ≤ 0.05). Music therapy proved effective in enhancing empathy towards peers (p ≤ 0.01), strangers (p ≤ 0.05), elderly individuals (p ≤ 0.05), animals (p ≤ 0.05), and cartoon characters (p ≤ 0.05). Limited changes were observed in the control group, primarily in the category of empathy towards strangers (p ≤ 0.05). The study suggests music therapy as a recommendable intervention for adolescents with mild intellectual disabilities, enhancing their ability to recognize diverse emotions. The study significantly contributes to the theoretical understanding of music therapy's role in emotional development among adolescents with mild intellectual disabilities, highlighting the nuanced influence of music selection on therapeutic outcomes. The study acknowledges and briefly discusses the ethical considerations involved in conducting research with adolescents, emphasizing the importance of ethical guidelines in working with vulnerable populations.

Music and Medicine: Promoting Harmony for Health

A multitude of clinical trials measuring hemodynamic and psychological parameters have shown the beneficial effects of music on health. However, there are no clear instructions on how to utilize the potential benefits of music to improve health outcomes. Moreover, whether the effect of music is transient or enduring has yet to be determined. To address the effect of music on vital parameters and emotional well-being of patients we provide an overview of methods and findings of some studies that have evaluated the physiological or psychological impacts of music. This review puts forward a proposed model for fostering an individualized approach that can examine the therapeutic effects of music.

Effects of music intervention combined with progressive muscle relaxation on anxiety, depression, stress and quality of life among women with cancer receiving chemotherapy: A pilot randomized controlled trial

Beneficial effects of music intervention and progressive muscle relaxation alone on psychological issues were reported, however, studies evaluating their combined effects are limited. This study aimed to investigate the feasibility, acceptability and preliminary effects of music intervention combined with progressive muscle relaxation on anxiety, depression, stress, and quality of life among breast and gynaecological cancer patients receiving chemotherapy.

METHODS

The study was carried out from March to May 2022 in an oncology hospital in Vietnam. A single-blinded randomized controlled trial was conducted among 24 women with breast and gynaecological cancer undergoing chemotherapy. The intervention group (n = 12) received a face-to-face training program about music listening and progressive muscle relaxation skills. They then performed the self-practice daily at home for three weeks. The control group (n = 12) received standard care, including health assessment, regular health advice and nutrition consultation. Ten participants in the intervention group were interviewed with open-ended questions to explore the acceptability of the intervention. Anxiety, depression and stress were measured using the Depression Anxiety Stress Scale, while The Functional Assessment of Cancer Therapy-General was used to evaluate the quality of life. The outcome measurements were collected at baseline (T0), post-intervention (3rd week, T1) and follow-up (6th week, T2). Appropriate descriptive statistics were used to depict the outcome measures across study time points.

RESULTS

A total of 24 patients were eligible to join, and 20 of them completed the study. Greater reductions in anxiety, depression and stress were observed in the intervention group than in the control group at T1 and T2. Greater improvements on quality of life were found in the intervention group than control group at T1 and T2 with respect to T0. The content analysis supported the acceptable intervention of participants through two themes, perceived beneficial effects on psychological and physical health and willingness to keep practising in the future.

CONCLUSIONS

Implementing music intervention combined with progressive muscle relaxation is feasible and had a trend in reducing anxiety, depression and stress levels. A larger scale randomized controlled trial is needed to confirm the effect of the intervention on outcomes.

TRIAL REGISTRATION

This trial was registered on ClinicalTrials.gov with ID: NCT05262621.

Barriers to Implementation of Music Listening Interventions for Cancer-Related Phenomena: A Mapping Review

Introduction: Despite music listening interventions (MLIs) being recommended in multiple clinical practice guidelines, implementation into oncology clinical practice sites has been slow. This mapping review aimed to critique and identify barriers to MLI clinical implementation, as well as offer practical solutions for both clinicians and researchers. Methods: A PRISMA-based mapping review of MLI literature was performed using CINAHL, PubMed, PsycINFO, and Web of Science databases. Eligibility criteria included studies with MLIs as independent variables and cancer-related phenomena as outcome variables. Search was performed in October 2021, and no date limit was set. Results: Thirty-eight studies met the eligibility criteria for inclusion. Several aspects of MLI studies suggested potential barrier status to clinician or patient adoption. These findings included choice of music, music delivery hardware, dose of MLI, and timing of MLI specific to outcomes of interest (e.g., pain, anxiety, mood). Few investigators addressed the concurrent effects of pharmaceuticals (e.g., analgesics, anxiolytics), and controlling for the effects of competing auditory stimuli was minimal. Discussion: This review has identified several barriers that may obstruct clinician and patient adoption of MLIs, despite level of evidence for MLIs that presently exists in the literature. The review makes practical suggestions for clinicians, researchers, and patients to overcome the present barriers and ease MLIs into common practice in clinics and homes.

Significance of music therapy in treating depression and anxiety disorders among people with cancer

Globally, cancer cases and mortality have recently escalated and have attracted global concern. The clinical diagnosis and manifestation of cancer can result in significant mental health issues like depression and anxiety disorders. The tendency of people with cancer to suffer from psychological disorders such as anxiety and depression is usually high. A significant number of deaths related to cancer may likely not be from the killer disease but from psychological disorders associated with the illness. The utilization of music as a remedial approach to healing mental disorders cannot be overstated. Thus, identifying the impacts of music therapy in dealing with depression and anxiety disorders among people with cancer is relevant, as the majority of methods used in treating cancer have some side effects which may trigger psychological disorders in cancer patients. Ultimately, this study explored the significance of music therapy in treating depression and anxiety disorders among people with cancer. To achieve the aim of this study, the authors employed a narrative literature review to investigate the significance of music therapy in addressing depression and anxiety disorders among people with cancer. The type of literature review employed in this study is to provide an understanding of the selected research papers. The review found that music therapy significantly reduces depression and anxiety disorders among breast cancer, lung cancer, prostate cancer, and colorectal cancer patients. It is needful for healthcare providers to incorporate music therapy interventions while treating people with cancer. This will help reduce cancer deaths resulting from psychological disorders rather than the killer disease, cancer. However, the standardized procedures and evaluation criteria for applying music-based intervention strategies in oncology medicine still need to be further established and improved.

Effects of Creative Arts Intervention on Anxiety, Depression and Sleep Quality Among Bone Marrow Transplantation Patients During Protective Isolation

BACKGROUND

Protective isolation remains part of the standard of care for patients undergoing hematopoietic stem cell transplant in many places of the world. The consequences of protective isolation include increased anxiety and depressive symptoms.

OBJECTIVE

The aim of this study was to determine the effects of creative interventions performed during the protective isolation period on anxiety, depression symptoms, and sleep quality of patients who underwent bone marrow transplantation (BMT).

INTERVENTIONS/METHODS

This study was a randomized, controlled, pre-post pilot design. A total of 20 patients made up the sample group. Participants were randomly assigned to the experimental (n = 9) or control group (n = 11). Hospital Anxiety and Depression Scale was applied to patients on the first day of admission to the unit and on the day of discharge. Questions prepared by researchers on sleep quantity and quality were administered every day during the patients' hospitalization. The patients in the experimental group carried out creative arts intervention for a total of 60 minutes a day, 3 to 4 days a week, while they were in the unit.

RESULTS

There was no difference in depression, anxiety, and sleep quality scores between the groups after intervention. However, depression and anxiety scores significantly decreased after the intervention in the experimental group, and sleep quality scores improved significantly.

CONCLUSION

Creative arts intervention may be beneficial for anxiety, depression, and sleep problems among patients undergoing BMT.

IMPLICATIONS FOR PRACTICE

Creative arts intervention is effective in coping with anxiety, depression, and sleep problems that patients may experience due to social isolation during the BMT process.

Effect of music therapy on postembolization syndrome in Thai patients with hepatocellular carcinoma: A quasi-experimental crossover study

Background

Postembolization syndrome (PES), including abdominal pain, nausea, and vomiting, are complications most severe on the first day after transarterial chemoembolization (TACE). Music therapy has been found to help manage pain. If pain, a cause of nausea and vomiting, can be relieved, then nausea and vomiting should also be reduced.

Objectives

This study aimed to examine the effect of music therapy on PES in patients with liver cancer after receiving TACE.

Methods

This study employed a quasi-experimental crossover design. The study was conducted at the inpatient units of a specialized hospital for cancer in Bangkok, Thailand, from March 2020 to October 2021. Thirty patients with liver cancer were purposively selected based on the pre-determined criteria. A change-over design was used to compare patients' changes in abdominal pain, nausea, and vomiting from the experimental period to the other control period. During the experimental period, music therapy was administered for 30 minutes on Day 0 after TACE, then twice a day in the morning and evening of Days 1 and 2 after TACE, and in the morning of Day 3 after TACE. During the control period, the patients used silent headphones. Data were analyzed using Wilcoxon signed ranks and Friedman tests.

Results

The participants perceived abdominal pain, nausea, and vomiting at a mild level during all periods. Pain scores in the music therapy period were significantly lower than those in the control period on Days 0, 1, and 2 after TACE (p <0.001, p <0.01, and p <0.001, respectively) and lower than at the baseline (p <0.001). There were no statistically significant differences in nausea and vomiting scores between the music therapy period and the control period on Days 0, 1, and 2 after TACE and no statistically significant differences at the baseline.

Conclusion

Music therapy effectively reduces mild pain among patients with liver cancer experiencing PES. This therapy can be used as a non-pharmacological treatment for nurses and other healthcare professionals in caring for patients with liver cancer.

The effect of music on pain and anxiety in patients receiving chemotherapy during COVID-19

OBJECTIVE

This research has been conducted to determine the effect of music on pain and anxiety levels of patients receiving chemotherapy during COVID-19.

METHODS

The research has been carried out in a real trial model with 92 adult patients (45 in the experimental group who received chemotherapy and 47 in the control group). The data have been collected by the researcher with Google Forms (using State and Trait Anxiety Inventory [STAI] and visual analogue scale [VAS]) through the links sent to the phones of participants on the day they received chemotherapy, between March 2020 and July 2020.

RESULTS

The mean scores obtained from the post-test STAI (53.11 ± 4.77) and VAS (3.44 ± 2.53) in the experimental group have been determined to statistically significantly decrease when compared to the pre-test measurement data (STAI: 54.26 ± 4.26; VAS: 4.22 ± 2.41) (p < 0.05). No statistically significant difference has been determined between pre-test and post-test mean scores of the patients in the control group.

CONCLUSION

It has been observed that music applications reduce the pain and anxiety levels of patients receiving chemotherapy during the COVID-19 process. It can be recommended to use music applications in the management of pain and anxiety symptoms.

Quality assessment of clinical practice guidelines on psychological distress of cancer patients using the AGREE II instrument

Objective

This study aimed to assess the quality of the clinical practice guidelines on psychological distress among cancer patients and provide users with recommendations for coping with psychological distress.

Methods

A systematic search of relevant clinical practice guidelines was undertaken to identify and select the clinical practice guidelines related to psychological distress among cancer patients. Literature databases were searched in PubMed, Web of Science, Excerpta Medica Database, the Cumulative Index to Nursing & Allied Health Literature, China Biology Medicine, China National Knowledge Infrastructure, WanFang and Weipu Journal Database. The guideline databases include Yimaitong Guidelines Network, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, American Society of Clinical Oncology (ASCO), New Zealand Guidelines Group, Scottish Intercollegiate GuidelinesNetwork, American Psychological Association, Registered Nurses' Association of Ontario and Cancer Care Ontario (CCO). Four independent reviewers assessed the eligible guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.

Results

Six clinical practice guidelines were included and assessed for critical evaluation. The median score for the scope and purpose domain was 71.5% (IQR 64%-77.25%), the stakeholder involvement domain was 65% (IQR 47.5%-74.5%), the rigour of the development domain was 61.5% (IQR 45.5%-85.25%), the clarity of the presentation domain was 91% (IQR 72.25%-94.5%), the applicability domain was 70% (IQR 33%-78.75%), and the editorial independence domain was 48.84% (IQR 61.75%-95%). Four guidelines (ASCO, 2014; Canadian Association of Psychosocial Oncology, 2015; NCCN, 2020, and CCO, 2016) were classified as "recommended," and the remaining (European Palliative Care Research Collaborative and Chinese Psychosocial Oncology Society) were "recommended with modifications," especially in the domains of Stakeholder involvement, rigour of development, and applicability. The inter-rater consistency of each domain showed moderate level (0.52-0.90) analyzing by intraclass correlation.

Conclusions

The clinical practice guidelines on psychological distress among cancer patients varied in quality, and there were discrepancies in terms of the recommendations and recommendation grades. These findings could contribute to improving the quality of clinical practice guidelines on psychological distress, and enable the development and implementation of evidence-based guidelines for cancer patients.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO, identifier CRD42020209204.

The Effect of Inhalation Aromatherapy and Music Therapy on Anxiety in Patients Undergoing Shockwave Lithotripsy: A Randomized Controlled Clinical Trial

Patients undergoing shock wave lithotripsy (SWL) have a high level of anxiety. This study was aimed to compare the effect of music therapy and aromatherapy on patients' anxiety levels during SWL. In this clinical trial, 176 patients undergoing SWL were randomly assigned to four groups: music therapy, aromatherapy, combined music therapy and aromatherapy, and control. The state-trait anxiety inventory (STAI) was used to collect data. In the aromatherapy group, three drops of rosemary essential oil were used during SWL. For the music therapy group, soft music was played during SWL. In the music therapy and aromatherapy group, soft music and three drops of rosemary essential oil were used simultaneously. In the control group, three drops of aromatic distilled water were used. The results showed that all patients had moderate anxiety before the intervention. The analysis of variance test did not show a statistically significant difference between the groups, but this difference was significant after the intervention. The levels of anxiety after the intervention were higher in the music therapy, aromatherapy, and combined music therapy and aromatherapy groups than in the control group. The results of the paired t-test showed the level of anxiety after the intervention was significantly increased in the intervention group (P < 001). In conclusion, the results indicated that music therapy, aromatherapy, and combined music therapy and aromatherapy had no effect on reducing patients' anxiety during SWL.

Positive Psychology in Therapeutic Songwriting for People Living with Late-Life Depression—An Intervention Protocol

(1) Background: An increasing number of people are living with late-life depression, yet non-pharmacological treatments to help manage symptoms are limited. Two interventions, positive psychology and music therapeutic songwriting, have independently led to decreased depressive symptoms and an improved wellbeing in older people over 65 years old. (2) Methods: This article describes the development of a therapeutic songwriting program for people living with late-life depression. Knowledge from positive psychology and therapeutic songwriting was combined to maximize the potential benefits. (3) Results: The intervention program has ten weekly 45 min sessions that incorporate elements from positive psychology into therapeutic songwriting. Using a three-song approach encompassing ongoing musical practices, different positive psychology interventions were incorporated to support the experiences associated with a flourishing life. The intervention protocol for older people presented here is distinct from previous deficit-orientated approaches in that it shifts the focus to positive experiences, resources, and the individual’s ability to decrease their own depressive symptoms and improve their wellbeing. (4) Discussion: This protocol presenting a therapeutic songwriting program meets the need to develop new non-pharmacological treatment options. However, further studies are needed to examine the feasibility and impact of the intervention program on late-life depression and wellbeing in older people.

Music affects functional brain connectivity and is effective in the treatment of neurological disorders

In a million years, under the pressure of natural selection, hominins have acquired the abilities for vocal learning, music, and language. Music is a relevant human activity, highly effective in enhancing sociality, is a universal experience common to all known human cultures, although it varies in rhythmic and melodic complexity. It has been part of human life since the beginning of our history, or almost, and it strengthens the mother-baby relation even within the mother's womb. Music engages multiple cognitive functions, and promotes attention, concentration, imagination, creativity, elicits memories and emotions, and stimulates imagination, and harmony of movement. It changes the chemistry of the brain, by inducing the release of neurotransmitters and hormones (dopamine, serotonin, and oxytocin) and activates the reward and prosocial systems. In addition, music is also used to develop new therapies necessary to alleviate severe illness, especially neurological disorders, and brain injuries.

Effects of music intervention on anxiety, depression, and quality of life of cancer patients receiving chemotherapy: a systematic review and meta-analysis

BACKGROUND

Music may be a safe and effective coping strategy for psychological management. The objectives of this review were to identify the effects of music interventions on anxiety, depression, and quality of life (QoL) among cancer patients receiving chemotherapy.

METHODS

Fourteen databases were searched from the inception date to December 2020 to identify eligible randomized controlled trials (RCTs). Gray literature was also examined. The protocol of this systematic review was registered with PROSPERO (registration number: CRD42021223845). Two reviewers independently assessed eligibility, extracted data, and evaluated methodological quality. Meta-analysis was done. Subgroup analysis was conducted for intervention types, the person selecting music, music delivery method, timing, and session duration.

RESULTS

Nine RCTs were identified, among which six were eligible for the meta-analysis. All studies were at a high risk of bias, and the overall quality of evidence was low to very low. The pooled results reveal that music intervention could reduce anxiety (SMD: - 0.29, 95% CI - 0.50 to - 0.08) and improve QoL (SMD: 0.42, 95% CI 0.02 to 0.82). However, it fails to affect depression (p = 0.79). The findings demonstrate no significant difference between patient-selected music and researcher-selected music, recorded music, and live music, while a length of 15-20 min/session and offering immediately before chemotherapy are more effective on anxiety than that of 30-45 min and delivering during chemotherapy.

CONCLUSIONS

Music intervention may be a beneficial tool for anxiety reduction and QoL among cancer patients receiving chemotherapy. More high-quality RCTs are needed to ascertain the true impact of those outcomes.

Incidence and Risk Factors of Post-Operative Depression in Patients Undergoing Transurethral Resection of Prostate for Benign Prostatic Hyperplasia

Background

Benign prostatic hyperplasia (BPH) is a frequent-occurring disease in middle-aged and elderly men. This work is a prospective study and aims at exploring the incidence of post-operative depression and the potential risk factors of depression in a cohort of patients with BPH in China.

Methods

In this survey, 611 men who underwent transurethral resection of the prostate (TURP) were strictly selected at our institution from January 2016 to August 2019. Zung Self-rating Depression Scale was used for evaluation of depressive symptoms. Sociodemographic, clinical and other data were also collected.

Results

We found that 152/611 (24.9%) patients suffered from different degree of depression at 6 months after TURP, including mild symptoms (20.9%) and moderate/severe symptoms (3.9%). A total of 421 (68.9%) patients developed post-TURP erectile dysfunction (ED). The occurrence of depression was closely associated with marital status, education level, cigarette smoking, alcohol consumption, severity of lower urinary tract symptoms (LUTS), duration of BPH, erectile function, and comorbidities (such as diabetes, dyslipidaemia and bladder stone). The risk factors related to the severity of depression included widowed or single marital status, frequent alcohol consumption, moderate or severe LUTS, longer duration (> 5 years) of BPH, ED, urinary continence, and comorbidities such as diabetes and bladder stone.

Conclusion

Many risk factors are related to the occurrence of depression in patients undergoing TURP. Widowed or single marital status, frequent alcohol consumption, moderate or severe LUTS, longer duration of BPH, ED, urinary incontinence and comorbidities such as diabetes and bladder stone are connected with the increase odds of moderate or severe depressive symptom.

Music Therapy for Anxiety Level and Quality of Life of Patients Infected by COVID-19

BACKGROUND: COVID-19 epidemic is changing the lives around the world. COVID-19 is a dangerous and frightening disease so that many people experience anxiety disorders and decreased quality of life. AIM: The purpose of this study was to analyze the effect of music therapy on the level of anxiety and quality of life of patients infected by COVID-19. MATERIALS AND METHODS: This type of research is an experimental quantitative study with a randomized controlled trial research design. The sampling technique used in this research is simple random sampling. Data analysis was performed using paired t-test and independent t-test. This study divided the subjects into two groups, namely, the intervention group as many as 51 respondents who received intervention in the form of music therapy with favorite music in the form of religious-themed music, dangdut, pop, and classical music and 51 respondents in the control group who were only given regular intervention. Data collection tool or anxiety questionnaire used Hamilton Anxiety Rating Scale with a reliability of 0.893. RESULTS: The type of this research was experimental quantitative research using a randomized controlled trial research design. The results showed that after being given music therapy, there was a decrease in anxiety level in the intervention group with an average of 18.7 (mild anxiety) and an average of 33.6 (severe anxiety) in the control group with a significance value of 0.000. In addition, music therapy significantly improved the quality of life with an average of 81.6 (very good quality of life) in the intervention group and an average of 36.7 (poor quality of life) in the control group with a significance value of 0.000. CONCLUSIONS: Music therapy which was given to COVID-19 patients was proven to reduce anxiety and improve the patient’s quality of life.

Music interventions for improving psychological and physical outcomes in people with cancer

BACKGROUND

This is an update of the review published on the Cochrane Library in 2016, Issue 8. Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in people with cancer. This review includes music interventions defined as music therapy offered by trained music therapists, as well as music medicine, which was defined as listening to pre-recorded music offered by medical staff.

OBJECTIVES

To assess and compare the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 3) in the Cochrane Library, MEDLINE via Ovid, Embase via Ovid, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the RILM Abstracts of Music Literature, http://www.wfmt.info/Musictherapyworld/ and the National Research Register. We searched all databases, except for the last two, from their inception to April 2020; the other two are no longer functional, so we searched them until their termination date. We handsearched music therapy journals, reviewed reference lists and contacted experts. There was no language restriction.

SELECTION CRITERIA

We included all randomized and quasi-randomized controlled trials of music interventions for improving psychological and physical outcomes in adults and pediatric patients with cancer. We excluded patients undergoing biopsy and aspiration for diagnostic purposes.

DATA COLLECTION AND ANALYSIS

Two review authors independently extracted the data and assessed the risk of bias. Where possible, we presented results in meta-analyses using mean differences and standardized mean differences. We used post-test scores. In cases of significant baseline difference, we used change scores. We conducted separate meta-analyses for studies with adult participants and those with pediatric participants. Primary outcomes of interest included psychological outcomes and physical symptoms and secondary outcomes included physiological responses, physical functioning, anesthetic and analgesic intake, length of hospitalization, social and spiritual support, communication, and quality of life (QoL) . We used GRADE to assess the certainty of the evidence.

MAIN RESULTS

We identified 29 new trials for inclusion in this update. In total, the evidence of this review rests on 81 trials with a total of 5576 participants. Of the 81 trials, 74 trials included adult (N = 5306) and seven trials included pediatric (N = 270) oncology patients. We categorized 38 trials as music therapy trials and 43 as music medicine trials. The interventions were compared to standard care. Psychological outcomes The results suggest that music interventions may have a large anxiety-reducing effect in adults with cancer, with a reported average anxiety reduction of 7.73 units (17 studies, 1381 participants; 95% confidence interval (CI) -10.02 to -5.44; very low-certainty evidence) on the Spielberger State Anxiety Inventory scale (range 20 to 80; lower values reflect lower anxiety). Results also suggested a moderately strong, positive impact of music interventions on depression in adults (12 studies, 1021 participants; standardized mean difference (SMD): -0.41, 95% CI -0.67 to -0.15; very low-certainty evidence). We found no support for an effect of music interventions on mood (SMD 0.47, 95% CI -0.02 to 0.97; 5 studies, 236 participants; very low-certainty evidence). Music interventions may increase hope in adults with cancer, with a reported average increase of 3.19 units (95% CI 0.12 to 6.25) on the Herth Hope Index (range 12 to 48; higher scores reflect greater hope), but this finding was based on only two studies (N = 53 participants; very low-certainty evidence). Physical outcomes We found a moderate pain-reducing effect of music interventions (SMD -0.67, 95% CI -1.07 to -0.26; 12 studies, 632 adult participants; very low-certainty evidence). In addition, music interventions had a small treatment effect on fatigue (SMD -0.28, 95% CI -0.46 to -0.10; 10 studies, 498 adult participants; low-certainty evidence). The results suggest a large effect of music interventions on adult participants' QoL, but the results were highly inconsistent across studies, and the pooled effect size was accompanied by a large confidence interval (SMD 0.88, 95% CI -0.31 to 2.08; 7 studies, 573 participants; evidence is very uncertain). Removal of studies that used improper randomization methods resulted in a moderate effect size that was less heterogeneous (SMD 0.47, 95% CI 0.06 to 0.88, P = 0.02, I² = 56%). A small number of trials included pediatric oncology participants. The findings suggest that music interventions may reduce anxiety but this finding was based on only two studies (SMD -0.94, 95% CI -1.9 to 0.03; very low-certainty evidence). Due to the small number of studies, we could not draw conclusions regarding the effects of music interventions on mood, depression, QoL, fatigue or pain in pediatric participants with cancer. The majority of studies included in this review update presented a high risk of bias, and therefore the overall certainty of the evidence is low. For several outcomes (i.e. anxiety, depression, pain, fatigue, and QoL) the beneficial treatment effects were consistent across studies for music therapy interventions delivered by music therapists. In contrast, music medicine interventions resulted in inconsistent treatment effects across studies for these outcomes.

AUTHORS' CONCLUSIONS

This systematic review indicates that music interventions compared to standard care may have beneficial effects on anxiety, depression, hope, pain, and fatigue in adults with cancer. The results of two trials suggest that music interventions may have a beneficial effect on anxiety in children with cancer. Too few trials with pediatric participants were included to draw conclusions about the treatment benefits of music for other outcomes. For several outcomes, music therapy interventions delivered by a trained music therapist led to consistent results across studies and this was not the case for music medicine interventions. Moreover, evidence of effect was found for music therapy interventions for QoL and fatigue but not for music medicine interventions. Most trials were at high risk of bias and low or very low certainty of evidence; therefore, these results need to be interpreted with caution.

Effect of instrumental music on anxiety and depression among hemodialysis patients: A randomized controlled trial

BACKGROUND

Hemodialysis patients suffer from mental disorders such as anxiety and depression. One of the known nonpharmacological methods to eliminate these disorders is music therapy. The present study aimed to investigate the effect of instrumental music on state depression and anxiety in hemodialysis patients.

MATERIALS AND METHODS

This study was a clinical trial. The population was hemodialysis patients in Hamedan in 2017 and 50 patients were selected and randomly divided into experimental and control groups. The duration each time of the instrumental music intervention for the experimental group was 3 weeks, 3 times a week for 20 min. Data were measured by beck depression inventory and SpeilBerger State-Trait Anxiety Inventory-Y1 before the intervention and immediately after the last intervention and analyzed using Yates correction, Chi-square test, Mann-Whitney U-test, independent t-test, and Wilcoxon test.

RESULTS

No significant difference between the intervention and control groups was observed before the study in terms of demographic variables (P > 0.05). In the intervention group, the mean and standard deviation of the depression score before the intervention was 8.99 ± 23.68 and after the intervention reached 7.54 ± 14.88, which shows that the variable was significant (P = 0.001); however, no significant difference was observed in the control group. In the intervention group, the mean of state anxiety before the intervention was 10.05 ± 53.76 and after the intervention reached 9.76 ± 42.48, which was statistically significant (P = 0.004), while no significant difference was observed in the control group.

CONCLUSION

The results indicate the positive effect of instrumental music on reducing anxiety and depression in hemodialysis patients. It is recommended that this therapy be used as a nursing method to reduce state anxiety and depression in hemodialysis patients.

Effect of Musical Therapy Langgam Jawa on Pre-chemotherapy Anxiety of Cancer Patients

BACKGROUND: Anxiety occurs in cancer patients who are undergoing chemotherapy for the 1st time. Excessive anxiety which occurred in the pre-chemotherapy phase can contribute to the failure of chemotherapy programs. One of attempts to reduce anxiety is providing musical therapy Langgam Jawa. AIM: The purpose of the research is to identify the effect of musical therapy Langgam Jawa to pre-chemotherapy anxiety score. METHODS: The research used quasi-experimental design which involved pre-posttest with control group. The research was conducted at a hospital in Central Java. The population was cancer patients who undergoing chemotherapy for the 1st time and experienced pre-chemotherapy anxiety. Samples were selected with purposive sampling technique that met inclusion criteria. Subjects were 42 respondents consisting of 21 in each group obtained by simple random sampling technique. Health education and deep breathing exercise were provided to the control group, while the treatment group obtained health education, deep breathing exercise, and musical therapy Langgam Jawa. The measurement of pre-chemotherapy anxiety in the cancer patients was using State-Trait Anxiety Inventory. An independent t-test performed the analysis. RESULTS: The results showed that pre-chemotherapy anxiety score decreases significantly in those two groups (p-value: 0.001; α: 0.05). The treatment group showed a higher decrease of pre-chemotherapy anxiety than the control group. CONCLUSION: The finding highlights musical therapy Langgam Jawa is effective to reduce pre-chemotherapy anxiety of cancer patients. It is recommended to apply musical therapy Langgam Jawa for cancer patients who’re undergoing chemotherapy.

Recitation of quran and music to reduce chemotherapy-induced anxiety among adult patients with cancer: A clinical trial

AIM

The aim of this study was to assess the effectiveness of listening to music or Quran in reducing cancer patients' anxiety before chemotherapy administration. Reducing anxiety in people with cancer, prior to chemotherapy administration, is a crucial goal in nursing care.

DESIGN

An experimental comparative study was conducted.

METHODS

A simple randomization sampling method was applied. Two hundred thirty-eight people with cancer who underwent chemotherapy were participated. They are assigned as Quran, music and control groups.

RESULTS

The overall score of Arabic State Anxiety Inventory in all groups revealed that there was a significant difference between pre-test and post-test among participants. Listening to Quran or music reduced the chemotherapy-induced anxiety. There was no difference between these two ways to reduce anxiety in people with cancer. Listening to Quran or music can be added in nursing care plans prior chemotherapy administrations to reduce cancer patients' anxiety.

African immigrant child health: A scoping review

The health of migrant children is a pressing issue. While most African migration takes place within Africa, a significant number of African migrants travel to outside of the continent. This article reports findings from a scoping review on the health of African immigrant children from sub-Saharan Africa now living outside of Africa. A systematic search for studies published between 2000 and 2019 resulted in only 20 studies reporting on the health of children up to 18 years of age migrating from sub-Saharan Africa. Data from these articles were thematically analyzed, highlighting concerns related to the children's nutrition status (n = 8), mental health (n = 7), and physical health (n = 5). Study participants were primarily from Somali and Ethiopia, and most studies were conducted in Australia or Israel. The review highlights several gaps related to the scope, range, and nature of evidence on the health of African immigrant children living outside of Africa. In particular, most focus on children's nutritional and mental health, but pay little attention to other health concerns this specific population may encounter or to the benefits associated with effective responses.

Biomarkers of Stress in Music Interventions: A Systematic Review

Psychological stress is a significant public health concern as it is associated with various comorbidities and long-term health implications. Music interventions are emerging therapies for alleviating psychological stress and improving one's physical and mental well-being. We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines for reporting to identify all neuroendocrine biomarkers used to evaluate psychological stress in randomized control trials involving music interventions. We identified 18 unique biomarkers of stress from 14 full-text randomized controlled trials studies. Only one of the 14 music studies included a music therapy intervention. The most frequently used biomarkers across the studies were plasma cortisol, salivary cortisol, and salivary α-amylase. Of the 14 studies, 12 included in this review assessed at least one of these three biomarkers. Of these 12 studies, five papers reported p-values for changes in both stress biomarkers and psychological stress outcome measures. Four of the five studies found significant p-values for the reduction of both stress biomarkers and psychological stress in music intervention groups. The variety of stress biomarkers used and the variance in study protocols makes it difficult to assess the magnitude of effect of music interventions on psychological stress. However, our findings suggest that music interventions have the potential for reducing both stress biomarker levels and psychological stress in acute stress situations.

Effectiveness of traditional Chinese medicine music therapy on anxiety and depression emotions of lung cancer patients: A protocol for systematic review and meta-analysis

BACKGROUND

Lung cancer patients often accompanied with severe depression and anxiety emotions, and those negative emotions could affects the treatment and recovery of the illness, decrease the patients' quality of life. In recent years, traditional Chinese medicine five-element music therapy (TCM-FEMT) is widely used for psychological problems of lung cancer patients for its unique advantages, TCM-FEMT applied to negative emotions management of lung cancer patients has been reported in many publications, but there is lacks evidence-based medicine, in this study, effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients will be systematically evaluated.

METHODS

PubMed, the Cochrane Library, Web of Science, Embase, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, WanFang Database were electronically searched to collect RCTs on the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients from inception to February 2021. In addition, retrospect the references of the included literature to supplement the relevant literature. Research selection, data extraction and quality evaluation of literature will be carried out by 2 researchers, respectively. RevMan 5.3 software will be used for statistical analysis.

RESULTS

This study will comprehensively summarize the current trials to determine the effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients.

CONCLUSION

This study will provide comprehensive evidence for the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients.

Music intervention on physiological and psychological responses of patients with cancer: A protocol for meta-analysis

BACKGROUND

Cancer is a life-threatening condition and also one of the biggest challenges facing human health and the medical community. This meta-analysis was to investigate the effects of music intervention on physiological and psychological responses of patients with cancer.

METHODS AND ANALYSIS

The following electronic databases will be searched from inception to December 2020: PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure Database, Chinese Science and the Wanfang Database. We only included music intervention vs placebo in cancer patients and pooled results were summarized by STATA 12.0 software. Two investigators independently selected the studies according to the inclusion and exclusion criteria, extracted the data, and assessed the quality of the selected studies. The existence of statistical heterogeneity would be evaluated by Chi2 test and its extension by the I2 test (I2 > 50% indicates high heterogeneity among studies). Publication bias was ruled out by funnel plot and statistically assessed by Begg test (P > .05 as no publication bias).

RESULTS

The study results will be published in relevant peer-reviewed journals and key findings will be presented at international scientific meetings.

CONCLUSION

Our study aims to systematically assess the effects of music intervention in cancer patients, which will be provide clinical guidance for cancer patients.

Post-Traumatic Stress Reactions in Caregivers of Children and Adolescents/Young Adults with Severe Diseases: A Systematic Review of Risk and Protective Factors

Severe illnesses in children and adolescents/young adults (AYAs) may represent a complex burden for patients and their caregivers, including a wide range of mental disorders, particularly post-traumatic stress disorder (PTSD). Few events are as potentially traumatizing as having a son or a daughter diagnosed with a severe, life-threatening, or disabling disease. The presence of PTSD symptoms in caregivers may compromise their efficacy as caregivers and negatively affect the child’s well-being. This systematic review aims at outlining potential risk and protective factors for the development of PTSD symptoms in caregivers of children and AYAs affected by severe acute or chronic illnesses. Thirty-one studies on caregivers of children and AYAs affected by severe, acute, or chronic diseases were included. Socio-demographic and socio-economic characteristics, illness-related distress, psychiatric symptoms, support, and coping styles were found as potential risk/protective factors across studies. It is crucial to consider risk factors affecting caregivers of severely ill young patients, in order to plan focused interventions aimed at preventing an adverse clinical outcome in caregivers and at enhancing caregivers’ coping skills, in order to ultimately improve their quality of life.

Effectiveness of Conventional Cognitive-Behavioral Therapy and Its Computerized Version on Reduction in Pain Intensity, Depression, Anger, and Anxiety in Children with Cancer: A Randomized, Controlled Trial

Background: Experiencing painful procedures during life is inevitable. Poor pain management is associated with negative effects on the quality of life, remaining for a long time after the experience. Long-term negative effects of pain possess a significant cost burden on society. Nowadays, computers are globally available, and computerized psychological interventions can reduce negative emotions. Objectives: The present study aimed at examining the effectiveness of conventional cognitive-behavioral therapy (CBT) and its computerized version on reduction in pain intensity, depression, anger, and anxiety in children with cancer. Methods: The present randomized, controlled, clinical trial was performed on three groups of conventional CBT, computerized CBT (cCBT), and control. Children with cancer, referring to Shafa Hospital of Ahvaz, Iran, constituted the study samples. A total of 15 children aged 9 - 12 years were assigned to each group by using the lottery method. All three groups received routine medical treatments during the study, but the two intervention groups also received psychological interventions as a complementary treatment. The control group received routine medical treatment and underwent cCBT intervention after the study. The data-i e, pre- and post-tests, were collected by a masters’ student in clinical psychology that was blind to the study objectives. Data were analyzed by MANCOVA, ANOVA, and t-tests of differential scores. Results: The findings of the study indicated that both interventions could reduce negative emotions associated with cancer (i. e, pain, anger, anxiety, and depression) in children compared with the control group (P < 0.0001). In addition, there were no significant differences between the two intervention groups (P < 0.01). It means both interventions were useful to reduce pain and enhance adjustment. Conclusions: The cCBT can be utilized in case of no access to psychologists and psychological services.

Beneficios de la musicoterapia como opción integrativa en el tratamiento oncológico

Objetivo: Identificar la eficacia de los tratamientos musicoterapéuticos que aborden la sintomatología en pacientes con cáncer y que constaten algún tipo de beneficio psicológico, fisiológico, espiritual, social o intelectual. Método: Se realizó un análisis documental que supuso un estudio comparativo de evidencias científicas. Resultados: La musicoterapia minimiza los efectos fisiológicos de tratamientos específicos oncológicos como la quimioterapia, se usa como complemento de la morfina o el sufentanilo disminuyendo el dolor e influye en la vida emocional del paciente. Conclusiones: Es una disciplina que demuestra evidencias positivas en situaciones de tipo emocional reduciendo la depresión, la ansiedad y el estrés, ayudando en la relajación y mejorando el umbral del dolor, postulándose como una opción no-farmacológica que debiera conducir a una implantación cada vez más normalizada en los centros hospitalarios.

Prevalence and predictors of anxiety and depressive symptoms among patients diagnosed with oral cancer in China: a cross-sectional study

BACKGROUND

Anxiety and depression are common mental health problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. The present study aims to explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms.

METHOD

A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. Two hundred thirty patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms.

RESULTS

The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Social isolation dimension of stigma (β = 0.436, OR = 1.547, CI:1.211 ~ 1.975), optimism (β = - 0.276, OR = 0.759, CI:0.624 ~ 0.922), and perceived stress (β = 0.217, OR = 1.243, CI:1.092 ~ 1.414) were predictors of anxiety symptoms. Marriage (β = 1.648, OR = 5.198, CI:1.427 ~ 18.924), positive readiness and expectancy dimension of hope (β = - 0.505, OR = 0.604, CI:0.395 ~ 0.923), social isolation dimension of stigma (β = 0.314, OR = 1.368, CI:1.054 ~ 1.776) and perceived stress (β = 0.273, OR = 1.314, CI:1.134 ~ 1.524) were predictors of depressive symptoms among oral cancer patients.

CONCLUSION

The prevalence of anxiety symptoms and depressive symptoms was high among oral cancer patients in China. The communal predictors of anxiety and depressive symptoms in patients with oral cancer were levels of perceived stress and social isolation of stigma. In addition, optimism was a predictor of anxiety symptoms and hope was a predictor of depressive symptoms.

TRIAL REGISTRATION

2015-16, registered 20 Dec 2015.

Effect of Music Therapy on the Chronic Pain and Midterm Quality of Life of Patients after Mechanical Valve Replacement

OBJECTIVE

To evaluate the effect of music therapy on the chronic pain and midterm quality of life of patients after mechanical valve replacement.

METHODS

Patients were divided into two groups according to whether or not they received music therapy. The patients in the music group received 30 minutes of music therapy every day for 6 months after the operation. The patients in the control group received standard treatment and had 30 minutes of quiet rest time every day in the same period. The short-form of McGill Pain Questionnaire (SF-MPQ) was used to evaluate the degree of postoperative chronic pain, and the SF-36 was used to evaluate the midterm quality of life of patients.

RESULTS

In terms of the degree of postoperative chronic pain, the score of the pain rating index (PRI) emotional item in the music group was significantly lower than that in the control group. In the evaluation of the postoperative midterm quality of life using the SF-36, the emotional function score in the music group was significantly higher than that in the control group.

CONCLUSION

This study preliminarily showed that music therapy can effectively reduce chronic pain and improve midterm quality of life after surgery.

Investigating psychological problems in caregiver of pediatrics with cancer: A systematic review

PURPOSE

Cancer is a type of chronic illness that causes many issues for patients and their caregivers, including a wide range of psychological problems. This study was conducted to determine the status and psychological problems of caregivers of pediatric patients with cancer who live in Iran.

METHODS

All articles from 2000 to March 2019 related to the psychological of caregivers and their child's cancer were included in the search. Domestic websites in Iran and international databases were searched. Keywords of the search included child, cancer, malignancy, care burden, stress, anxiety, depression, coping strategies, psychological hardiness, posttraumatic stress, parents, father, mother, and pediatric. The search, data extraction, quality assessment and screening were conducted independently by two researchers.

RESULTS

In the initial search, 345 articles were extracted regarding the psychological problems of caregivers. After final screening 15 articles were selected; from these four referred to care burden, four articles for coping skills, three articles for posttraumatic stress disorder (PTSD) and four articles for stress, anxiety, and depression among carers of children with cancer.

CONCLUSION

Considering the existence of psychological problems such as caregiver burden, PTSD, stress, anxiety, and depression in caregivers of children with cancer, it is necessary to provide nursing interventions for this group of parents; particularly interventions that provide the necessary ground for reducing psychological problems and improving caregivers' mental health.

The Effect of Music Therapy and Aromatherapy with Chamomile-Lavender Essential Oil on the Anxiety of Clinical Nurses: A Randomized and Double-Blind Clinical Trial

Nurses may be anxious due to critical and emergencies, and anxiety can affect their professional performance. Non-pharmacological interventions, as a safe method, can reduce anxiety. This study aimed to determine the effect of music therapy and aromatherapy with chamomile - lavender essential oil on the anxiety of clinical nurses. This was a randomized, double-blind clinical trial. One hundred twenty nurses from clinical wards of Besat Hospital in Sanandaj, Iran, were selected between 2018 and 2019 by purposeful sampling. The samples were randomly assigned to three groups with different interventions, namely music therapy, both aromatherapy with chamomile-lavender essential oil and music therapy, and aromatherapy with chamomile-lavender essential oil, along with a control group as well. The anxiety of nurses was measured based on the Beck Anxiety Inventory before the intervention and after three work shifts. The data were analyzed using the SPSS v.22 software. One-way ANOVA was used to test the hypotheses. The findings showed that the mean scores of the anxiety of nurses after the intervention in the three groups namely the group for which music therapy was applied, the group for which aromatherapy with chamomile-lavender essential oil was used and the group for which both music therapy and aromatherapy with chamomile-lavender essential oil were applied, were (39.28), (37.82) and (40.03), respectively. Therefore, the obtained mean score of each group was significantly lower than that of the control group (56.08) (p < 0.0001). The results showed that the interventions of music therapy and aromatherapy with chamomile-lavender essential oil could reduce the anxiety of nurses. Therefore, it is recommended to use music therapy and aromatherapy with chamomile-lavender essential oil to reduce the anxiety of nurses in the clinical setting.

The Psychometric Properties of the Center for Epidemiological Studies Depression Scale (CES-D) for Iranian Cancer Patients

Objectives:

The Center for Epidemiologic Studies Depression Scale (CES-D) was specifically created to assess depression in cancer patients. However, to date, the CES-D has not been validated in Farsi. Therefore, this study aimed to assess the psychometric properties of the CES-D in Iranian cancer patients.

Methods:

During a three-month period (October to December, 2015), a total of 380 cancer patients completed a Farsi version of the CES-D. The construct validity of the scale was evaluated by exploratory factor analysis. Reliability was assessed using Cronbach’s alpha and McDonald Omega. All of the statistical procedure were run by SPSS 22 (SPSS Inc., Chicago, IL, USA).

Results:

The construct validity of the CES-D determined three factors (somatic affect, negative affect, and positive affect), which explained 65.60% of the total variance. The internal consistency was greater than 0.70.

Conclusion:

Findings revealed that the Farsi version of the CES-D has acceptable validity and reliability, which can be used to measure depression in Iranian cancer patients.

Outcomes of music therapy interventions in cancer patients-A review of the literature

BACKGROUND

Effectiveness of music-based interventions (MI) on cancer patients' anxiety, depression, pain and quality of life (QoL) is a current research theme. MI are highly variable, making it challenging to compare studies.

OBJECTIVE AND METHODS

To summarize the evidence on MI in cancer patients, 40 studies were reviewed following the PRISMA statement. Studies were included if assessing at least one outcome among anxiety, depression, QoL and pain in patients aged ≥ 18, with an active oncological/onco-haematological diagnosis, participating to any kind of Music Therapy (MT), during/after surgery, chemotherapy or radiotherapy.

RESULTS

A positive effect of MI on the outcomes measured was supported. Greater reductions of anxiety and depression were observed in breast cancer patients. MI involving patients admitted to a hospital ward were less effective on QoL.

CONCLUSION

The increasing evidence about MI effectiveness, tolerability, feasibility and appreciation, supports the need of MI implementation in Oncology, Radiotherapy and Surgery wards, and promotion of knowledge among health operators.

Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial

Background

Mothers of preterm infants often have symptoms of anxiety and depression, recognized as risk factors for the development of cardiovascular diseases and associated with low rates of heart rate variability (HRV). This study aimed to evaluate the influence of music therapy intervention on the autonomic control of heart rate, anxiety, and depression in mothers.

Methods

Prospective randomized clinical trial including 21 mothers of preterms admitted to the Neonatal Intensive Care Unit of a tertiary hospital, recruited from August 2015 to September 2017, and divided into control group (CG; n = 11) and music therapy group (MTG; n = 10). Participants underwent anxiety and depression evaluation, as well as measurements of the intervals between consecutive heartbeats or RR intervals for the analysis of HRV at the first and the last weeks of hospitalization of their preterms. Music therapy sessions lasting 30–45 min were individually delivered weekly using receptive techniques. The mean and standard deviation of variables were obtained and the normality of data was analyzed using the Kolmogorov-Smirnov test. The paired sample t-test or Wilcoxon test were employed to calculate the differences between variables before and after music therapy intervention. The correlations anxiety versus heart variables and depression versus heart variables were established using Spearman correlation test. Fisher’s exact test was used to verify the differences between categorical variables. A significance level of p < 0.05 was established. Statistical analysis were performed using the Statistical Package for the Social Sciences, version 20.

Results

Participants in MTG had an average of seven sessions of music therapy, and showed improvement in anxiety and depression scores and autonomic indexes of the time domain (p < 0.05). Significant correlations were found between depression and parasympathetic modulation using linear (r = − 0.687; p = 0.028) and nonlinear analyses (r = − 0.689; p = 0.027) in MTG.

Conclusion

Music therapy had a significant and positive impact on anxiety and depression, acting on prevention of cardiovascular diseases, major threats to modern society.

Trial registration

Brazilian Registry of Clinical Trials (no. RBR-3x7gz8). Retrospectively registered on November 17, 2017.

The Effect of Listening to Holy Quran Recitation on Anxiety: A Systematic Review

BACKGROUND

Among all mental health disorders in the general population, anxiety is the most frequent. Both pharmacological and non-pharmacological interventions are used to manage anxiety in various settings. There is a growing interest among researchers on religion therapy as a non-pharmacological intervention for anxiety management. Hence, due to the importance of Holy Quran in Muslims' lives, this systematic review was performed to assess the studies that evaluated the effect of Quran recitation on anxiety in various settings.

MATERIALS AND METHODS

This systematic review study was performed on articles published between January 1990 and September 2017. Several online databases including SID, Iranmedex, Magiran, IranDoc, PubMed, Scopus, and Google Scholar were searched with the keywords of "Quran," "anxiety," "clinical trial." The risk of bias across all included studies was assessed using the Cochrane Collaboration's risk of bias tool.

RESULTS

Of the 973 articles found in the initial search, 28 randomized controlled trials and quasi-experiments were selected for the systematic review. In most studies, State-Trait Anxiety Inventory was used to measure participants' anxiety. Findings of this review revealed a positive effect of listening to Holy Quran recitation in reducing anxiety in various settings. Only one study had reported that anxiety level in Holy Quran recitation group was less than that of the control group, but it was not statistically significant.

CONCLUSIONS

Based on the available researches, Quran recitation can be used as a useful non-pharmacological treatment to reduce anxiety. However, methodologically strong randomized controlled trials are needed in this area.

Music therapy for depression

BACKGROUND

Depression is a highly prevalent mood disorder that is characterised by persistent low mood, diminished interest, and loss of pleasure. Music therapy may be helpful in modulating moods and emotions. An update of the 2008 Cochrane review was needed to improve knowledge on effects of music therapy for depression.

OBJECTIVES

1. To assess effects of music therapy for depression in people of any age compared with treatment as usual (TAU) and psychological, pharmacological, and/or other therapies.2. To compare effects of different forms of music therapy for people of any age with a diagnosis of depression.

SEARCH METHODS

We searched the following databases: the Cochrane Common Mental Disorders Controlled Trials Register (CCMD-CTR; from inception to 6 May 2016); the Cochrane Central Register of Controlled Trials (CENTRAL; to 17 June 2016); Thomson Reuters/Web of Science (to 21 June 2016); Ebsco/PsycInfo, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PubMed (to 5 July 2016); the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), ClinicalTrials.gov, the National Guideline Clearing House, and OpenGrey (to 6 September 2016); and the Digital Access to Research Theses (DART)-Europe E-theses Portal, Open Access Theses and Dissertations, and ProQuest Dissertations and Theses Database (to 7 September 2016). We checked reference lists of retrieved articles and relevant systematic reviews and contacted trialists and subject experts for additional information when needed. We updated this search in August 2017 and placed potentially relevant studies in the "Awaiting classification" section; we will incorporate these into the next version of this review as appropriate.

SELECTION CRITERIA

All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) comparing music therapy versus treatment as usual (TAU), psychological therapies, pharmacological therapies, other therapies, or different forms of music therapy for reducing depression.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected studies, assessed risk of bias, and extracted data from all included studies. We calculated standardised mean difference (SMD) for continuous data and odds ratio (OR) for dichotomous data with 95% confidence intervals (CIs). We assessed heterogeneity using the I2 statistic.

MAIN RESULTS

We included in this review nine studies involving a total of 421 participants, 411 of whom were included in the meta-analysis examining short-term effects of music therapy for depression. Concerning primary outcomes, we found moderate-quality evidence of large effects favouring music therapy and TAU over TAU alone for both clinician-rated depressive symptoms (SMD -0.98, 95% CI -1.69 to -0.27, 3 RCTs, 1 CCT, n = 219) and patient-reported depressive symptoms (SMD -0.85, 95% CI -1.37 to -0.34, 3 RCTs, 1 CCT, n = 142). Music therapy was not associated with more or fewer adverse events than TAU. Regarding secondary outcomes, music therapy plus TAU was superior to TAU alone for anxiety and functioning. Music therapy and TAU was not more effective than TAU alone for improved quality of life (SMD 0.32, 95% CI -0.17 to 0.80, P = 0.20, n = 67, low-quality evidence). We found no significant discrepancies in the numbers of participants who left the study early (OR 0.49, 95% CI 0.14 to 1.70, P = 0.26, 5 RCTs, 1 CCT, n = 293, moderate-quality evidence). Findings of the present meta-analysis indicate that music therapy added to TAU provides short-term beneficial effects for people with depression if compared to TAU alone. Additionally, we are uncertain about the effects of music therapy versus psychological therapies on clinician-rated depression (SMD -0.78, 95% CI -2.36 to 0.81, 1 RCT, n = 11, very low-quality evidence), patient-reported depressive symptoms (SMD -1.28, 95% CI -3.75 to 1.02, 4 RCTs, n = 131, low-quality evidence), quality of life (SMD -1.31, 95% CI - 0.36 to 2.99, 1 RCT, n = 11, very low-quality evidence), and leaving the study early (OR 0.17, 95% CI 0.02 to 1.49, 4 RCTs, n = 157, moderate-quality evidence). We found no eligible evidence addressing adverse events, functioning, and anxiety. We do not know whether one form of music therapy is better than another for clinician-rated depressive symptoms (SMD -0.52, 95% CI -1.87 to 0.83, 1 RCT, n = 9, very low-quality evidence), patient-reported depressive symptoms (SMD -0.01, 95% CI -1.33 to 1.30, 1 RCT, n = 9, very low-quality evidence), quality of life (SMD -0.24, 95% CI -1.57 to 1.08, 1 RCT, n = 9, very low-quality evidence), or leaving the study early (OR 0.27, 95% CI 0.01 to 8.46, 1 RCT, n = 10). We found no eligible evidence addressing adverse events, functioning, or anxiety.

AUTHORS' CONCLUSIONS

Findings of the present meta-analysis indicate that music therapy provides short-term beneficial effects for people with depression. Music therapy added to treatment as usual (TAU) seems to improve depressive symptoms compared with TAU alone. Additionally, music therapy plus TAU is not associated with more or fewer adverse events than TAU alone. Music therapy also shows efficacy in decreasing anxiety levels and improving functioning of depressed individuals.Future trials based on adequate design and larger samples of children and adolescents are needed to consolidate our findings. Researchers should consider investigating mechanisms of music therapy for depression. It is important to clearly describe music therapy, TAU, the comparator condition, and the profession of the person who delivers the intervention, for reproducibility and comparison purposes.