Table 1.
Characteristics of randomized controlled trials included for the meta-analysis of music therapy for post-traumatic stress disorder (PTSD).
| Study | Participants | Diagnostic criteria of PTSD | Experimental intervention | Control intervention | Details of music therapy | Music prescription | Numbers of participants in the experimental vs. control groups | Efficacy outcome measure |
|---|---|---|---|---|---|---|---|---|
| Carr et al. (2012) | PTSD patients who did not respond to CBT in United Kindom | DSM-IV | Group music therapy + pharmacotherapy | Waitlist + pharmacotherapy | Group psychodynamic music therapy, a combination of active and receptive activities, led by music therapists, 10 weekly one-hour sessions over a period of 2.5 months | Participants engaged in free music improvisation using a wide range of musical instruments. Therapists provided improvised instrumental support, and the musical instruments were specifically selected for their ease of accessibility. | 8 (M/F: 3/5, mean age: 34 years) vs. 8 (M/F: 4/4, mean age: 44 years) | Post-treatment IES-R score |
| Gao & Chen (2018) | Patients with breast cancer receiving chemotherapy who developed PTSD in China | NR | Listening to music + CAU | CAU | Group listening to Gregorian hymns and Mozart music, 80 daily sessions over a period of 2.5 months | Recordings of Gregorian hymns and Mozart music were used. The music was selected by patients’ treating physicians. | 40 (M/F: 0/40, mean age: NR) vs. 40 (M/F: 0/40, mean age: NR) | Post-treatment PTSD-SS score |
| Pezzin et al. (2018)* | Veterans with PTSD in United States | ICD-9CM | Active, music-instruction intervention + CAU | Waitlist + CAU | Individual and group music instruction, led by professional music teachers, six weekly one-hour sessions over a period of 1.5 months | Participants were provided guitars and offered personal and group instructions on playing the guitar. | 25 (M/F: 22/3, mean age: 49.8 years) vs. 15 (M/F: 14/1, mean age: 53.8 years) | Post-treatment PCL-C score |
| Du et al. (2019) | Patients with spinal cord injury who developed PTSD in China | DSM-V | Music therapy + CAU | CAU | Individual receptive music therapy, led by music therapists, 12 biweekly 50-minute sessions over a period of three months | Recordings of Bandari light music were played to induce muscle relaxation, and soft, beautiful, cheerful, and lively music was utilized for music-guided imagery. The selection criteria for the music were not specified. | 27 (M/F: 21/6, mean age: 35.6 years) vs. 27 (M/F: 20/7, mean age: 34.3 years) | Post-treatment PTSD-SS score |
| Beck et al. (2021) | Refugees with PTSD in Denmark | ICD-10 and DSM-IV | Trauma-focused music and imagery + pharmacotherapy (if needed) | Standard psychotherapy + pharmacotherapy (if needed) | Individual trauma-focused music and imagery, led by music therapists, 16 weekly one-hour sessions over a period of 4 months | Recordings of music were utilized, with pieces selected from the Guided Imagery and Music repertoire that included classical music, light classical music, film music, and meditative music. Pieces from the participant’s own musical tradition were also incorporated. The therapists chose the music after consultation with the patient. | 39 (M/F: 22/17, mean age: 42 years) vs. 35 (M/F: 21/14, mean age: 42 years) | Post-treatment HTQ-IV score |
| Pourmovahed et al. (2021) | Mothers of premature neonates hospitalized in NICU who developed PTSD in Iran | NR | Listening to the non-verbal music + CAU | CAU | Group listening to the non-verbal music, 14 daily 20-minute sessions over a period of two weeks | Sound recordings of rain, sea, and nature, characterized by a slow, gentle, and soothing rhythm, were used. The selection criteria for the music were not specified. | 23 (M/F: 0/23, mean age: 28.1 years) vs. 22 (M/F: 0/22, mean age: 28.0 years) | Post treatment PPQ score |
| Zhang et al. (2022) | Patients with multiple injuries who developed PTSD in China | NR | Mindfulness training with soothing music + CAU | CAU | Individual mindfulness training with soothing music, daily 30-minute sessions | Recordings of soothing and gentle Chinese classical music were played. The music was selected based on expert consultations with clinical and music professionals, as well as the patient's preferences. | 53 (M/F: 30/23, mean age: 36.1 years) vs. 52 (M/F: 28/24, mean age: 35.3 years) | Post-treatment PCL-C score |
| Li et al. (2023) | Patients with acute ischemic stroke who developed PTSD in China | DSM-V | Five-element music from Traditional Chinese Medicine + CAU | CBT + CAU | Individually listening to five-element music, 20 daily 30-minute sessions over a period of one month | Recordings of the five-element music from Traditional Chinese Medicine were used. The selection of music was based on the patient’ preference. | 34 (M/F: 16/18, mean age: 59.3 years) vs. 34 (M/F: 15/19, mean age: 58.5 years) | Post-treatment PCL-C score |
| Rudstam et al. (2022) | Women referred for treatment of PTSD/CPTSD in Sweden | DSM-V and ICD-11 | Trauma-focused group music and imagery + pharmacological treatments (if needed) | Waitlist + pharmacological treatments (if needed) | Group trauma-focused receptive music and imagery, 12 weekly 2.5-hour sessions over a period of 4 months | Recordings, predominantly of classical music from the western tradition, were utilized. These selections were drawn from the Bonny Method of Guided Imagery and Music repertoire. The choice of music was based on therapists’ professional assessments of each group's capacity to handle varying music intensities, while ensuring optimal arousal levels. | 22 (M/F: 0/22, mean age: 45.2 years) vs. 23 (M/F: 0/23, mean age: 42.2 years) | Post-treatment PCL-5 score |
Note: CBT, Cognitive Behavioral Therapy; NIUC, Neonatal Intensive Care Unit; CPTSD, complex PTSD; DSM, Diagnostic & Statistical Manual of Mental Disorders; ICD, International Classification of Diseases; NR, not reported; CAU, Care as usual; M/F, male/female; IES-R, Impact of Event Scale-Revised; PTSD-SS, PTSD Self-rating Scale; PCL-C, PTSD Checklist-Civilian Version; HTQ-IV, Harvard Trauma Questionnaire, section IV; PPQ, Perinatal PTSD Questionnaire; PCL-5, PTSD Checklist for DSM-5. *In Pezzin et al.'s 2018 study, the experimental group underwent music therapy for six weeks, while the control group was only observed for four weeks. To ascertain the average PCL-C score of the control group at six weeks, we first determined the weekly change in mean PCL-C score. Then we calculated the mean PCL-C score at six weeks by using the formula: baseline mean PCL-C score – (6 * change in mean PCL-C score per week). The standard deviation (SD) of the PCL-C score at six weeks was directly obtained from the SD at the fourth week.