An Austrian study that appears in the current issue of Psychotherapy and Psychosomatics applies music therapy to the treatment of depression.
Evidence suggests that music therapy should be further explored as a possible treatment. Music therapy is generally not associated with negative side effects and can be easily implemented. These factors contribute to high adherence and favorable treatment outcomes. Previous efficacy studies of music therapy for depression treatment suffered from a lack of specific stimuli, methodological shortcomings, or utilization of small samples.
This study deals with the largest trial to date investigating 2 forms of receptive music therapy among adults with depression. Recruited through media and by contacting doctors, potential subjects were screened online using the Goldberg Depression Questionnaire (GDQ). 203 subjects entered the study protocol. The study design included 4 arms: music therapy 1 (MT1), music therapy 2 (MT2), placebo (nature sounds), and waiting-list control. Assignment to study arms was based on subjects’ preferences for the date of their initial study appointment (only on working days). The T1 period represents the central trial element of this study, while the additional study periods (T2, T3 and T4) were employed to explore wash-out effects, subject adherence, and treatment preferences. This report only draws on data from T1. During T1, the subjects were asked to strictly follow their assigned study protocol with the aim of determining the effects of MT1 and MT2. Subjects who received audio programs (i.e. MT1, MT2, or placebo) were blinded to the program they had received and could not switch from their assigned program to alternative music programs during T1. MT1 and MT2 were individualized music-focused audio therapies developed by the study investigators as receptive music therapies for depression treatment. MT1 incorporated newly composed polyphonic modern music and MT2 consisted of specifically arranged classical music. Subjects listened twice daily for 30 min. Depression status was assessed at the beginning of T1 and T2 using the Hamilton Rating Scale for Depression (HAM-D), the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS-D). A composite (COMP) depression scale was constructed based on the HAM-D (double weighted), BDI, and HADS-D z-scores. The overall drop-out rate at the beginning of T2 equaled 17.2% (35/203).
Compared to the control arm, a significant positive effect in COMP was observed for MT1 in T1 (p = 0.030), but not for MT2. Both MT1 and MT2 were associated with a significant positive effect on HAM-D and HADS-D scores. MT2 subjects experienced a positive effect on BDI scores, but not MT1 listeners. No significant change in any depression score was detected in the placebo arm. HAM-D, BDI, and HADS-D score changes correlated only moderately, with the highest correlation observed between BDI and HADS-D (p=0.59). In bivariate analysis, a ‘worries’ scale was the only possible confounder significantly associated with all 4 depression scores, suggesting that the HAM-D, BDI, and HADS-D scales may focus on different aspects of the construct of depression (e.g. cognitive and emotional factors).
Based on possible neurophysiologic and neurochemical effects, receptive music therapy, as explored in this pilot controlled trial, appears to be associated with reduced depressive symptoms and high treatment compliance, and may therefore potentially represent an effective depression treatment alternative, alone or in combination with psychosocial and pharmacological approaches.