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Deutsches Arzteblatt International Apr 2022Chronic tinnitus is a commonly occurring symptom of the auditory system. Epidemiological studies assume a lifetime prevalence in men and women of 3.5% for chronic... (Review)
Review
BACKGROUND
Chronic tinnitus is a commonly occurring symptom of the auditory system. Epidemiological studies assume a lifetime prevalence in men and women of 3.5% for chronic tinnitus requiring treatment. Almost 25% of all Germans have experienced at least one episode of tinnitus. No causal therapy is yet available, but numerous treatment strategies are being pursued. Rigorous scientific assessment of these procedures is essential.
METHODS
For this exhaustive revision of the German clinical practice guideline, the literature in the medical databases PubMed and Cochrane Library, including existing guidelines from various countries, was systematically searched using keywords on the topic of chronic tinnitus. On the basis of the revised guideline, a separate guideline was written in language accessible to patients.
RESULTS
Chronic tinnitus is often associated with hearing loss, but the mental distress caused by the ear noise is another crucial element. Apart from expert counseling, the recommended treatment comprises psychotherapeutic interventions, particularly cognitive behavioral therapy (with effect sizes of 0.54 to 0.91 for reduction of the tinnitus-related distress), and measures to improve the hearing. There is insufficient evidence regarding the effects of drug treatment, sound and music therapy, and neuromodulation (magnetic stimulation or electrostimulation).
CONCLUSION
Alongside thorough and sound diagnosis and counseling, the principal treatment options for chronic tinnitus are specific cognitive behavioral therapy and expert psychotherapeutic interventions on an individual or group basis. Future-preferably interdisciplinary-research should evaluate the long-term effects of the treatment options, with particular attention to psychosomatic comorbidity.
Topics: Cognitive Behavioral Therapy; Counseling; Female; Hearing Loss; Humans; Male; Music Therapy; Practice Guidelines as Topic; Tinnitus
PubMed: 35197187
DOI: 10.3238/arztebl.m2022.0135 -
American Journal of Critical Care : An... Mar 2020Management of delirium in intensive care units is challenging because effective therapies are lacking. Music is a promising nonpharmacological intervention. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Management of delirium in intensive care units is challenging because effective therapies are lacking. Music is a promising nonpharmacological intervention.
OBJECTIVES
To determine the feasibility and acceptability of personalized music (PM), slow-tempo music (STM), and attention control (AC) in patients receiving mechanical ventilation in an intensive care unit, and to estimate the effect of music on delirium.
METHODS
A randomized controlled trial was performed in an academic medical-surgical intensive care unit. After particular inclusion and exclusion criteria were applied, patients were randomized to groups listening to PM, relaxing STM, or an audiobook (AC group). Sessions lasted 1 hour and were given twice daily for up to 7 days. Patients wore noise-canceling headphones and used mp3 players to listen to their music/audiobook. Delirium and delirium severity were assessed twice daily by using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the CAM-ICU-7, respectively.
RESULTS
Of the 1589 patients screened, 117 (7.4%) were eligible. Of those, 52 (44.4%) were randomized, with a recruitment rate of 5 patients per month. Adherence was higher in the groups listening to music (80% in the PM and STM groups vs 30% in the AC group; P = .01), and 80% of patients surveyed rated the music as enjoyable. The median number (interquartile range) of delirium/coma-free days by day 7 was 2 (1-6) for PM, 3 (1-6) for STM, and 2 (0-3) for AC (P = .32). Median delirium severity was 5.5 (1-7) for PM, 3.5 (0-7) for STM, and 4 (1-6.5) for AC (P = .78).
CONCLUSIONS
Music delivery is acceptable to patients and is feasible in intensive care units. Further research testing use of this promising intervention to reduce delirium is warranted.
Topics: Adolescent; Adult; Aged; Blood Pressure; Critical Illness; Delirium; Diastole; Female; Heart Rate; Humans; Intensive Care Units; Male; Middle Aged; Music Therapy; Pilot Projects; Respiration, Artificial; Severity of Illness Index; Single-Blind Method; Young Adult
PubMed: 32114612
DOI: 10.4037/ajcc2020175 -
BMC Complementary Medicine and Therapies Mar 2023The objective of this study was to determine the effect of music therapy as an alternative treatment on depression in children and adolescents with attention-deficit... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The objective of this study was to determine the effect of music therapy as an alternative treatment on depression in children and adolescents with attention-deficit hyperactivity disorder (ADHD) by activating serotonin (5-HT) and improving stress coping ability.
METHODS
This study is designed based on randomization method. A total of 36 subjects participated in the experiment, consisting of an ADHD control group (n = 18) and ADHD music therapy group (n = 18). The ADHD control group received standard care, while the ADHD music therapy group received music therapy and standard care. The ADHD music therapy group received both active music therapy (improvisation) and receptive music therapy (music listening) for 50 minutes, twice a week, for 3 months: a total of 24 times. From a neurophysiological perspective, changes in depression and stress were tracked by measuring 5-HT secretion, cortisol expression, blood pressure (BP), heart rate (HR), and CDI and DHQ psychological scales.
RESULTS
The ADHD music therapy group's 5-HT secretion increased (p < 0.001), whereas cortisol expression (p < 0.001), BP (p < 0.001) and HR (p < 0.001) decreased. The CDI and DHQ psychological scales also showed positive changes (p < 0.01 and p < 0.001, respectively). However, the ADHD Con G's (who did not receive music therapy) 5-HT secretion did not increase, whereas cortisol expression, BP, and HR did not decrease. In addition, the CDI and DHQ psychological scales did not display positive changes.
CONCLUSIONS
In conclusion, the application of music therapy as an alternative treatment for ADHD children and adolescents showed positive neurophysiological and psychological effects. Therefore, this study would like to propose a new alternative to medicine for preventing and treating depression through various uses of music therapy.
Topics: Adolescent; Child; Humans; Adaptation, Psychological; Attention Deficit Disorder with Hyperactivity; Depression; Hydrocortisone; Music Therapy; Serotonin
PubMed: 36879223
DOI: 10.1186/s12906-022-03832-6 -
Trends in Cardiovascular Medicine Aug 2022Although music is predominantly utilized for religious, enjoyment or entertainment purposes, it is gradually emerging as a promising non-pharmacological intervention for... (Review)
Review
Although music is predominantly utilized for religious, enjoyment or entertainment purposes, it is gradually emerging as a promising non-pharmacological intervention for improving health outcomes in both healthy and diseased populations, especially in those with cardiovascular diseases. As such, music of various genres and types has been postulated to possess features that stimulate or inhibit the autonomic nervous system, which leads to variable effects on cardiovascular function. However, music intervention has not been adequately explored as a cardiovascular therapeutic modality due to the lack of extensive studies with quality methodology. Thus, the aim of this systematic review is to explore the available literature on the effect of music on the cardiovascular system, discuss the limitations of current research, and suggest future directions in this field.
Topics: Autonomic Nervous System; Heart; Heart Rate; Humans; Music; Music Therapy
PubMed: 34237410
DOI: 10.1016/j.tcm.2021.06.004 -
Psychiatria Danubina Nov 2018Music Therapy can be broadly described as the use of Music in a therapeutic context in order to help improve mental health. Music Therapy does not simply imply the... (Review)
Review
Music Therapy can be broadly described as the use of Music in a therapeutic context in order to help improve mental health. Music Therapy does not simply imply the playing of music to patients, relaxing though this may be, but in fact it does involve more active involvement of the patient, so as to use the power of music in order to help improve the mental health of patients and in order to treat mental health conditions. We review the evidence for the effect of Music Therapy on Depression, Anxiety, Schizophrenia, Sleep Disorders, and Dementia. Encouraging singing appears to be a good adjunct to treating all of these conditions, and it also seems to help bonding between mothers and children within families. Music appears to be beneficial to both the individual, and also to the improvement of social cohesion. The reasons for this must reside in the nature of music itself as an art form which supports human interactions within society.
Topics: Adult; Anxiety; Child; Dementia; Depression; Humans; Mental Disorders; Music Therapy; Parent-Child Relations; Quality of Life
PubMed: 30439854
DOI: No ID Found -
Psychiatria Danubina Dec 2016Art is a product of human creativity; it is a superior skill that can be learned by study, practice and observation. Modern neuroscience and neuroimaging enable study of... (Review)
Review
Art is a product of human creativity; it is a superior skill that can be learned by study, practice and observation. Modern neuroscience and neuroimaging enable study of the processes during artistic performance. Creative people have less marked hemispheric dominance. It was found that the right hemisphere is specialized for metaphoric thinking, playfulness, solution finding and synthesizing, it is the center of visualization, imagination and conceptualization, but the left hemisphere is still needed for artistic work to achieve balance. A specific functional organization of brain areas was found during visual art activities. Marked hemispheric dominance and area specialization is also very prominent for music perception. Brain is capable of making new connections, activating new pathways and unmasking secondary roads, it is "plastic". Music is a strong stimulus for neuroplasticity. fMRI studies have shown reorganization of motor and auditory cortex in professional musicians. Other studies showed the changes in neurotransmitter and hormone serum levels in correlation to music. The most prominent connection between music and enhancement of performance or changing of neuropsychological activity was shown by studies involving Mozart's music from which the theory of "The Mozart Effect" was derived. Results of numerous studies showed that listening to music can improve cognition, motor skills and recovery after brain injury. In the field of visual art, brain lesion can lead to the visuospatial neglect, loss of details and significant impairment of artistic work while the lesions affecting the left hemisphere reveal new artistic dimensions, disinhibit the right hemisphere, work is more spontaneous and emotional with the gain of artistic quality. All kinds of arts (music, painting, dancing...) stimulate the brain. They should be part of treatment processes. Work of many artists is an excellent example for the interweaving the neurology and arts.
Topics: Adult; Art; Brain; Brain Mapping; Cognition; Creativity; Dancing; Dominance, Cerebral; Emotions; Female; Humans; Magnetic Resonance Imaging; Male; Music; Music Therapy; Neuronal Plasticity; Perception
PubMed: 27855424
DOI: No ID Found -
The Cochrane Database of Systematic... May 2022Social interaction and social communication are among the central areas of difficulty for autistic people. Music therapy uses music experiences and the relationships... (Review)
Review
BACKGROUND
Social interaction and social communication are among the central areas of difficulty for autistic people. Music therapy uses music experiences and the relationships that develop through them to enable communication and expression, thus attempting to address some of the core problems of autistic people. Music therapy has been applied in autism since the early 1950s, but its availability to autistic individuals varies across countries and settings. The application of music therapy requires specialised academic and clinical training which enables therapists to tailor the intervention to the specific needs of the individual. The present version of this review on music therapy for autistic people is an update of the previous Cochrane review update published in 2014 (following the original Cochrane review published in 2006).
OBJECTIVES
To review the effects of music therapy, or music therapy added to standard care, for autistic people.
SEARCH METHODS
In August 2021, we searched CENTRAL, MEDLINE, Embase, eleven other databases and two trials registers. We also ran citation searches, checked reference lists, and contacted study authors to identify additional studies.
SELECTION CRITERIA
All randomised controlled trials (RCTs), quasi-randomised trials and controlled clinical trials comparing music therapy (or music therapy alongside standard care) to 'placebo' therapy, no treatment, or standard care for people with a diagnosis of autism spectrum disorder were considered for inclusion.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methodological procedures. Four authors independently selected studies and extracted data from all included studies. We synthesised the results of included studies in meta-analyses. Four authors independently assessed risk of bias (RoB) of each included study using the original RoB tool as well as the certainty of evidence using GRADE. MAIN RESULTS: We included 16 new studies in this update which brought the total number of included studies to 26 (1165 participants). These studies examined the short- and medium-term effect of music therapy (intervention duration: three days to eight months) for autistic people in individual or group settings. More than half of the studies were conducted in North America or Asia. Twenty-one studies included children aged from two to 12 years. Five studies included children and adolescents, and/or young adults. Severity levels, language skills, and cognition were widely variable across studies. Measured immediately post-intervention, music therapy compared with 'placebo' therapy or standard care was more likely to positively effect global improvement (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.06 to 1.40; 8 studies, 583 participants; moderate-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) = 11 for low-risk population, 95% CI 6 to 39; NNTB = 6 for high-risk population, 95% CI 3 to 21) and to slightly increase quality of life (SMD 0.28, 95% CI 0.06 to 0.49; 3 RCTs, 340 participants; moderate-certainty evidence, small to medium effect size). In addition, music therapy probably results in a large reduction in total autism symptom severity (SMD -0.83, 95% CI -1.41 to -0.24; 9 studies, 575 participants; moderate-certainty evidence). No clear evidence of a difference between music therapy and comparison groups at immediately post-intervention was found for social interaction (SMD 0.26, 95% CI -0.05 to 0.57, 12 studies, 603 participants; low-certainty evidence); non-verbal communication (SMD 0.26, 95% CI -0.03 to 0.55; 7 RCTs, 192 participants; low-certainty evidence); and verbal communication (SMD 0.30, 95% CI -0.18 to 0.78; 8 studies, 276 participants; very low-certainty evidence). Two studies investigated adverse events with one (36 participants) reporting no adverse events; the other study found no differences between music therapy and standard care immediately post-intervention (RR 1.52, 95% CI 0.39 to 5.94; 1 study, 290 participants; moderate-certainty evidence). AUTHORS' CONCLUSIONS: The findings of this updated review provide evidence that music therapy is probably associated with an increased chance of global improvement for autistic people, likely helps them to improve total autism severity and quality of life, and probably does not increase adverse events immediately after the intervention. The certainty of the evidence was rated as 'moderate' for these four outcomes, meaning that we are moderately confident in the effect estimate. No clear evidence of a difference was found for social interaction, non-verbal communication, and verbal communication measured immediately post-intervention. For these outcomes, the certainty of the evidence was rated as 'low' or 'very low', meaning that the true effect may be substantially different from these results. Compared with earlier versions of this review, the new studies included in this update helped to increase the certainty and applicability of this review's findings through larger sample sizes, extended age groups, longer periods of intervention and inclusion of follow-up assessments, and by predominantly using validated scales measuring generalised behaviour (i.e. behaviour outside of the therapy context). This new evidence is important for autistic individuals and their families as well as for policymakers, service providers and clinicians, to help in decisions around the types and amount of intervention that should be provided and in the planning of resources. The applicability of the findings is still limited to the age groups included in the studies, and no direct conclusions can be drawn about music therapy in autistic individuals above the young adult age. More research using rigorous designs, relevant outcome measures, and longer-term follow-up periods is needed to corroborate these findings and to examine whether the effects of music therapy are enduring.
Topics: Adolescent; Autistic Disorder; Bias; Child; Humans; Music Therapy; Odds Ratio; Quality of Life
PubMed: 35532041
DOI: 10.1002/14651858.CD004381.pub4 -
Respiratory Care Mar 2021Music therapy, as a non-drug therapy, is widely used in patients with COPD. However, the effects of music therapy on dyspnea, anxiety, depression and other physiological... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Music therapy, as a non-drug therapy, is widely used in patients with COPD. However, the effects of music therapy on dyspnea, anxiety, depression and other physiological parameters has not been elucidated. Therefore, we sought to investigate the effects of passive music therapy (listening to music) and mixed music (combination of listening and singing) in adults with COPD.
METHODS
A systematic literature search was performed in PubMed, Cochrane, Embase, Web of Science, China National Knowledge Infrastructure, VIP, and Wanfang Data up to June 26, 2019. All randomized controlled trials that compared music with usual care or other non-musical types of intervention in subjects with COPD were included in the study. The risk of bias for randomized controlled trials was assessed with the Cochrane risk of bias tool. Outcomes included dyspnea, anxiety, depression, sleep quality, and quality of life, as well as physiological parameters (eg, blood pressure and breathing frequency).
RESULTS
After initial screening of 216 potentially relevant records, 59 studies were eligible, and 12 studies with 812 participates met the inclusion criteria and were included in the final meta-analysis. Analysis showed that music therapy had a significant effect in relieving dyspnea (mean difference: -0.69, 95% CI -0.80 to -0.58, < .001) and anxiety (standardized mean difference: -1.87, 95% CI -2.72 to -1.02, < .001) in adults with COPD. Compared with the control group, music had no statistically significant effect on depression or St George Respiratory Questionnaire score. However, when it came to improving sleep quality, music reduced the total Pittsburgh Sleep Quality Index score ( < .001). In addition, the pooled results showed that there was a significant improvement in systolic blood pressure (mean difference: -7.45, 95% CI -10.95 to -3.96, < .001) and diastolic blood pressure (mean difference: -4.07, 95% CI -7.03 to -1.12, = .007) in the music group compared to the control.
CONCLUSIONS
Music therapy is effective in reducing dyspnea and anxiety in subjects with COPD. Additionally, music therapy may also improve sleep quality and physiological parameters of subjects with COPD. However, our conclusions need to be supported further by larger and longer well-designed trials.
Topics: Adult; Anxiety; China; Humans; Music Therapy; Pulmonary Disease, Chronic Obstructive; Quality of Life
PubMed: 33144384
DOI: 10.4187/respcare.07489 -
Psychiatria Polska 2015The neurologic music therapy is a new scope of music therapy. Its techniques deal with dysfunctions resulting from diseases of the human nervous system. Music can be... (Review)
Review
The neurologic music therapy is a new scope of music therapy. Its techniques deal with dysfunctions resulting from diseases of the human nervous system. Music can be used as an alternative modality to access functions unavailable through non-musical stimulus. Processes in the brain activated by the influence of music can be generalized and transferred to non-musical functions. Therefore, in clinical practice, the translation of non-musical therapeutic exercises into analogous, isomorphic musical exercises is performed. They make use of the executive peculiarity of musical instruments and musical structures to prime, cue and coordinate movements. Among musical components, a repetitive rhythm plays a significant role. It regulates physiologic and behavioural functions through the mechanism of entrainment (synchronization of biological rhythms with musical rhythm based on acoustic resonance). It is especially relevant for patients with a deficient internal timing system in the brain. Additionally, regular rhythmic patterns facilitate memory encoding and decoding of non-musical information hence music is an efficient mnemonic tool. The music as a hierarchical, compound language of time, with its unique ability to access affective/motivational systems in the brain, provides time structures enhancing perception processes, mainly in the range of cognition, language and motor learning. It allows for emotional expression and improvement of the motivation for rehabilitation activities. The new technologies of rhythmic sensory stimulation (i.e. Binaural Beat Stimulation) or rhythmic music in combination with rhythmic light therapy appear. This multimodal forms of stimulation are used in the treatment of stroke, brain injury, dementia and other cognitive deficits. Clinical outcome studies provide evidence of the significant superiority of rehabilitation with music over the one without music.
Topics: Acoustic Stimulation; Autonomic Nervous System; Central Nervous System Diseases; Cognition Disorders; Emotions; Humans; Music; Music Therapy; Quality of Life
PubMed: 26488358
DOI: 10.12740/PP/25557 -
The Cochrane Database of Systematic... May 2017Music therapy is a therapeutic approach that uses musical interaction as a means of communication and expression. Within the area of serious mental disorders, the aim of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Music therapy is a therapeutic approach that uses musical interaction as a means of communication and expression. Within the area of serious mental disorders, the aim of the therapy is to help people improve their emotional and relational competencies, and address issues they may not be able to using words alone.
OBJECTIVES
To review the effects of music therapy, or music therapy added to standard care, compared with placebo therapy, standard care or no treatment for people with serious mental disorders such as schizophrenia.
SEARCH METHODS
We searched the Cochrane Schizophrenia Group's Trials Study-Based Register (December 2010 and 15 January, 2015) and supplemented this by contacting relevant study authors, handsearching of music therapy journals and manual searches of reference lists.
SELECTION CRITERIA
All randomised controlled trials (RCTs) that compared music therapy with standard care, placebo therapy, or no treatment.
DATA COLLECTION AND ANALYSIS
Review authors independently selected, quality assessed and data extracted studies. We excluded data where more than 30% of participants in any group were lost to follow-up. We synthesised non-skewed continuous endpoint data from valid scales using a standardised mean difference (SMD). We employed a fixed-effect model for all analyses. If statistical heterogeneity was found, we examined treatment dosage (i.e. number of therapy sessions) and treatment approach as possible sources of heterogeneity.
MAIN RESULTS
Ten new studies have been added to this update; 18 studies with a total 1215 participants are now included. These examined effects of music therapy over the short, medium, and long-term, with treatment dosage varying from seven to 240 sessions. Overall, most information is from studies at low or unclear risk of biasA positive effect on global state was found for music therapy compared to standard care (medium term, 2 RCTs, n = 133, RR 0.38 95% confidence interval (CI) 0.24 to 0.59, low-quality evidence, number needed to treat for an additional beneficial outcome NNTB 2, 95% CI 2 to 4). No binary data were available for other outcomes. Medium-term continuous data identified good effects for music therapy on negative symptoms using the Scale for the Assessment of Negative Symptoms (3 RCTs, n = 177, SMD - 0.55 95% CI -0.87 to -0.24, low-quality evidence). General mental state endpoint scores on the Positive and Negative Symptoms Scale were better for music therapy (2 RCTs, n = 159, SMD -0.97 95% CI -1.31 to -0.63, low-quality evidence), as were average endpoint scores on the Brief Psychiatric Rating Scale (1 RCT, n = 70, SMD -1.25 95% CI -1.77 to -0.73, moderate-quality evidence). Medium-term average endpoint scores using the Global Assessment of Functioning showed no effect for music therapy on general functioning (2 RCTs, n = 118, SMD -0.19 CI -0.56 to 0.18, moderate-quality evidence). However, positive effects for music therapy were found for both social functioning (Social Disability Screening Schedule scores; 2 RCTs, n = 160, SMD -0.72 95% CI -1.04 to -0.40), and quality of life (General Well-Being Schedule scores: 1 RCT, n = 72, SMD 1.82 95% CI 1.27 to 2.38, moderate-quality evidence). There were no data available for adverse effects, service use, engagement with services, or cost.
AUTHORS' CONCLUSIONS
Moderate- to low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state (including negative and general symptoms), social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders. However, effects were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided. Further research should especially address the long-term effects of music therapy, dose-response relationships, as well as the relevance of outcome measures in relation to music therapy.
Topics: Humans; Interpersonal Relations; Music Therapy; Quality of Life; Randomized Controlled Trials as Topic; Schizophrenia; Schizophrenic Psychology
PubMed: 28553702
DOI: 10.1002/14651858.CD004025.pub4