Lassner Alexander, Siafis Spyridon, Wiese Emanuel, Leucht Stefan, Metzner Susanne, Wagner Elias, Hasan Alkomiet
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Germany.
Department of Psychiatry and Psychotherapy, TUM School of Medicine and Health, Technical University of Munich, Germany; and DZPG (German Center for Mental Health), University of Augsburg, Germany.
BJPsych Open. 2024 Dec 13;11(1):e4. doi: 10.1192/bjo.2024.826.
Music therapy is a commonly used intervention added to usual care for psychiatric disorders.
We review the evidence for music therapy and assess its efficacy as an adjunct therapy across psychiatric disorders.
A systematic literature search was conducted in four scientific databases to identify relevant meta-analyses. Articles were assessed with the AMSTAR-2 tool. The results of the high-quality articles were recalculated with the data from the primary studies. We decided to add the results of the lower-rated articles, using a narrative approach. We pooled the primary studies and calculated standardised mean differences (SMD) for the transdiagnostic outcomes of depression, anxiety and quality of life. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool to assess the level of evidence.
Meta-analyses were available for autism, dementia, depression, insomnia, schizophrenia and substance use disorders. We identified 40 relevant articles. One article per domain was identified as high quality. Music therapy added to treatment as usual showed therapeutic value in each disorder. The transdiagnostic results showed a positive effect of music therapy on depression (SMD = 0.57, 95% CI 0.36-0.78), anxiety (SMD = 0.47, 95% CI 0.27-0.66) and quality of life (SMD = 0.47, 95% CI 0.24-0.71). However, these effects were not maintained at follow-up, and all results were based on low or very low evidence.
Music therapy shows promising potential as an adjunctive treatment for psychiatric disorders, but methodological weaknesses and variability limit the evidence. More high-quality, well-powered studies are needed to reliably confirm its effect size.
音乐疗法是一种常用的干预措施，常被添加到精神疾病的常规治疗中。
我们回顾音乐疗法的证据，并评估其作为辅助疗法在各类精神疾病中的疗效。
在四个科学数据库中进行系统的文献检索，以识别相关的荟萃分析。使用AMSTAR-2工具对文章进行评估。对高质量文章的结果，根据原始研究的数据重新计算。我们决定采用叙述性方法纳入评级较低文章的结果。我们汇总了原始研究，并计算了抑郁、焦虑和生活质量等跨诊断结果的标准化均值差（SMD）。我们使用推荐分级、评估、制定与评价（GRADE）工具来评估证据水平。
有针对自闭症、痴呆症、抑郁症、失眠症、精神分裂症和物质使用障碍的荟萃分析。我们识别出40篇相关文章。每个领域各有一篇文章被确定为高质量。与常规治疗相结合的音乐疗法在每种疾病中均显示出治疗价值。跨诊断结果表明，音乐疗法对抑郁（SMD = 0.57，95%CI 0.36 - 0.78）、焦虑（SMD = 0.47，95%CI 0.27 - 0.66）和生活质量（SMD = 0.47，95%CI 0.24 - 0.71）有积极影响。然而，这些效果在随访时未得到维持，且所有结果均基于低或极低质量的证据。
音乐疗法作为精神疾病的辅助治疗显示出有前景的潜力，但方法学上的弱点和变异性限制了证据。需要更多高质量、有充分效力的研究来可靠地证实其效应大小。
