The Use of Music in the Treatment and Management of Serious Mental Illness: A Global Scoping Review of the Literature

Abstract

Mental and substance use disorders have been identified as the leading cause of global disability, and the global burden of mental illness is concentrated among those experiencing disability due to serious mental illness (SMI). Music has been studied as a support for SMIs for decades, with promising results; however, a lack of synthesized evidence has precluded increased uptake of and access to music-based approaches. The purpose of this scoping review was to identify the types and quantity of research at intersections of music and SMIs, document evidentiary gaps and opportunities, and generate recommendations for improving research and practice. Studies were included if they reported on music's utilization in treating or mitigating symptoms related to five SMIs: schizophrenia, bipolar disorder, generalized anxiety disorder, major depressive disorder, or post-traumatic stress disorder. Eight databases were searched; screening resulted in 349 included studies for data extraction. Schizophrenia was the most studied SMI, with bipolar disorder studied the least. Demographics, settings, and activity details were found to be inconsistently and insufficiently reported; however, listening to recorded music emerged as the most common musical activity, and activity details appeared to have been affected by the conditions under study. RCTs were the predominant study design, and 271 unique measures were utilized across 289 primary studies. Over two-thirds of primary studies (68.5%) reported positive results, with 2.8% reporting worse results than the comparator, and 12% producing indeterminate results. A key finding is that evidence synthesis is precluded by insufficient reporting, widely varied outcomes and measures, and intervention complexity; as a result, widespread changes are necessary to reduce heterogeneity (as feasible), increase replicability and transferability, and improve understandings of mechanisms and causal pathways. To that end, five detailed recommendations are offered to support the sharing and development of information across disciplines.

A Neurobiological Framework for the Therapeutic Potential of Music and Sound Interventions for Post-Traumatic Stress Symptoms in Critical Illness Survivors

“…Various music and sound interventions have been used to improve health outcomes in a broad spectrum of psychological and neurological disorders [ 70 , 71 , 72 , 73 ]. Music therapy has demonstrated significant effectiveness for the reduction of depression in people with dementia [ 71 , 74 ] and improvement of mobility in people with stroke [ 75 ].…”

The State of Music-Based Interventions for Mental Illness: Thought Leaders on Barriers, Opportunities, and the Value of Interdisciplinarity

“…Instead, scoping reviews deliver a landscape of an emerging topic area—illuminating gaps and barriers in extant research and indicating key research opportunities moving forward. The scoping review for this initiative, titled “The Use of Music in the Treatment and Management of Serious Mental Illness: A Global Scoping Review of the Literature,” was published in Frontiers in Psychology (Golden et al., 2021 ).…”

“…Since the mid-twentieth century, studies regarding music’s effects on mental health have steadily accumulated across multiple disciplines, with a substantial increase over the last 15 years (Golden et al 2021 ). Hundreds of publications now point to a growing, multidisciplinary interest in the utilization and study of music as a support for mental health, emerging from fields such as psychology (McFerran et al 2018 ; Pezzin et al 2018 ), music therapy (Gold et al 2006 ; Moe, 2002 ), neurology (Tan et al 2016 ; Ventouras et al 2015 ); nursing (Pölkki et al 2012 ; McAffrey and Locsin 2002 ), and psychiatry (Grasser et al 2019 ; Grocke et al 2008 ), among many others.…”

“…These limitations can be traced in part to the interdisciplinary nature of research related to music and mental health, combined with the difficulty of communicating and coordinating findings across disciplinary boundaries (see Domino et al, 2007 ). For example, disciplines involved in music and mental health research vary not only in how they define terms, but also in their selected outcomes and outcome measures, and in their practices for conducting and reporting research (see Golden et al, 2021 ). This variety limits researchers’ and practitioners’ ability to synthesize evidence, generate shared best practices and clinical practice guidelines, and promote relevant policies.…”

Effects of Sound Interventions on the Permeability of the Blood–Brain Barrier and Meningeal Lymphatic Clearance

“…Music is receiving increasing attention for its beneficial effects on a variety of health outcomes. One area of recent attention is severe mental illness [ 5 ]. Golden and colleagues conducted a global scoping review of evidence on the uses of music to treat or mitigate symptoms of severe mental illness.…”