Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial

Mayara K A Ribeiro, Tereza R M Alcântara-Silva, Jordana C M Oliveira, Tamara C Paula, João B R Dutra, Gustavo R Pedrino, Karina Simões, Romes B Sousa, Ana C S Rebelo, Mayara K A Ribeiro, Tereza R M Alcântara-Silva, Jordana C M Oliveira, Tamara C Paula, João B R Dutra, Gustavo R Pedrino, Karina Simões, Romes B Sousa, Ana C S Rebelo

Abstract

Background: Mothers of preterm infants often have symptoms of anxiety and depression, recognized as risk factors for the development of cardiovascular diseases and associated with low rates of heart rate variability (HRV). This study aimed to evaluate the influence of music therapy intervention on the autonomic control of heart rate, anxiety, and depression in mothers.

Methods: Prospective randomized clinical trial including 21 mothers of preterms admitted to the Neonatal Intensive Care Unit of a tertiary hospital, recruited from August 2015 to September 2017, and divided into control group (CG; n = 11) and music therapy group (MTG; n = 10). Participants underwent anxiety and depression evaluation, as well as measurements of the intervals between consecutive heartbeats or RR intervals for the analysis of HRV at the first and the last weeks of hospitalization of their preterms. Music therapy sessions lasting 30-45 min were individually delivered weekly using receptive techniques. The mean and standard deviation of variables were obtained and the normality of data was analyzed using the Kolmogorov-Smirnov test. The paired sample t-test or Wilcoxon test were employed to calculate the differences between variables before and after music therapy intervention. The correlations anxiety versus heart variables and depression versus heart variables were established using Spearman correlation test. Fisher's exact test was used to verify the differences between categorical variables. A significance level of p < 0.05 was established. Statistical analysis were performed using the Statistical Package for the Social Sciences, version 20.

Results: Participants in MTG had an average of seven sessions of music therapy, and showed improvement in anxiety and depression scores and autonomic indexes of the time domain (p < 0.05). Significant correlations were found between depression and parasympathetic modulation using linear (r = - 0.687; p = 0.028) and nonlinear analyses (r = - 0.689; p = 0.027) in MTG.

Conclusion: Music therapy had a significant and positive impact on anxiety and depression, acting on prevention of cardiovascular diseases, major threats to modern society.

Trial registration: Brazilian Registry of Clinical Trials (no. RBR-3x7gz8 ). Retrospectively registered on November 17, 2017.

Keywords: Anxiety; Depression; Heart rate variability; Mothers; Music therapy.

Conflict of interest statement

Ethics approval and consent to participate

The research project was approved by the WHMDI Academic Board and by the Ethics and Research Committee of the Universidade Federal de Goiás (no. 636368). It was registered in the Brazilian Registry of Clinical Trials (no. RBR-3x7gz8) and endorses the rules of the Committee on Publication Ethics. All participants provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overview of the study design based on CONSORT diagram
Fig. 2
Fig. 2
Correlation between the deltas of the Beck Depression Inventory results and the deltas of the heart rate variability indices (RMSSD and SD1). BDI: Beck Depression Inventory; SD1: instantaneous beat-to-beat variability; RMSSD: root mean square of successive differences between adjacent RR intervals (ms).

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