Music therapy for patients with depression: Systematic review and meta-analysis of randomised controlled trials

Background Depression is one of the most common mental diseases, leading to a decline in both psychiatric and physical functions. One non-pharmacological therapeutic strategy for the management of psychiatric disorders is music therapy. Aims To assess the clinical effectiveness of music therapy and its various subscales for managing depressive symptoms (primary outcome) and related problems (secondary outcome) in comparison with other conventional treatments. Method A comprehensive search of MEDLINE, Embase, Cochrane Review, CINAHL, PsyInfo and KMbase was conducted to identify randomised controlled trials published up to 31 August 2023. Studies assessing the clinical effectiveness of music therapy for individuals with depression were included, and data on participants, music therapy and clinical measurement scores were extracted. This study was registered with PROSPERO (no. CRD42023466833). Results Music therapy was significantly more effective than controls in reducing depressive symptoms (standardised mean difference (SMD) -0.97 [95% CI: -1.23 to -0.71], P < 0.01). This benefit was consistent regardless of music therapy types, delivery methods or provider professionalism. In addition, music therapy was significantly better than controls in improving quality of life (SMD 0.51 [95% CI: 0.19-0.83], P < 0.01) and sleep quality (SMD -0.61 [95% CI: -1.03 to -0.19], P < 0.01), although it showed only a non-significant trend towards reducing anxiety (SMD -0.98 [95% CI: -2.01 to 0.06], P = 0.06). The evidence level was very low due to high risk of bias, inconsistency due to high heterogeneity and imprecision. Conclusions Despite the very low evidence level, music therapy may be recommended with weak strength for patients with depression, considering the results of the meta-analysis and the high accessibility and broad applicability of music.