Study leaders Professor Jaakko Erkkilä and Professor Christian Gold, and colleagues, recruited 79 people of working age (18 to 50 years old) living in Finland, who had been diagnosed with depression using the ICD-10 Classification of Mental and Behavioural Disorders.
The participants were randomly assigned to receive twenty, 60-minute sessions of individual music therapy plus standard care (33 people), or standard care only (46 people). In Finland, standard care for depression comprises antidepressant medication, 5 to 6 sessions of individual psychotherapy, and psychiatric counselling.
Twice a week, with the help of trained music therapists, in one-to-one sessions, the participants in the intervention group learned how to improvise music using a mallet instrument, a percussion instrument or an acoustic, West African djembe drum.
On average, each participant in this group attended 18 sessions with 88% (29 individuals) attending at least 15 sessions.
The researchers clinically assessed all participants at the start of the study, then at 3 months and 6 months afterwards. The assessment included taking measures of depression, anxiety, general functioning, quality of life and alexithymia (inability to express feelings with words).
The researchers found that:
- After 3 months, the participants receiving music therapy and standard care showed greater improvement than those receiving standard care only in symptoms of depression (mean difference 4.65, 95% Confidence Interval CI 0.59 to 8.70), anxiety (1.82, 95% CI 0.09 to 3.55) and general functioning (-4.58, 95% CI -8.93 to -0.24).
- However, after 6 months, although the improvements were still evident, the differences between the groups were no longer statistically significant.
"Individual music therapy combined with standard care is effective for depression among working-age people with depression. The results of this study along with the previous research indicate that music therapy with its specific qualities is a valuable enhancement to established treatment practices. "
Gold told the press that:
"Music therapy has specific qualities that allow people to express themselves and interact in a non-verbal way - even in situations when they cannot find the words to describe their inner experiences."
Erkkilä agreed, adding that they found people often expressed what they were feeling by drumming, or with the tones they made with a mallet instrument.
"Some people described their playing experience as cathartic," added Erkkilä.
One way to interpret these results is that the music therapy helped, but only while it was ongoing, that is during the first three months of the study.
However, although small, the trial appears to be well-designed and conducted, as Dr Mike Crawford, a specialist in mental health services at the Centre for Mental Health, Imperial College London, in the UK, writes in an accompanying journal editorial:
"This is a high-quality randomised trial of music therapy specifically for depression, and the results suggest that it can improve the mood and general functioning of people with depression."
"Music-making is social, pleasurable and meaningful. It has been argued that music making engages people in ways that words may simply not be able to," he adds.
Erkkilä said someone now needs to replicate the findings "with a larger sample of people, and further research is needed to assess the cost-effectiveness of such therapy".
Written by Catharine Paddock, PhD