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Therapeutic Effects of Music: A Review

Authors:
  • Department of Biology, Faculty of Sciences, Shiraz Branch, Islamic Azad University, Shiraz, Iran.

Abstract

Introduction: Side effects of most synthetic drugs used in the treatment of various diseases have led researchers around the world to conduct studies on the identification of alternative therapies. In this vein, the present study aims to review the research carried out in association with the therapeutic effects of music used in the treatment of relatively common diseases. Methods: To develop this review article, researchers conducted some computer search using keywords in databases including Google scholar, SID, Iranmedex, Medline, PubMed, Springer, Science Direct, ProQuest, and ISC, and collected and probed the results of over 100 published articles from 2000 to 2018 dealing with the effect of music therapy in the treatment of 12 relatively common diseases. Results: The findings show that music therapy has a positive effect on the treatment of the diseases studied. Conclusion: Music can have positive effects on pain, sleep disorders, learning, memory, IQ, depression, anxiety and special diseases such as schizophrenia and autism.
Report of Health Care Review Article
Volume 4, Issue 4, 2018, p. 1-13
Therapeutic Effects of Music: A Review
Seyed Ebrahim Hosseini * 1, Seyed Ali Hosseini 2
1. Department of Biology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
2. Department of Sport Physiology, Marvdasht Branch, Islamic Azad University, Marvdasht, Iran
Introduction
Music is an existing portion of all human
beings. There are beats and rhythms in our
heart rate, and in our breaths and movements
as well. Melody has been created in our
laughs, cries, screams or songs. Our entire
range of emotions can be expressed in
different rhythms and harmonies, styles and
musical terms. Musical sounds, due to
affective and emotional loads, have a profound
effect on morale, personality, and the
cultivation of human emotions. The idea that
music can be used as having a therapeutic
effect to heal and improve health and behavior
at least dates back to Aristotle and Plato's
writings, and has since undergone many
courses. Music therapy has been defined by
the Australian music therapy association as
"the creative and planned use of music for
health and vitality and preservation". Or in
accordance with what the American music
therapy association (1999) has stated; the
attitude to music therapy comprises "the use of
music in order to achieve the goals of therapy,
that is to improve, maintain and promote the
health of the mind and body" (1). Music is a
valuable tool for stimulating excitement, and
processing and receiving music sensations do
not require to recognize and understand the
melody. Neural networks in the brain are
sensitive to the perception of music (e.g.,
substrate, rhythm, intensity of sound, etc.), so
that alteration in each of the factors in a
melody (song) can be associated with the
reactions of each of the related brain centers.
According to the arousal- manner hypothesis,
listening to music affects arousal and manner.
In fact, the manipulation and alteration in the
structure of limbic and melodic music are
accompanied by changes in mood and arousal,
as changing elements such as mode, the
complexity of harmony and rhythm contribute
to the creation of the valence and the positive
and negative emotions, while altering other
elements such as beat, accent, and rhythm
affect stimulating arousal (2). Today, the side
http://jrhc.miau.ac.ir
Abstract
Introduction: Side effects of most synthetic drugs used in the treatment of
various diseases have led researchers around the world to conduct studies on
the identification of alternative therapies. In this vein, the present study aims
to review the research carried out in association with the therapeutic effects
of music used in the treatment of relatively common diseases.
Methods: To develop this review article, researchers conducted some
computer search using keywords in databases including Google scholar,
SID, Iranmedex, Medline, PubMed, Springer, Science Direct, ProQuest, and
ISC, and collected and probed the results of over 100 published articles from
2000 to 2018 dealing with the effect of music therapy in the treatment of 12
relatively common diseases.
Results: The findings show that music therapy has a positive effect on the
treatment of the diseases studied.
Conclusion: Music can have positive effects on pain, sleep disorders,
learning, memory, IQ, depression, anxiety and special diseases such as
schizophrenia and autism.
Keywords: Music, Treatment, Disorder
Received: 19 April 2018
Accepted: 21 August 2018
Published online: 1 October 2018
*Corresponding author:
Seyed Ebrahim Hosseini.
Department of Physiology, Shiraz
Branch, Islamic Azad University,
Shiraz, Iran
Phone: +989171183917
Fax: +987143311172
Email:
ebrahim.hossini@yahoo.com
Competing interests: The authors
declare that no competing interests
exist.
Citation: Hosseini SE, Hosseini
SA. Therapeutic effects of music: a
review. Rep Health Care. 2018; 4
(4): 1- 13.
effects of most synthetic drugs used in the
treatment of various diseases have led to
alternative or complementary therapies such as
music, massage, physical relaxation,
psychodrama, and the same therapies as
interventions in which no drug is used to treat
various disorders (3- 6). Music has long been a
favorite of humans, and its long history
reflects the importance of music in human life
(7). Music is one of the most attractive
branches of art, which is associated with
mobility, energy generation and abstraction,
and is used in various branches of medicine,
psychology and counseling (8). Today, the use
of non-pharmacological methods to relieve
pain and disturbances such as anxiety is
increasing, and one of these methods is the use
of pleasant audio stimuli and music therapy
(9). The findings suggest that music therapy
can be used as a psychological treatment in
various situations and diseases (10). In this
vein, considering the interest of different
human societies in music around the world, as
well as the tendency of medical specialists to
use new therapies that have positive effects on
various diseases and lack side effects of
chemical drugs, the current study, drawing on
over 100 papers published in 2000- 2018
worldwide, aims to review the effects of music
therapy on 12 relatively common illnesses all
over the world.
Music and attention deficit
hyperactivity disorder
Attention deficit hyperactivity disorder
(ADHD) is rather one of the most prevalent
diseases. Research has shown that music
therapy is most likely to reduce aggression and
attention deficit hyperactivity disorder in
children with ADHD through modification of
brain function (11). Music, on the one hand,
with the increase of dopamine in different
regions of the brain, prevents aggressive
behaviors and, on the other hand, by
improving the function of the pre- frontal
regions and other parts of the brain that have
been affected in these patients, improves the
disease in children with ADHD disorder (12).
It has been shown that listening to music can
improve attention and memory performance
(13). The results of a study show that music,
dance and rhythmic movements cause positive
changes in the emotional and behavioral
symptoms of 5 to 7 year-old boys with ADHD
disorder (14). Another study showed that the
implementation of music therapy is useful in
the treatment of children with ADHD disorder
(15). It has also been shown that music therapy
along with rhythmic body movements,
individually or chorally, has a positive effect
on symptom correction of the disease in
children with ADHD, and the effects of group
therapy are greater than individual treatment
(16). Given that studies have shown
interactions between the musical centers of the
brain at the temporal lobe and the brain
segments involved in ADHD, (17) therefore,
music by modifying the operations of these
centers may improve the disease.
Music and pain relief
A study revealed that gentle and mild music is
likely to relieve the pain through opioid and
dopamine systems in the brain (18). A review
in cancer patients showed that music therapy
could be used as a non-invasive method to
reduce pain (19). In a study regarding the
impact of two non-pharmacological pain-
relieving methods (music therapy and
progressive muscle relaxation) on the amount
of pain in cancer patients, it was indicated that
both music therapy and progressive muscle
relaxation techniques are effective in reducing
pain (20); also it was shown that progressive
muscle relaxation and relaxing music along
with other common interventions are effective
in reducing the severity of fatigue and pain in
patients with breast cancer (21). Music with
the stimulation of opioidergic neurons and the
increase of opioid substances, such as
endorphins, reduces pain, heart rate, and blood
pressure (22). Also, music relieves the pain by
reducing the severity of depression and
anxiety (23). Music therapy is a method that
Hosseini and Hosseini
2 Report of Health Care. 2018; 4 (4): 1- 13
plays a role in pain relief, reduces the need for
analgesic drugs and hence eliminates the side
effects of analgesics (24).
Music, memory and learning
Musical and rhythmic activities, due to rhythm
and beat that play an important role in the time
perception and mental meditation, increase
mental abilities and working memory (25).
The results of a study showed that the use of
music therapy can improve the return of
autobiographical memory in people with
Alzheimer's disorder (26). The results of
another study showed that listening to classical
music could improve the performance of
working memory in students. Therefore, it is
recommended that classical music be used in
working environments where memory
performance is important. Another study on
the effect of memory attenuation and light
music on the onset of morphine dependence on
adult male rat using conditioned place
preference showed that relaxing music is
likely to increase the activity of dopaminergic
neurons, and so elevates morphine-induced
conditioned place preference (28). It has been
shown that the treatment with pleasant music
through improving memory helps to cure
Alzheimer's disease, and in fact the learning
power can be increased up to 5 times using
this kind of music (29). Listening to music
strengthens memory and stimulates
dopaminergic neurons in the brain, causing
positive inspiration in the individual (30). In
another review, it was shown that group music
therapy reduces the agitated behaviors of
elderly women with Alzheimer's disease (31).
Music therapy reduces the non-aggressive,
aggressive, and restless physical behaviors of
elderly individuals with Alzheimer's disease
(32- 34). Musical education is the key to the
involvement and maintenance of brain systems
involved in the acknowledged attention and
memory (26). It has been shown in a study that
music therapy reduces behavioral disorders in
patients with dementia (35). It has also been
shown that working memory in musicians is
stronger than non-musicians (36).
Music and addiction
Pleasant music activates various regions in the
Brain; such as the nucleus accumbens,
orbitofrontal cortex, Insula regions, anterior
cerebellum, thalamus, ventral striatum,
amygdala, and complementary motor regions
that interfere with motivation processes as
well as pleasure and reward gain (37). Studies
have shown that the reinforcement, reward and
relaxation aspects of listening to music are
concerned with dopaminergic stimuli and
increasing the release of dopamine in the
nucleus accumbens and ventral tegmentum
and increasing the neurotransmitter of GABA
in the amygdala and other areas of the limbic
system (38, 39). In another study, it was
shown that rushing music increases morphine
dependence in the conditioned place
preference model, while slow music lacks such
an effect (40). According to the findings of a
study, it can be said that music therapy is a
useful method in reducing the relapse of
depression and the stress of drug addicts, so
music therapy can be used as an effective way
for the treatment of addiction consequences
(41). Still again, in another study it was shown
that music has no effect on the performance of
the pituitary-adrenal axis, and also on
inflammation caused by carrageenan injection
(42), so the analgesic effects of music are
through pathways other than reducing
inflammation or steroid hormones. The results
of studies have shown that music stimulates
oxytocin secretion in the brain and thereby by
stimulating and increasing the secretion of
morphine-like materials, reduces the sensation
of pain (43- 45). Also, serotonin is one of the
most important neurotransmitters in relieving
pain, and music increases its analgesic effect
by increasing this neurotransmitter (46).
Music and spiritual health
A study on the effectiveness of relaxing and
instrumental music on the spiritual health of
Hosseini and Hosseini
Report of Health Care. 2018; 4 (4): 1- 13 3
adolescent girls in Shiraz showed that relaxing
and instrumental music significantly and
effectively enhances the spiritual health of
female adolescents (47). Music plays an
important role in outpouring emotions and
awareness of the self and environment, and
when speaking is not effective, music expands
emotions, empathy and sympathy; also it can
be used as an effective means for people who
seek sense, hope, and recognition (48). In this
regard, a study has shown that listening to
music along with spiritual therapy reduces
depression, anxiety and stress in pregnant
women (49).
Music and childbirth
Labor pain is one of the most excruciating
experiences of women in which relieving the
pain is upmost major goal of midwifery care,
because this pain can have plenty of adverse
effects on the mother and the baby (50).
Psychological empowerment and the
protection of women during childbirth also
have an impact on the health of their children
(51). Regarding the side effects of chemical
drugs on the mother and the embryo during
pregnancy and delivery, the use of non-
pharmacological methods in the reduction of
labor pain and the duration of labor has been
studied by various researchers. In the
meantime, research reveals the positive effects
of methods such as massage therapy and music
therapy on the severity of pain and the
duration of labor, both during pregnancy and
at the time of delivery (52, 53). The results of
a study showed that music therapy reduced the
pain and delivery time in primiparous women
(52). Another study also found that listening to
music had a positive effect on the process of
delivery and reduced time, pain and anxiety
during delivery, and also had a positive effect
on the maternal parameters of the fetus (54).
Listening to fast-tempo music in the active
phase of labor can reduce the amount of pain
and the length of delivery (55). The results of
another study showed that slow-paced music
reduces labor pain, however, it does not affect
if it continues for more than 3 hours (56). In
another study, it was shown that in
primiparous pregnant women, music therapy
reduced the pain and anxiety of the latent
phase, while it doesn’t affect the active phase
(57). In addition, in a clinical trial, it was
shown that music therapy has no effect on pain
and delivery (58). The results of a study
showed that music therapy in mothers
undergoing cesarean section before entering
the operating room reduced the amount of
anxiety and postoperative pain and shortened
the recovery of the patient. Therefore, this
treatment should be considered by doctors,
nurses and medical staff (59). Also, the results
of studies have shown that therapeutic
methods, such as massage therapy and music
therapy that reduce the level of anxiety and
increase the level of brain opioids, reduce the
labor pain and the duration of delivery (59,
60).
Music and anxiety treatment
Anxiety is one of the diseases that is most
prevalent in behavioral problems (61). Music
through distraction of the senses of anxiety
stimulators can be implemented to treat
anxiety disorders (62). Music increases the
alpha waves or brain relaxation wave and thus
causes a relaxing condition (22). The results of
a study showed that music therapy before
surgery in mothers undergoing cesarean
section reduced the amount of anxiety and
postoperative pain and shortened the recovery
of the patient. Therefore, it is necessary for
this treatment to be considered by doctors,
nurses and medical staff (59, 63). Music,
especially of the familiar type, can have
positive effects in reducing anxiety, pain and
control of some of the vital signs of patients
(64). In a study, music therapy in mothers
under cesarean section was shown to reduce
anxiety and pain (65). Music therapy also
reduces anxiety in patients with Alzheimer's
disease (66). Music is widely used to reduce
stress and anxiety and to improve health (67).
Music therapy has also reduced anxiety in
Hosseini and Hosseini
4 Report of Health Care. 2018; 4 (4): 1- 13
mice treated with simvastatin (68). It has been
argued that music has psychological benefits
such as reducing fear and anxiety as well as
enhancing mood and a feeling of relaxation
(69). Music creates positive excitement and
affection in individuals (70). Music therapy
has been shown to be effective in reducing
anger, depression and anxiety, as well as
improving social skills for adolescents (71).
Music and cardiovascular disorders
Music reduces the amount of resting heart rate,
blood pressure and respiratory rate (72). The
results of a review show that music expands
cardiovascular function, respiratory function
and milk sucking; improves sleep patterns of
premature children, and also decreases the
stress of their parents (73). In one study, music
was shown to have a significant effect on
systolic and diastolic blood pressure in
individuals during dental root canal treatment,
so that changes in blood pressure can be
prevented using music during root canal
treatment (74). Listening to music or
instrumental sounds has a dramatic effect by
reducing the secretion of catecholamines on
systolic and diastolic blood pressure and heart
rate (3, 75). Music therapy exerts its
antihypertensive effects through reducing the
risk factors involved in cardiovascular
disorders and moderating the effects of the
autonomic nervous system on heart rate (76).
However, the results of a study showed that
immediately after the end of a high intensity
exercise listening to music during the initial
phase of recovery, reduced the efficiency of
cardio-respiratory system by reducing the
stroke volume and the current volume and
increasing the number of respiration and heart
rate (77).
Music and sleep disorders
Sleep is one of the basic needs of human
beings. Sleep deprivation has many harmful
effects on human body and spirit. Considering
the importance of sleep for patients admitted
to the cardiac care unit, meeting this essential
need using sensory stimuli such as music and
massage is mandatory (78). The results of a
study showed that the use of instrumental
music can be effective in improving the
quality and quantity of sleep in patients, and
nurses can use this non-pharmacological
method in their usual care to improve their
patients’ sleep (79).
Music and depression
Depression is one of the common
psychological disorders that is associated with
biochemical, cognitive, behavioral, and
psychological changes, and according to the
world health organization (WTO), it is the
second cause of referral to health centers by
2020 (80, 81). Findings of a study showed that
music therapy can be used as a way to reduce
the severity of depression in the elderly, and
the impact of these interventions can vary
between two genders; also this difference can
be seen in reducing the sense of loneliness).
Findings of another study suggest that music
therapy can be used as a cost-effective and
affordable way to increase cheerfulness,
improve quality of life, and reduce depression
in women with depression (83). The results of
a study show that music therapy can improve
the mental status of people with depression
disorder (84). One study found that group
music therapy improves depression in patients
with dementia (85). In a study, music therapy
has been shown to reduce the severity of
depression in patients with depression disorder
(86). Music therapy reduces anxiety and
improves functional status in depressed
patients (87). The results of another study
showed that music therapy is effective in the
treatment based on the depressed patients’
admission and commitment (88). One study
showed that group music therapy improves
patients with mild to moderate depression and
this method also strengthens the effect of
psychological treatments (89). Music through
endogenous opioids improves the positive and
negative emotions of individuals (90). In a
study comparing the effect of music on the
Hosseini and Hosseini
Report of Health Care. 2018; 4 (4): 1- 13 5
excitement of depressed and non-depressed
subjects, it has been shown that music in
depressed people has a greater effect on
positive emotions than normal people (91).
Music and schizophrenia
Schizophrenia, with a prevalence of about one
percent in the global community, usually
appears at a young age (before the age of 25)
and lasts until the end of life, and since drugs
for this disease have several side effects, the
use of non-pharmacological treatments such as
music therapy is recommended, so that the use
of music reduces the pathological effects of
schizophrenia (92). In a study, musical activity
has been shown to enhance the memory of
schizophrenic patients, but for more
impressive effects, side interventions are also
required (93). The results of Khalaf Beigi et
al.’s studies in 2003 showed that Mozart
music and rhythmic movements increase the
memory scores and attention of people with
schizophrenia disorder (94). Considering that
in schizophrenic patients the analysis and
brain disorders, are observed, especially in the
mid part of the temporal lobe, and studies have
shown that the music causes neural flexibility
in the brain, in particular the temporal lobe
(95), thus music can improve cognitive
disorder and other symptoms of schizophrenia.
Music and autism disease
A study has shown that music therapy
improves the verbal and nonverbal social
communication of autistic children (96, 97). It
also shows that music therapy reduces self-
harm behavior in autistic children (98). Music
therapy along with game therapy increases the
social behavior of children with autism and
reduces their stereotypical behavior.
Therefore, it can be concluded that the
combination of music therapy with game
therapy should be one of the main pillars for
professionals and educators in the education
and treatment of children with autism disorder
(99). The emotional evacuation instigated by
listening to music decreases the frequency and
severity of stereotypical behaviors in autistic
individuals (100). Many of the behavioral
problems of children with autism disorder are
due to the dysfunction in mirror neurons, and
music therapy by activating these neurons in
the brain can improve and reduce the problems
of these children (101). A study found that the
use of music in the classroom of autistic
students helps them in learning and training
(102). A study indicated that music therapy
has a positive effect on learning social skills
and improving the emotional and cognitive
impairments of individuals with autism (103).
In another study, music was shown to enhance
brain functions and reduce the stereotypical
movements of children with autism (104). It
was also shown that group music therapy
improves the social interactions of patients
with autism disorder (105).
Conclusion
Essentially, compositions of notes, namely
melodic processing, occur in the inner regions
and around the auditory cortex and motor
areas, while the more complex patterns of
these distributed network components are
analyzed in the anterior temporal lobe and
frontal areas. According to numerous
evidence, the right hemisphere is involved in
melody processing and the left hemisphere in
rhythm processing. The forehead region is
among the regions associated with the auditory
cortex in music processing that interferes with
the shape and interpretation of memory. Over
the past years, neurological studies have
shown that music is a valuable tool for
stimulating emotions (106), therefore in
various studies the effects of music have been
studied. In the field of psychology, music is
regarded as a language, as common as other
spoken languages of the world, which has its
own specific regions in the brain; and
understanding music, the same as language,
needs education. Thus, music holds
communicative functions such as language, as
there are certain musical regions in the brain
that are activated through musical sounds and
Hosseini and Hosseini
6 Report of Health Care. 2018; 4 (4): 1- 13
display their functions (107). Regarding what
was mentioned in this article, it can be
concluded that music can have positive effects
on pain relief, sleep disorders, learning,
memory, IQ, depression, anxiety and special
diseases such as schizophrenia and autism.
With the recognition of musical impacts and
inspirations, a way can hopefully be opened to
the practical applications of music in different
fields.
Ethical issues
Not applicable.
Authors’ contributions
All authors equally contributed to the writing
and revision of this paper.
Acknowledgments
The present authors express their thanks and
gratitude to the Vice-Chancellor of Research
and Technology of Marvdasht Branch, Islamic
Azad University.
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... The functions of temporal lobe is mainly related to hearing, memory and mental activity (Bougeard and Fischer, 2002). There is evidence that music can also activate the temporal lobe area (Alfredson et al., 2004;Hosseini and Hosseini, 2019). For the right hand, the right temporal lobe is its non-dominant hemispherical temporal lobe. ...
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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 I(2) 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.
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