HTA Austria - Austrian Institute for Health Technology Assessment GmbH, Austria.
Royal Melbourne Institute of Technology, Australia.
Eur J Public Health. 2022 Feb 1;32(1):27-34. doi: 10.1093/eurpub/ckab042.
BACKGROUND: Music therapy (MT) aims at maintaining, restoring and furthering physical/emotional/mental health. This review assesses effectiveness of MT and its methods for autism spectrum disorder (ASD), dementia, depression, insomnia and schizophrenia. METHODS: A search for systematic reviews and health technology assessment reports was conducted and yielded 139 hits. Given the large amount, we focused on five frequent diagnostic groups with available Cochrane reviews. A second search was conducted in four databases. Two authors independently performed study selection, data extraction and assessed methodological quality. Only trials with moderate/low risk of bias (RoB) were selected. RESULTS: Ten randomized controlled trials (1.248 participants) met inclusion criteria. For schizophrenia, no studies with low/moderate RoB were found; therefore, updating was not possible. The Cochrane authors stated that quality of life (QoL), social functioning, global/mental state improved for schizophrenia, but not global functioning. For ASD, MT improved behaviour, social communication, brain connectivity and parent-child relationship. For depression, mood was enhanced, and for insomnia, sleep quality, stress, anxiety, total sleep time, disease severity and psychological QoL improved. MT positively affected mood, neuropsychiatric behaviour, apathy, communication and physical functions for dementia; behavioural/psychological symptoms improved only in severe, and memory and verbal fluency only in mild Alzheimer's disease. Cognition improved for dementia in one of four studies. Both active (playing music) and receptive (listening to music) methods were used for dementia, whereas for ASD and depression, active methods were applied. For insomnia, only receptive methods were used. CONCLUSION: These findings provide evidence that MT helps patients improving their physical/psychosocial health. More research investigating long-term effects is needed.
背景:音乐治疗(MT)旨在维持、恢复和促进身心健康。本综述评估了 MT 及其方法在自闭症谱系障碍(ASD)、痴呆、抑郁、失眠和精神分裂症中的有效性。
方法:对系统评价和卫生技术评估报告进行了检索,共获得 139 项研究。由于数量庞大,我们主要关注有 Cochrane 综述的五个常见诊断组。在四个数据库中进行了第二次检索。两位作者独立进行了研究选择、数据提取和方法学质量评估。仅选择了低/中度偏倚风险(RoB)的试验。
结果:10 项随机对照试验(1248 名参与者)符合纳入标准。对于精神分裂症,没有发现低/中度 RoB 的研究;因此,无法进行更新。Cochrane 作者指出,精神分裂症的生活质量(QoL)、社会功能、整体/精神状态有所改善,但整体功能没有改善。对于 ASD,MT 改善了行为、社会交流、大脑连接和亲子关系。对于抑郁,情绪得到改善,对于失眠,睡眠质量、压力、焦虑、总睡眠时间、疾病严重程度和心理 QoL 得到改善。MT 对痴呆症的情绪、神经精神行为、冷漠、沟通和身体功能有积极影响;只有在严重的情况下,行为/心理症状才会改善,只有在轻度阿尔茨海默病中,记忆和语言流畅性才会改善。认知在四项研究中的一项研究中得到了改善。音乐治疗既可以采用主动(演奏音乐)的方法,也可以采用被动(听音乐)的方法,用于痴呆症;而对于 ASD 和抑郁症,则采用主动方法。对于失眠,只使用了被动方法。
结论:这些发现提供了证据表明,音乐治疗有助于患者改善身心健康。需要进一步研究以调查长期效果。
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