gms | German Medical Science

Background/research question: Music therapy (MT) is a complementary creative arts treatment and aims at maintaining, restoring, and furthering physical, emotional, and mental health. This systematic review aims at assessing the effectiveness of MT for the treatment of autism spectrum disorder, dementia, depression, insomnia, and schizophrenia. In addition, MT methods used for these indications are analysed.

Methods: For this update of five Cochrane reviews, studies published from 2013 to 2020 were systematically searched in four databases (Medline via Ovid, Embase, The Cochrane Library, and PsycINFO). Two review authors independently performed the study selection and data extraction; for assessing the methodological quality of the included trials the ROBINS-I and The Cochrane Collaboration’s tool were used.

Results: Ten randomized controlled trials, involving 1.248 patients, investigating the effectiveness of MT in autism spectrum disorder, dementia, depression and insomnia, compared to standard treatment or no treatment (e.g., waiting list), met the inclusion criteria. For the indication schizophrenia, only studies with a high risk of bias were found, and no study could be included. Therefore, an update was not possible.

In autistic children, MT improved behaviour, social communication skills and the quality of the parent-child relationship. Depressed patients enhanced mood, and sleep quality improved in patients diagnosed with insomnia due to music therapy.

MT positively affects on mood in demented patients. Behavioural symptoms enhanced only in the severe Alzheimer’s stage. No long-term effects on mood and behavioural symptoms could be found. Cognition did not ease due to MT, but cognitive function ameliorated. Short and long-term memory improved in the mild Alzheimer’s disease stage, but not in the moderate or severe stage.

Mixed forms of MT methods were used in demented patients, while the authors of the studies on autism spectrum disorder and depression applied active methods. In patients diagnosed with insomnia, only receptive methods were used.

Conclusion: The findings of this update of reviews provide evidence that MT may help patients diagnosed with an autism spectrum disorder, dementia, depression, insomnia, and schizophrenia. MT improves physical, psychological and social aspects. It is crucial to focus on patient-related evidence-based health care. More research investigating the long-term effects is needed. It is crucial to specify how long the effects of MT last.

Competing interests: The authors declare no conflict of interest.