Background
Depression is a highly prevalent disorder associated with reduced social functioning, impaired quality of life, and increased mortality. Music therapy has been used in the treatment of a variety of mental disorders, but its impact on those with depression is unclear.

Objectives
To examine the efficacy of music therapy with standard care compared to standard care alone among people with depression and to compare the effects of music therapy for people with depression against other psychological or pharmacological therapies.

Search methods
CCDANCTR-Studies and CCDANCTR-References were searched on 7/11/2007, MEDLINE, PsycINFO, EMBASE, PsycLit, PSYindex, and other relevant sites were searched in November 2006. Reference lists of retrieved articles were hand searched, as well as specialist music and arts therapies journals.

Selection criteria
All randomised controlled trials comparing music therapy with standard care or other interventions for depression.

Data collection and analysis
Data on participants, interventions and outcomes were extracted and entered onto a database independently by two review authors. The methodological quality of each study was also assessed independently by two review authors. The primary outcome was reduction in symptoms of depression, based on a continuous scale.

Main results
Five studies met the inclusion criteria of the review. Marked variations in the interventions offered and the populations studied meant that meta-analysis was not appropriate. Four of the five studies individually reported greater reduction in symptoms of depression among those randomised to music therapy than to those in standard care conditions. The fifth study, in which music therapy was used as an active control treatment, reported no significant change in mental state for music therapy compared with standard care. Dropout rates from music therapy conditions appeared to be low in all studies.

Authors' conclusions
Findings from individual randomised trials suggest that music therapy is accepted by people with depression and is associated with improvements in mood. However, the small number and low methodological quality of studies mean that it is not possible to be confident about its effectiveness. High quality trials evaluating the effects of music therapy on depression are required.

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Music therapy for depression

Summary During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson's disease, epilepsy, or multiple sclerosis. Music-based interventions can affect divergent functions such as motor performance, speech, or cognition in these patient groups. However, the psychological effects and neurobiological mechanisms underlying the effects of music interventions are likely to share common neural systems for reward, arousal, affect regulation, learning, and activity-driven plasticity. Although further controlled studies are needed to establish the efficacy of music in neurological recovery, music-based interventions are emerging as promising rehabilitation strategies.

Music-based interventions in neurological rehabilitation

BACKGROUND: Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research has been directed towards non-pharmacological treatments. In this review, we examined the evidence for effects of music-based interventions. OBJECTIVES: To assess the effects of music-based therapeutic interventions for people with dementia on emotional well-being including quality of life, mood disturbance or negative affect, behavioural problems, social behaviour and cognition at the end of therapy and four or more weeks after the end of treatment. SEARCH METHODS: We searched ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG) on 19 June 2017 using the terms: music therapy, music, singing, sing, auditory stimulation. Additional searches were carried out on 19 June 2017 in the major healthcare databases MEDLINE, Embase, PsycINFO, CINAHL and LILACS; and in trial registers and grey literature sources. SELECTION CRITERIA: We included randomised controlled trials of music-based therapeutic interventions (at least five sessions) for people with dementia that measured any of our outcomes of interest. Control groups either received usual care or other activities with or without music. DATA COLLECTION AND ANALYSIS: Two review authors worked independently to screen the retrieved studies against the inclusion criteria and then to extract data and assess methodological quality of the included studies. If necessary, we contacted trial authors to ask for additional data, including relevant subscales, or for other missing information. We pooled data using random-effects models. MAIN RESULTS: We included 22 studies with 1097 randomised participants. Twenty-one studies with 890 participants contributed data to meta-analyses. Participants in the studies had dementia of varying degrees of severity, and all were resident in institutions. Seven studies delivered an individual music intervention; the other studies delivered the intervention to groups of participants. Most interventions involved both active and receptive musical elements. The methodological quality of the studies varied. All were at high risk of performance bias and some were at high risk of detection or other bias.At the end of treatment, we found low-quality evidence that the interventions may improve emotional well-being and quality of life (standardised mean difference (SMD) 0.32, 95% confidence interval (CI) 0.02 to 0.62; 9 studies, 348 participants) and reduce anxiety (SMD -0.43, 95% CI -0.72 to -0.14; 13 studies, 478 participants). We found low-quality evidence that music-based therapeutic interventions may have little or no effect on cognition (SMD 0.15, 95% CI -0.06 to 0.36; 7 studies, 350 participants). There was moderate-quality evidence that the interventions reduce depressive symptoms (SMD -0.27, 95% CI -0.45 to -0.09; 11 studies, 503 participants) and overall behaviour problems (SMD -0.23, 95% CI -0.46 to -0.01; 10 studies, 442 participants), but do not decrease agitation or aggression (SMD -0.07, 95% CI -0.24 to 0.10; 14 studies, 626 participants). The quality of the evidence on social behaviour was very low, so effects were very uncertain.The evidence for long-term outcomes measured four or more weeks after the end of treatment was of very low quality for anxiety and social behaviour, and for the other outcomes, it was of low quality for little or no effect (with small SMDs, between 0.03 and 0.34). AUTHORS' CONCLUSIONS: Providing people with dementia who are in institutional care with at least five sessions of a music-based therapeutic intervention probably reduces depressive symptoms and improves overall behavioural problems at the end of treatment. It may also improve emotional well-being and quality of life and reduce anxiety, but may have little or no effect on agitation or aggression or on cognition. We are uncertain about effects on social behaviour and about long-term effects. Future studies should examine the duration of effects in relation to the overall duration of treatment and the number of sessions.

/pdf/music-based-therapeutic-interventions-for-people-with-3osfm8ed21.pdf

Music‐based therapeutic interventions for people with dementia

Objective:The aims of this study were to determine the effectiveness of group music therapy for improving depression and delaying the deterioration of cognitive functions in elderly persons with de...

The impact of group music therapy on depression and cognition in elderly persons with dementia a randomized controlled study

Does music therapy enhance behavioral and cognitive function in elderly dementia patients? A systematic review and meta-analysis

Aims
In this study, we investigated the effects of group assertiveness training on assertiveness, social anxiety and satisfaction with interpersonal communication among patients with chronic schizophrenia.

Background
Only limited studies highlighted the effectiveness of group assertiveness training among inpatients with schizophrenia. Given the lack of group assertiveness training among patients with schizophrenia, further development of programmes focusing on facilitating assertiveness, self-confidence and social skills among inpatients with chronic schizophrenia is needed.

Design
This study used a prospective, randomized, single-blinded, parallel-group design.

Methods
This study employed a prospective, randomized, parallel-group design. Seventy-four patients were randomly assigned to experimental group receiving 12 sessions of assertiveness training, or a supportive control group. Data collection took place for the period of June 2009–July 2010.

Results
Among patients with chronic schizophrenia, assertiveness, levels of social anxiety and satisfaction with interpersonal communication significantly improved immediately after the intervention and at the 3-month follow-up in the intervention group. The results of a generalized estimating equation (GEE) indicated that: (1) assertiveness significantly improved from pre- to postintervention and was maintained until the follow-up; (2) anxiety regarding social interactions significantly decreased after assertiveness training; and (3) satisfaction with interpersonal communication slightly improved after the 12-session intervention and at the 3-month follow-up.

Conclusion
Assertivenss training is a non-invasive and inexpensive therapy that appears to improve assertiveness, social anxiety and interpersonal communication among inpatients with chronic schizophrenia. These findings may provide a reference guide to clinical nurses for developing assertiveness-training protocols.

The effects of assertiveness training in patients with schizophrenia: a randomized, single-blind, controlled study.

Purpose: This study aimed to explore the effectiveness of music therapy in reducing anxiety in hospitalized psychiatric patients.Methodology: The authors used a randomized clinical trial design and...

The effect of music therapy on hospitalized psychiatric patients' anxiety, finger temperature, and electroencephalography: a randomized clinical trial

Aims and objectives. To assess the reliability and validity of a developed instrument entitled Newly Diagnosed Breast CancerStress Scale.Background. Distress, clinical anxiety and depression are evident in patients with cancer, leading to poor psychosocial andquality-of-life outcomes.Design. Instrument development study with norm-referenced measurements.Methods. Content validity was determined by expert review. Cronbach’s a was used to assess internal consistency reliabilityand product-moment correlations were conducted. Exploratory factor analysis measured validity of items using varimaxrotation method. Criterion-related validity testing used the Perceived Stress Scale and the convergent validity test ofconstruct validity used the Hospital Anxiety and Depression Scale. A total of 125 women pathologically diagnosed withbreast cancer were interviewed on the day prior to initial breast surgery.Results. After testing, the Newly Diagnosed Breast Cancer Stress Scale consisted of four main factors with 17 items withacceptable reliability and good validity, and its length and time to complete the questionnaire were appropriate. Internalconsistency reliability of the scale was shown by Cronbach’s a = 0 84, the criterion validity of Perceived Stress Scale-10 wasr = 0 46 (p < 0 001), the convergent validity of Hospital Anxiety and Depression Scale-14 was r = 0 57 (p < 0 001) foranxiety and r = 0 35 (p < 0 001) for depression.Conclusions. The Newly Diagnosed Breast Cancer Stress Scale has acceptable reliability and good validity to measure stressin newly diagnosed patients with breast cancer.Relevance to clinical practice. The Newly Diagnosed Breast Cancer Stress Scale can provide healthcare workers with aninstrument to better identify stress levels in newly diagnosed breast cancer patients and provide valuable information whendeﬁning psychosocial care interventions.Key words: breast cancer, newly diagnosed patients, questionnaire, reliability, stress scale, validity

Measuring reliability and validity of a newly developed stress instrument: Newly Diagnosed Breast Cancer Stress Scale.

Background: Phthalates are widely used in consumer products, food packaging, and personal care products, so exposure is widespread. Several studies have investigated the association of phthalate exposure with obesity, insulin resistance, and hypertension. However, little is known about the associations of phthalate exposure with sex, age, and menopausal status in metabolic syndrome (MetS). The purpose of this study was to investigate the association between 11 urinary phthalate metabolite concentrations and metabolic syndrome in adults. Methods: We conducted a cross-sectional analysis of 1337 adults aged 30–70 years from the Taiwan Biobank 2016–2020. Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were calculated using logistic regression and stratified by sex, age, and menopausal status. Results: Participants with MetS comprised 16.38%. Higher concentrations of MEP metabolites were associated with more than two- to three-fold increased odds of MetS in males and males ≥ 50 years (adj. POR Q3 vs. Q1 = 2.13, 95% CI: 1.01, 4.50; p = 0.047 and adj. POR Q2 vs. Q1 = 3.11, 95% CI: 0.13, 8.63; p = 0.029). When assessed by menopausal status, postmenopausal females with higher ∑DEHP concentrations had more than nine-fold higher odds of MetS compared with postmenopausal females with the lowest ∑DEHP concentrations (adj. POR Q3 vs. Q1 = 9.58, 95% CI: 1.18, 77.75; p = 0.034). Conclusions: The findings suggest differential associations between certain phthalate metabolites and MetS by sex, age, and menopausal status.

/pdf/sex-differences-between-urinary-phthalate-metabolites-and-1er5mwbg.pdf

Tso Ying Lee

Papers

The impact of group music therapy on depression and cognition in elderly persons with dementia a randomized controlled study

The effects of assertiveness training in patients with schizophrenia: a randomized, single-blind, controlled study.

The effect of music therapy on hospitalized psychiatric patients' anxiety, finger temperature, and electroencephalography: a randomized clinical trial

Measuring reliability and validity of a newly developed stress instrument: Newly Diagnosed Breast Cancer Stress Scale.

Sex Differences between Urinary Phthalate Metabolites and Metabolic Syndrome in Adults: A Cross-Sectional Taiwan Biobank Study