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Music interventions associated with improvement in mental and physical health-related QOL

31st March 2022

The use of music interventions appear to be associated with clinically meaningful improvements in mental and a smaller improvement in physical health-related quality of life. However, the specific type of music intervention providing the greatest benefit remains unclear.

This was the conclusion from a meta-analysis of studies by researchers from the Institute of Music Physiology and Musicians’ Medicine, Hannover University of Music, Hannover, Germany.

The use of music interventions (MIs) such as listening to music, playing an instrument or singing, has been shown to positively impact on the global and social functioning of patients with mental health conditions such as schizophrenia.

 Furthermore, there is also reliable evidence for the positive effects of music and singing on wellbeing (related to the positive aspects of a person’s life) in adults without underlying mental health problems.

Other evidence from an umbrella review of performing arts as a health resource, concluded that positive health effects were associated with as little as 30 to 60 minutes of performing arts participation.

The CDC in the US defines health-related quality of life (HRQOL) as an individual’s or a group’s perceived physical and mental health over time. HRQOL can be assessed using dedicated questionnaires, including the 36-item Health Survey Short Form (SF-36) and related, reduced 12-item Health Survey Short Form (SF-12). Moreover, both the SF-36 and 12 have been used in studies of music interventions.

Although music interventions appear to give rise to improvements in both HRQOL and well-being, what remains unclear is the associations between different types of MIs and changes in HRQOL as measured using both the SF-36 and SF-12.

This was the purpose of the current study and the German team included randomised and non-randomised trials that investigated music making (singing, listening, playing music) interventions and which reported changes in SF-36 or SF-12, before and after the intervention.

The researchers focused on both the mental component summary (MCS) and the physical component summary (PCS) of the SF-36 or SF-12 since higher scores in each of these domains were indicative of better mental and physical HRQOL. The threshold mean difference in MCS scores was set as a mean difference of 3 or more.

Music interventions and MCS and PCS scores

The literature search identified 26 eligible studies with 779 participants (mean age = 60 years) and which comprised listening to music, music therapy, singing with one study exploring the effect of gospel music.

Overall, a music intervention was associated with a significant decrease in both MCS (total mean difference, TMD = 2.95, p < 0.01) and PCS scores (TMD = 1.09, p = 0.02) compared to pre-intervention values.

In subgroup analysis, in which MIs were added to usual treatment, there was a significant increase in MCS scores vs usual treatment alone (TMD = 3.72, 95% CI 0.40 – 7.05) but not for PCS. However, it was not possible to identify any important differences based on the type of musical intervention.

The authors concluded that while MIs led to a significant increase in mental HRQOL, the changes in PCS were equivocal. They added that given the variation in the effect of the different interventions such as singing, listening to music etc, it was not possible to provide any firm recommendations about the optimal intervention or dosage for use in specific clinical scenarios.

McCrary JM et al. Association of Music Interventions With Health-Related Quality of Life: A Systematic Review and Meta-analysis JAMA Netw Open 2022