Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users

Daisy Fancourt, Rosie Perkins, Sara Ascenso, Livia A Carvalho, Andrew Steptoe, Aaron Williamon, Daisy Fancourt, Rosie Perkins, Sara Ascenso, Livia A Carvalho, Andrew Steptoe, Aaron Williamon

Abstract

Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location.) Significant improvements were found in the drumming group but not the control group: by week 6 there were decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11) and increases in social resilience (7.69 SE 2.00 CI 3.60 to 11.78), and by week 10 these had further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social resilience: 10.59 SE 1.78 CI 6.94 to 14.24) alongside significant improvements in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19) and mental wellbeing (6.14 SE 0.92 CI 4.25 to 8.04). All significant changes were maintained at 3 months follow-up. Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses. Consequently, participants in the drumming group also provided saliva samples to test for cortisol and the cytokines interleukin (IL) 4, IL6, IL17, tumour necrosis factor alpha (TNFα), and monocyte chemoattractant protein (MCP) 1. Across the 10 weeks there was a shift away from a pro-inflammatory towards an anti-inflammatory immune profile. Consequently, this study demonstrates the psychological benefits of group drumming and also suggests underlying biological effects, supporting its therapeutic potential for mental health.

Trial registration: ClinicalTrials.gov NCT01906892.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flow of participants involved in…
Fig 1. Flow of participants involved in the study.
Fig 2. Psychological results.
Fig 2. Psychological results.
Within-subject change from baseline (with standard error) at weeks 6 and 10 for drumming and control groups for (A) Anxiety (HADSA), (B) Depression (HADSD)(C) Social Resilience (CDRISC), (D) Mental Wellbeing (WEMWBS) (E) and Perceived Stress (PSS). * = p

Fig 3. Biological results.

Mean cytokines levels…

Fig 3. Biological results.

Mean cytokines levels (with standard errors) in response to drumming across…

Fig 3. Biological results.
Mean cytokines levels (with standard errors) in response to drumming across the 10 weeks for(A) interleukin 4 (IL4), (B) monocyte chemoattractant protein 1 (MCP1), and (C) interleukin 17 (IL17). * = p

Fig 4. Pro- vs anti-inflammatory responses.

Mean…

Fig 4. Pro- vs anti-inflammatory responses.

Mean z scores for TNFα and IL4 (with standard…

Fig 4. Pro- vs anti-inflammatory responses.
Mean z scores for TNFα and IL4 (with standard errors) in response to drumming across the 10 weeks.
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References
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This research was carried out as part of ‘Creative Practice as Mutual Recovery’, a Connected Communities project funded by the UK's Arts and Humanities Research Council (grant ref. AH/K003364/1). It was also supported by grants from CW+ and an Arnold Bentley New Initiatives Award from the Society for Education, Music and Psychology Research (SEMPRE). DF is supported by the Maurice-Marks Foundation, and AS and LAC are supported by the British Heart Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Fig 3. Biological results.
Fig 3. Biological results.
Mean cytokines levels (with standard errors) in response to drumming across the 10 weeks for(A) interleukin 4 (IL4), (B) monocyte chemoattractant protein 1 (MCP1), and (C) interleukin 17 (IL17). * = p

Fig 4. Pro- vs anti-inflammatory responses.

Mean…

Fig 4. Pro- vs anti-inflammatory responses.

Mean z scores for TNFα and IL4 (with standard…

Fig 4. Pro- vs anti-inflammatory responses.
Mean z scores for TNFα and IL4 (with standard errors) in response to drumming across the 10 weeks.
Fig 4. Pro- vs anti-inflammatory responses.
Fig 4. Pro- vs anti-inflammatory responses.
Mean z scores for TNFα and IL4 (with standard errors) in response to drumming across the 10 weeks.

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