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What Is a Good Thesis Statement About Depression?

Do you need to compose an informative or an argumentative essay on depression? One of the vital parts of your paper is a thesis statement on depression. Note there are various types of thesis statements, and what you use depends on the type of essay you are writing. A thesis summarizes the concept that you write on your research paper or the bottom line that you will write in your essay. It should elaborate more on the depression topics for the research paper you are working on. But at times, you might have a hard time writing your thesis statement.

Good Thesis Statement about Teenage Depression

Bipolar disorder thesis statements about depression, interesting thesis statements about depression, interesting thesis statement about diagnosis and treatment of depression, thesis statement about stress and depression, free thesis statements about depression and anxiety, get help with your depression research paper.

Here is a list of thesis statements to have an easier time writing your essay. They cover different topics, making it easy to select what excites you. Here we go!

Are you writing about teenagers and how they are always overthinking about their future, and they end up getting depressed? You need to write a good thesis statement for a depression research paper. That will help your depression argumentative essay stand out. Here are some thesis statement for depression to check out.

• There is a link between depression and alcohol among teenagers and the various ways to control it.
• Teenagers dealing with mood disorders eat and sleep more than usual, getting less interested in regular activities.
• Mediation is an effective way to reach out to adolescents that show heightened symptoms of depression.
• Self-blaming attributions are social cognitive mechanisms among adolescents.
• Peer victimization causes high-stress levels among adolescents and has negative psychological consequences.

Choosing a good depression thesis statement on bipolar disorder can be hectic. Research on bipolar will require a good thesis statement for mental health. Choose a thesis statement about mental health awareness here.

• People with Bipolar depression have more difficulties getting quality sleep.
• Bipolar disorder influences every aspect of a person’s life and changes their quality of life.
• Bipolar disorder causes depressive moods or lows of mental disorder.
• Bipolar is a severe mental issue that can negatively impact your moods, self-esteem, and behavior.
• Psychological evaluations play a significant role in diagnosing bipolar disorder.

When writing your essay, ensure that the thesis statement for mental health is fascinating. You will impress your professors if you get the right depression research paper outline as your thesis statement. Here is a depression thesis statement you can use.

• The effects of human psychology are viewed in the form of depression.
• Clinical psychology can help to bring outpatients who have depression.
• Treating long-term depression in bipolar patients is possible.
• Bipolar patients are drained to the roots of depression.
• Well-established rehabilitation centers can help bring drug addicts from depression.

Are you thinking of writing a thesis on depression and how to treat it? If so, you need to have an excellent thesis statement about mental health that will impress your professor. Read this list to find a thesis you need for your research paper.

• There are different ways to diagnose and treat depression from its early stage.
• People who show signs of depression from an early stage and seek treatment are likely to recover instead of those who do not show early signs.
• After you receive treatment for depression, putting the right measure in place is one of the best and effective ways to ensure that you do not get it again for the second time.
• Anxiety can interfere with daily living, and it can get anyone from children to adults.
• Besides medication, you need a lifestyle change and acceptance to treat depression.

Is your research about stress and how it can impact mental health? Getting a thesis statement for depression research paper that impresses your examiners can be challenging. Choose a thesis statement for your mental illness research paper below.

• Although it is normal for various situations to cause stress, having constant stress can have detrimental effects.
• To survive the modern industrial society, you need to have stress management strategies.
• The challenges of understanding and adapting to the changing environment can lead to stress.
• Lack of proper stress management will lead to inefficiency in everything people do.
• Stress does not come unless there are underlying stressors in your life.

Our team of writers is well-conversant about a free thesis statement about anxiety you can use. The best anxiety thesis statement will help you get the best grades. Here is a list of statements that stands out:

• Many factors can lead to early anxiety, but the leading cause of anxiety in adolescents is directly linked to families.
• Anxiety is a severe mental disorder that can occur without any apparent triggers.
• Long-term depression and anxiety can impact your mental health, but you can recover if you seek treatment.
• Depression and anxiety are not interlinked, and it is essential to learn how to differentiate them on practical grounds.
• Society has a role to play in helping people come out of depression and anxiety.

How do you write a research paper about depression and how it affects mental health? Before choosing a thesis statement on mental health, have a clear understanding of the essay that you are writing. That will help you get the best thesis to make our essay stand out.

But don’t keep stressing out about your thesis statement for mental illness research paper. We have your work cut out because our skilled writers have compiled a list of thesis statements about mental health and depression topics for research paper writing. We will also suggest correct thesis statements for your essay homework or assignment.

If you are still unsure of the statement to use, get in touch with us today. We have a team of skilled and experienced writers that can help you with your essay or research project and ensure that you get the best grades.

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10 New Thesis Statement about Depression & Anxiety | How to Write One?

Did you know according to the National Institute of Mental Health; it is estimated that approximately 8.4% of adults are patients of major depression in the US? Well, depression is a common illness globally that affects a lot of people. Yet, the reasons for this psychological sickness vary from person to person and numerous studies are being conducted to discover more about depression.

Therefore, college and university students are currently assigned to write research papers, dissertations, essays, and a thesis about depression. However, writing essays on such topics aims to increase the awareness of physical and mental well-being among youth and help them find solutions.

However, a lot of students find it pretty challenging to write a thesis statement about depression and seek someone to write my essay . No worries! In this article, you will learn about what is a good thesis statement about mental health and some effective methods and approaches to write a killer headline and compose an astonishing essay about depression.

5 Thesis Statement About Depression:

• “The complexity of depression, which includes biological, psychological, and environmental components, emphasizes the need for individualized treatment plans that consider each person’s particular requirements.”
• “Depression in the workplace not only affects an individual’s productivity but also carries economic implications, emphasizing the importance of fostering a mental health-friendly work environment.”
• “Alternative, holistic approaches to mental health care have the potential to be more successful as the link between creative expressions, such as art therapy, and depression management becomes more commonly recognized.”
• “It is critical to enhance geriatric mental health treatment and reduce the stigma associated with mental illness in older people since depression in senior populations is typically underdiagnosed and mistreated.”
• “The link between early childhood adversity and the risk of developing depression later in life accentuates the importance of early intervention and support systems for children exposed to adverse experiences.”

5 Thesis Statements about Anxiety & Depression :

• “Depression and anxiety Co-occurring disorders are a major concern in mental health, necessitating integrated treatment options that meet the unique challenges that co-occurring diseases provide.”
• “The utilization of technology-driven therapies, such as smartphone apps and telehealth services, is a realistic approach of addressing persons suffering from anxiety and depression, while also increasing access to mental health care.”
• “The examination of the gut-brain connection and its potential role in anxiety and depression showcases a burgeoning area of research that could lead to novel treatments emphasizing nutrition and gut health.”
• “Adolescents who experience both anxiety and depression face a serious issue that calls for comprehensive school-based mental health programs and preventative measures to promote young people’s mental health.”
• “Exploring the impact of sociocultural factors and the role of community support systems in the experience of anxiety and depression provides insights into the development of culturally sensitive mental health interventions.”

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Follow 7 Proven Methods to Compose Thesis Statement about Depression

A thesis is the overview of the concepts and ideas that you will write in your research paper or in the essay. Yet, a thesis statement about anxiety focuses more on the stress and depression topics for the paper you’re working on, which can be written by following the tips given below.

Nonetheless, you can compose an outline by covering the points mentioned below:

1. Pick a good study topic and perform a basic reading. Look for some intriguing statistics and try to come up with creative ways to approach your subject. Examine a few articles for deficiencies in understanding.

2. Make a list of your references and jot down when you come across a noteworthy quotation. You can cite them in your paper as references. Organize all of the information you’ve acquired in one location.

3. In one phrase, state the purpose of your essay. Consider what you want to happen when other people read your article.

4. Examine your notes and construct a list of all the key things you wish to emphasize. Make use of brainstorming strategies and jot down any ideas that come to mind.

5. Review and revise the arguments and write a thesis statement for a research paper or essay about depression.

6. Organize your essay by organizing the list of points. Arrange the points in a logical sequence. Analyze all elements to ensure that they are all relevant to your goal.

7. Reread all of your statements and arrange your outline in a standard manner, such as a bulleted list.

Final Words

So, what is an ideal way to write a thesis statement about depression for your research paper or essay? We hope you have a thorough idea of the essay you’re writing before picking a thesis statement about mental well-being. That will assist you in developing the greatest thesis for our essay.

But don’t get too worked up over your thesis statement for a research paper on mental disorders. Our professional subject experts have produced a list of thesis statements about mental health and depression themes for research paper writing, so you’ve got your job cut out for you. For your essay assignments or assignments, we will also offer appropriate thesis statements.

If you’re still confused about which statement to use, contact us right away. We have a staff of highly qualified and seasoned writers who can assist you with your essay or research work and guarantee that you receive the highest possible score.

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Anxiety and Depression Among College Students Essay

Introduction, methods section.

Education is expected to have appositive importance on the student’s life by enhancing their capability to think and improving their competency. However, it often acts as a source of stress that affects students’ mental health adversely. This causation of academic stress often emanates from the need to have high grades, the requirement to change attitude for success, and even pressures put by various school assignments. These pressures introduced by education can make the student undergo a series of anxiety, depression, and stress trying to conform to the forces. The causes of academic stress are well-researched but there is still no explanation why the rate of strain increases despite some measures being implemented to curb student stress. This research explores this niche by using 100 participants who study at my college.

Nowadays there are many reasons that cause stress among growing number of students who might not know they are going through the condition most of the time. Hence, undiscovered discouragement or uneasiness can cause understudies to feel that they are continually passing up unique open doors. It prompts substance misuse; self-destruction is the second most typical reason for death among undergrads. The main hypothesis of this article is that college and university students have higher depression rates.

Problem Statement

This proposal undercovers how the problem of anxiety and depression is progressing if not addressed. With such countless youngsters experiencing undiscovered tension, it may be challenging for them to appreciate school. Understudies’ emotional well-being is risked when pressure and trouble go unnoticed, which can prompt social and educational issues (Nelson & Liebel, 2018). Educators might battle to perceive uneasiness since these circumstances manifest themselves contrastingly in different people.

Anxiety and depression are complicated disorders with numerous elements that impact people differently. Teachers and staff must be well trained to deal with these unforeseen events. Understudies coming to college come from various financial foundations, which can prompt an assortment of psychological wellness chances (Li et al., 2021). Additionally, current works will be evaluated to differentiate the risk factors associated with stress among university undergraduates worldwide.

There are various reasons which might cause the onset of anxiety and depression. It can be absence of rest, terrible dietary patterns, and lack of activity add to the gloom in undergrads (Ghrouz et al., 2019). Scholarly pressure, which incorporates monetary worries, strain to track down a decent profession after graduation, and bombed connections, is sufficient to drive a few understudies to exit school or more awful.

Numerous parts of school life add to despondency risk factors. For example, understudies today are owing debtors while having fewer work prospects than prior. Discouraged kids are bound to foster the problems like substance misuse (Lattie et al., 2019). For adaptation to close-to-home trouble, discouraged understudies are more inclined than their non-discouraged companions to knock back the firewater, drink pot, and participate in unsafe sexual practices.

Hypothesis on the Topic

The central hypothesis for this study is that college students have a higher rate of anxiety and depression. The study will integrate various methodologies to prove the hypothesis of nullifying it. High rates of anxiety and depression can lead to substance misuse, behavioral challenges, and suicide (Lipson et al., 2018). Anxiety is one of the most critical indicators of academic success, it shows how students’ attitudes change, reflecting on their overall performance.

Participants

The study will use college students who are joining and those already in college. The research period is planned to last six months; college students are between the ages of 18 and 21 and life is changing rapidly at this age (Spillebout et al., 2019). This demography will come from the college where I study. The participants will be chosen randomly, the total number will be 100, both female and male, and from all races.

Apparatus/ Materials/ Instruments

Some of the materials to be used in the study will include pencils, papers, and tests. Paper and pencil are typical supplies that students are familiar with, so using them will not cause additional stress. It will be used during the interview with the students and throughout the study will be in effect (Huang et al., 2018). These have been applied in various studies before, and, hence, they will be instrumental in this study.

The study will follow a step-wise procedure to get the required results. First, the students’ pre-depression testing results would be researched and recorded. Second, the students would undergo standardized testing in the same groups. Scholarly accomplishment is impacted by past intellectual performance and standardized testing (Chang et al., 2020). Third, the students’ levels of depression and anxiety would be monitored along with their test results.

The study will use a descriptive, cross-sectional design with categorical and continuous data. The sample demographic characteristics were described using descriptive statistics. Pearson’s proportion of skewness values and common mistake of skewness was utilized to test the ordinariness of the persistent factors. The distinctions in mean scores between sociodemographic variables and stress will be examined using Tests (Lipson et al., 2018). The independent variable will be essential because it will provide the basis of measurement.

The 100 participants had different anxiety levels, as seen from the Test taken and the various evaluations. Forty-five of the participants had high levels, 23 had medium levels, while the remaining 32 had low levels (Lipson et al., 2018). The correlation and ANOVA, which had a degree of era margin of 0.05, were allowed (Lipson et al., 2018). This finding aligns intending to have clear and comprehensive outcomes.

Significance of the Study

If the results would be not significant, it means that students are not subjected to more pressure on average. If the study results in significant outcomes, this would mean that there is much that needs to be done to reduce student’s anxiety. The idea that scholarly accomplishment is indispensable to progress is built up in higher instructive conditions (Nelson & Liebel, 2018). Many colleges devote money to tutoring, extra instruction, and other support services to help students succeed.

APA Ethical Guidelines

The study will have to follow the APA ethical guidelines because it involves experimenting with humans. Some of the policies include having consent from the participant, debriefing the participant on the study’s nature, and getting IRB permission (Nelson & Liebel, 2018). Ethical guidelines should comply with proficient, institutional, and government rules. They habitually administer understudies whom they likewise instruct to give some examples of obligations.

Limitations

The study also had some limitations, making it hard to get the desired outcomes. It was not easy to detect the population-level connections, but not causality. This case hardened the aspect of confounding and getting the relevant random assignment needed for the study had to access (Nelson & Liebel, 2018). For the right individuals for the investigation to be identified, the sampling was not easy.

This study would be essential as it will create a platform for future studies. The result that was gotten shows that many college students are undergoing the problem of anxiety and depression without knowing that it is happening. Educators will have awareness on what aspects of academics they need to modify to ensure their students are not experiencing mental health challenges. Hence, it makes it possible for future researchers to conduct studies to provide possible solutions.

Chang, J., Yuan, Y., & Wang, D. (2020). Mental health status and its influencing factors among college students during the epidemic of COVID-19. Journal of Southern Medical University , 40(2), 171-176.

Ghrouz, A. K., Noohu, M. M., Manzar, D., Warren Spence, D., BaHammam, A. S., & Pandi-Perumal, S. R. (2019). Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing Journal , 23(2), 627-634.

Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., & Wang, J. (2018). Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research , 107, 1-10.

Lattie, E. G., Adkins, E. C., Winquist, N., Stiles-Shields, C., Wafford, Q. E., & Graham, A. K. (2019). Digital mental health interventions for depression, anxiety, and enhancement of psychological well-being among college students: A systematic review. Journal of Medical Internet Research , 21(7), e12869.

Li, Y., Zhao, J., Ma, Z., McReynolds, L. S., Lin, D., Chen, Z.,… & Liu, X. (2021). Mental health among college students during the COVID-19 pandemic in China: A 2-wave longitudinal survey. Journal of Affective Disorders , 281, 597-604.

Lipson, S. K., Kern, A., Eisenberg, D., & Breland-Noble, A. M. (2018). Mental health disparities among college students of color. Journal of Adolescent Health , 63(3), 348-356.

Nelson, J. M., & Liebel, S. W. (2018). Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant, sex, and subtype differences. Journal of American College Health , 66(2), 123-132.

Spillebout, A., Dechelotte, P., Ladner, J., & Tavolacci, M. P. (2019). Mental health among university students with eating disorders and irritable bowel syndrome in France. Journal of Affective Disorders , 67(5), 295-301.

The following table shows the significant issues that affect the mental health state of most college students. Based on Huang et al.’s research, the biggest concern for most students included stress about their loved ones. Additionally, the authors found that worrying about one’s academics and schooling was the second depressing experience among most college students.

The following figure shows how on top of the current stressors for students, COVID-19 affects their mental health. Li et al.’s research demonstrates that COVID-19 placed more financial burden than before, especially on students with part-time jobs who often face anxiety and stress due to lack of tuition fees (Li et al., 2021). Generally, the research shows that the financial consequences of coronavirus affect the mental state of most college students.

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• Chicago (A-D)
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7 Depression Research Paper Topic Ideas

Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.

Cara Lustik is a fact-checker and copywriter.

In psychology classes, it's common for students to write a depression research paper. Researching depression may be beneficial if you have a personal interest in this topic and want to learn more, or if you're simply passionate about this mental health issue. However, since depression is a very complex subject, it offers many possible topics to focus on, which may leave you wondering where to begin.

If this is how you feel, here are a few research titles about depression to help inspire your topic choice. You can use these suggestions as actual research titles about depression, or you can use them to lead you to other more in-depth topics that you can look into further for your depression research paper.

What Is Depression?

Everyone experiences times when they feel a little bit blue or sad. This is a normal part of being human. Depression, however, is a medical condition that is quite different from everyday moodiness.

Your depression research paper may explore the basics, or it might delve deeper into the  definition of clinical depression  or the  difference between clinical depression and sadness .

What Research Says About the Psychology of Depression

Studies suggest that there are biological, psychological, and social aspects to depression, giving you many different areas to consider for your research title about depression.

Types of Depression

There are several different types of depression  that are dependent on how an individual's depression symptoms manifest themselves. Depression symptoms may vary in severity or in what is causing them. For instance, major depressive disorder (MDD) may have no identifiable cause, while postpartum depression is typically linked to pregnancy and childbirth.

Depressive symptoms may also be part of an illness called bipolar disorder. This includes fluctuations between depressive episodes and a state of extreme elation called mania. Bipolar disorder is a topic that offers many research opportunities, from its definition and its causes to associated risks, symptoms, and treatment.

Causes of Depression

The possible causes of depression are many and not yet well understood. However, it most likely results from an interplay of genetic vulnerability  and environmental factors. Your depression research paper could explore one or more of these causes and reference the latest research on the topic.

For instance, how does an imbalance in brain chemistry or poor nutrition relate to depression? Is there a relationship between the stressful, busier lives of today's society and the rise of depression? How can grief or a major medical condition lead to overwhelming sadness and depression?

Who Is at Risk for Depression?

This is a good research question about depression as certain risk factors may make a person more prone to developing this mental health condition, such as a family history of depression, adverse childhood experiences, stress , illness, and gender . This is not a complete list of all risk factors, however, it's a good place to start.

The growing rate of depression in children, teenagers, and young adults is an interesting subtopic you can focus on as well. Whether you dive into the reasons behind the increase in rates of depression or discuss the treatment options that are safe for young people, there is a lot of research available in this area and many unanswered questions to consider.

Depression Signs and Symptoms

The signs of depression are those outward manifestations of the illness that a doctor can observe when they examine a patient. For example, a lack of emotional responsiveness is a visible sign. On the other hand, symptoms are subjective things about the illness that only the patient can observe, such as feelings of guilt or sadness.

An illness such as depression is often invisible to the outside observer. That is why it is very important for patients to make an accurate accounting of all of their symptoms so their doctor can diagnose them properly. In your depression research paper, you may explore these "invisible" symptoms of depression in adults or explore how depression symptoms can be different in children .

How Is Depression Diagnosed?

This is another good depression research topic because, in some ways, the diagnosis of depression is more of an art than a science. Doctors must generally rely upon the patient's set of symptoms and what they can observe about them during their examination to make a diagnosis. 

While there are certain  laboratory tests that can be performed to rule out other medical illnesses as a cause of depression, there is not yet a definitive test for depression itself.

If you'd like to pursue this topic, you may want to start with the Diagnostic and Statistical Manual of Mental Disorders (DSM). The fifth edition, known as DSM-5, offers a very detailed explanation that guides doctors to a diagnosis. You can also compare the current model of diagnosing depression to historical methods of diagnosis—how have these updates improved the way depression is treated?

Treatment Options for Depression

The first choice for depression treatment is generally an antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are the most popular choice because they can be quite effective and tend to have fewer side effects than other types of antidepressants.

Psychotherapy, or talk therapy, is another effective and common choice. It is especially efficacious when combined with antidepressant therapy. Certain other treatments, such as electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS), are most commonly used for patients who do not respond to more common forms of treatment.

Focusing on one of these treatments is an option for your depression research paper. Comparing and contrasting several different types of treatment can also make a good research title about depression.

A Word From Verywell

The topic of depression really can take you down many different roads. When making your final decision on which to pursue in your depression research paper, it's often helpful to start by listing a few areas that pique your interest.

From there, consider doing a little preliminary research. You may come across something that grabs your attention like a new study, a controversial topic you didn't know about, or something that hits a personal note. This will help you narrow your focus, giving you your final research title about depression.

Remes O, Mendes JF, Templeton P. Biological, psychological, and social determinants of depression: A review of recent literature . Brain Sci . 2021;11(12):1633. doi:10.3390/brainsci11121633

National Institute of Mental Health. Depression .

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition . American Psychiatric Association.

National Institute of Mental Health. Mental health medications .

Ferri, F. F. (2019). Ferri's Clinical Advisor 2020 E-Book: 5 Books in 1 . Netherlands: Elsevier Health Sciences.

By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.  

434 Depression Essay Titles & Research Topics: Argumentative, Controversial, and More

Depression is undeniably one of the most prevalent mental health conditions globally, affecting approximately 5% of adults worldwide. It often manifests as intense feelings of hopelessness, sadness, and a loss of interest in previously enjoyable activities. Many also experience physical symptoms like fatigue, sleep disturbances, and appetite changes. Recognizing and addressing this mental disorder is extremely important to save lives and treat the condition.

In this article, we’ll discuss how to write an essay about depression and introduce depression essay topics and research titles for students that may be inspirational.

• 🔝 Top Depression Essay Titles
• ✅ Essay Prompts
• 💡 Research Topics
• 🔎 Essay Titles
• 💭 Speech Topics
• 📝 Essay Structure

🔗 References

🔝 top 12 research titles about depression.

• How is depression treated?
• Depression: Risk factors.
• The symptoms of depression.
• What types of depression exist?
• Depression in young people.
• Differences between anxiety and depression.
• The parents’ role in depression therapy.
• Drugs as the root cause of depression.
• Dangerous consequences of untreated depression.
• Effect of long-term depression.
• Different stages of depression.
• Treatment for depression.

✅ Prompts for Essay about Depression

Struggling to find inspiration for your essay? Look no further! We’ve put together some valuable essay prompts on depression just for you!

Prompt for Personal Essay about Depression

Sharing your own experience with depression in a paper can be a good idea. Others may feel more motivated to overcome their situation after reading your story. You can also share valuable advice by discussing things or methods that have personally helped you deal with the condition.

For example, in your essay about depression, you can:

• Tell about the time you felt anxious, hopeless, or depressed;
• Express your opinion on depression based on the experiences from your life;
• Suggest a way of dealing with the initial symptoms of depression ;
• Share your ideas on how to protect mental health at a young age.

How to Overcome Depression: Essay Prompt

Sadness is a common human emotion, but depression encompasses more than just sadness. As reported by the National Institute of Mental Health, around 21 million adults in the United States, roughly 8.4% of the total adult population , faced at least one significant episode of depression in 2020. When crafting your essay about overcoming depression, consider exploring the following aspects:

• Depression in young people and adolescents;
• The main causes of depression;
• The symptoms of depression;
• Ways to treat depression;
• Help from a psychologist (cognitive behavioral therapy or interpersonal therapy ).

Postpartum Depression: Essay Prompt

The birth of a child often evokes a spectrum of powerful emotions, spanning from exhilaration and happiness to apprehension and unease. It can also trigger the onset of depression. Following childbirth, many new mothers experience postpartum “baby blues,” marked by shifts in mood, bouts of tears, anxiety, and sleep disturbances. To shed light on the subject of postpartum depression, explore the following questions:

• What factors may increase the risk of postpartum depression?
• Is postpartum depression predictable?
• How to prevent postpartum depression?
• What are the symptoms of postpartum depression?
• What kinds of postpartum depression treatments exist?

Prompt for Essay about Teenage Depression

Teenage depression is a mental health condition characterized by sadness and diminishing interest in daily activities. It can significantly impact a teenager’s thoughts, emotions, and behavior, often requiring long-term treatment and support.

By discussing the primary symptoms of teenage depression in your paper, you can raise awareness of the issue and encourage those in need to seek assistance. You can pay attention to the following aspects:

• Emotional changes (feelings of sadness, anger, hopelessness, guilt, etc.);
• Behavioral changes (loss of energy and appetite , less attention to personal hygiene, self-harm, etc.);
• New addictions (drugs, alcohol, computer games, etc.).

💡 Research Topics about Depression

• The role of genetics in depression development.
• The effectiveness of different psychotherapeutic interventions for depression.
• Anti-depression non-pharmacological and medication treatment.
• The impact of childhood trauma on the onset of depression later in life.
• Exploring the efficacy of antidepressant medication in different populations.
• The impact of exercise on depression symptoms and treatment outcomes.
• Mild depression: pharmacotherapy and psychotherapy.
• The relationship between sleep disturbances and depression.
• The role of gut microbiota in depression and potential implications for treatment.
• Investigating the impact of social media on depression rates in adolescents.
• Depression, dementia, and delirium in older people .
• The efficacy of cognitive-behavioral therapy in preventing depression relapse.
• The influence of hormonal changes on depression risk.
• Assessing the effectiveness of self-help and digital interventions for depression.
• Herbal and complementary therapies for depression.
• The relationship between personality traits and vulnerability to depression.
• Investigating the long-term consequences of untreated depression on physical health.
• Exploring the link between chronic pain and depression.
• Depression in the elderly male.
• The impact of childhood experiences on depression outcomes in adulthood.
• The use of ketamine and other novel treatments for depression.
• The effect of stigma on depression diagnosis and treatment.
• The conducted family assessment: cases of depression.
• The role of social support in depression recovery.
• The effectiveness of online support groups for individuals with depression.
• Depression and cognitive decline in adults.
• Depression: PICOT question component exploration .
• Exploring the impact of nutrition and dietary patterns on depression symptoms.
• Investigating the efficacy of art-based therapies in depression treatment.
• The role of neuroplasticity in the development and treatment of depression.
• Depression among HIV-positive women.
• The influence of gender on depression prevalence and symptomatology.
• Investigating the impact of workplace factors on depression rates and outcomes.
• The efficacy of family-based interventions in reducing depression symptoms in teenagers.
• Frontline nurses’ burnout, anxiety, depression, and fear statuses.
• The role of early-life stress and adversity in depression vulnerability.
• The impact of various environmental factors on depression rates.
• Exploring the link between depression and cardiovascular health.
• Depression detection in adults in nursing practice.
• Virtual reality as a therapeutic tool for depression treatment.
• Investigating the impact of childhood bullying on depression outcomes.
• The benefits of animal-assisted interventions in depression management.
• Depression and physical exercise .
• The relationship between depression and suicidal behavior .
• The influence of cultural factors on depression symptom expression.
• Investigating the role of epigenetics in depression susceptibility.
• Depression associated with cognitive dysfunction.
• Exploring the impact of adverse trauma on the course of depression.
• The efficacy of acceptance and commitment therapy in treating depression.
• The relationship between depression and substance use disorders .
• Depression and anxiety among college students .
• Investigating the effectiveness of group therapy for depression.
• Depression and chronic medical conditions.

Psychology Research Topics on Depression

• The influence of early attachment experiences on the development of depression.
• The impact of negative cognitive biases on depression symptomatology.
• Depression treatment plan for a queer patient .
• Examining the relationship between perfectionism and depression.
• The role of self-esteem in depression vulnerability and recovery.
• Exploring the link between maladaptive thinking styles (e.g., rumination, catastrophizing) and depression.
• Investigating the impact of social support on depression outcomes and resilience.
• Identifying depression in young adults at an early stage.
• The influence of parenting styles on the risk of depression in children and adolescents.
• The role of self-criticism and self-compassion in depression treatment.
• Exploring the relationship between identity development and depression in emerging adulthood.
• The role of learned helplessness in understanding depression and its treatment.
• Depression in the elderly.
• Examining the connection between self-efficacy beliefs and depression symptoms.
• The influence of social comparison processes on depression and body image dissatisfaction.
• Exploring the impact of trauma-related disorders on depression.
• The role of resilience factors in buffering against the development of depression.
• Investigating the relationship between personality traits and depression.
• Depression and workplace violence .
• The impact of cultural factors on depression prevalence and symptom presentation.
• Investigating the effects of chronic stress on depression risk.
• The role of coping strategies in depression management and recovery.
• The correlation between discrimination/prejudice and depression/anxiety .
• Exploring the influence of gender norms and societal expectations on depression rates.
• The impact of adverse workplace conditions on employee depression.
• Investigating the effectiveness of narrative therapy in treating depression.
• Cognitive behavior and depression in adolescents .
• Childhood emotional neglect and adult depression.
• The influence of perceived social support on treatment outcomes in depression.
• The effects of childhood bullying on the development of depression.
• The impact of intergenerational transmission of depression within families.
• Depression in children: symptoms and treatments .
• Investigating the link between body dissatisfaction and depression in adolescence.
• The influence of adverse life events and chronic stressors on depression risk.
• The effects of peer victimization on the development of depression in adolescence.
• Counselling clients with depression and addiction.
• The role of experiential avoidance in depression and its treatment.
• The impact of social media use and online interactions on depression rates.
• Depression management in adolescent.
• Exploring the relationship between emotional intelligence and depression symptomatology.
• Investigating the influence of cultural values and norms on depression stigma and help-seeking behavior.
• The effects of childhood maltreatment on neurobiological markers of depression.
• Psychological and emotional conditions of suicide and depression .
• Exploring the relationship between body dissatisfaction and depression.
• The influence of self-worth contingencies on depression vulnerability and treatment response.
• The impact of social isolation and loneliness on depression rates.
• Psychology of depression among college students .
• The effects of perfectionistic self-presentation on depression in college students.
• The role of mindfulness skills in depression prevention and relapse prevention.
• Investigating the influence of adverse neighborhood conditions on depression risk.
• Personality psychology and depression.
• The impact of attachment insecurity on depression symptomatology.

Postpartum Depression Research Topics

• Identifying risk factors for postpartum depression.
• Exploring the role of hormonal changes in postpartum depression.
• “Baby blues” or postpartum depression and evidence-based care .
• The impact of social support on postpartum depression.
• The effectiveness of screening tools for early detection of postpartum depression.
• The relationship between postpartum depression and maternal-infant bonding .
• Postpartum depression educational program results.
• Identifying effective interventions for preventing and treating postpartum depression.
• Examining the impact of cultural factors on postpartum depression rates.
• Investigating the role of sleep disturbances in postpartum depression.
• Depression and postpartum depression relationship .
• Exploring the impact of a traumatic birth experience on postpartum depression.
• Assessing the impact of breastfeeding difficulties on postpartum depression.
• Understanding the role of genetic factors in postpartum depression.
• Postpartum depression: consequences.
• Investigating the impact of previous psychiatric history on postpartum depression risk.
• The potential benefits of exercise on postpartum depression symptoms.
• The efficacy of psychotherapeutic interventions for postpartum depression.
• Postpartum depression in the twenty-first century.
• The influence of partner support on postpartum depression outcomes.
• Examining the relationship between postpartum depression and maternal self-esteem.
• The impact of postpartum depression on infant development and well-being.
• Maternal mood symptoms in pregnancy and postpartum depression.
• The effectiveness of group therapy for postpartum depression management.
• Identifying the role of inflammation and immune dysregulation in postpartum depression.
• Investigating the impact of childcare stress on postpartum depression.
• Postpartum depression among low-income US mothers .
• The role of postnatal anxiety symptoms in postpartum depression.
• The impact of postpartum depression on the marital relationship.
• The influence of postpartum depression on parenting practices and parental stress.
• Postpartum depression: symptoms, role of cultural factors, and ways to support.
• Investigating the efficacy of pharmacological treatments for postpartum depression.
• The impact of postpartum depression on breastfeeding initiation and continuation.
• The relationship between postpartum depression and post-traumatic stress disorder.
• Postpartum depression and its identification.
• The impact of postpartum depression on cognitive functioning and decision-making.
• Investigating the influence of cultural norms and expectations on postpartum depression rates.
• The impact of maternal guilt and shame on postpartum depression symptoms.
• Beck’s postpartum depression theory: purpose, concepts, and significance .
• Understanding the role of attachment styles in postpartum depression vulnerability.
• Investigating the effectiveness of online support groups for women with postpartum depression.
• The impact of socioeconomic factors on postpartum depression prevalence.
• Perinatal depression: research study and design.
• The efficacy of mindfulness-based interventions for postpartum depression.
• Investigating the influence of birth spacing on postpartum depression risk.
• The role of trauma history in postpartum depression development.
• The link between the birth experience and postnatal depression .
• How does postpartum depression affect the mother-infant interaction and bonding ?
• The effectiveness of home visiting programs in preventing and managing postpartum depression.
• Assessing the influence of work-related stress on postpartum depression.
• The relationship between postpartum depression and pregnancy-related complications.
• The role of personality traits in postpartum depression vulnerability.

🔎 Depression Essay Titles

Depression essay topics: cause & effect.

• The effects of childhood trauma on the development of depression in adults.
• The impact of social media usage on the prevalence of depression in adolescents.
• “Predictors of Postpartum Depression” by Katon et al.
• The effects of environmental factors on depression rates.
• The relationship between academic pressure and depression among college students.
• The relationship between financial stress and depression.
• The best solution to predict depression because of bullying .
• How does long-term unemployment affect mental health ?
• The effects of unemployment on mental health, particularly the risk of depression.
• The impact of genetics and family history of depression on an individual’s likelihood of developing depression.
• The relationship between depression and substance abuse.
• Child abuse and depression.
• The role of gender in the manifestation and treatment of depression.
• The effects of chronic stress on the development of depression.
• The link between substance abuse and depression.
• Depression among students at Elon University .
• The influence of early attachment styles on an individual’s vulnerability to depression.
• The effects of sleep disturbances on the severity of depression.
• Chronic illness and the risk of developing depression.
• Depression: symptoms and treatment.
• Adverse childhood experiences and the likelihood of experiencing depression in adulthood.
• The relationship between chronic illness and depression.
• The role of negative thinking patterns in the development of depression.
• Effects of depression among adolescents .
• The effects of poor body image and low self-esteem on the prevalence of depression.
• The influence of social support systems on preventing symptoms of depression.
• The effects of child neglect on adult depression rates.
• Depression caused by hormonal imbalance .
• The link between perfectionism and the risk of developing depression.
• The effects of a lack of sleep on depression symptoms.
• The effects of childhood abuse and neglect on the risk of depression.
• Social aspects of depression and anxiety .
• The impact of bullying on the likelihood of experiencing depression.
• The role of serotonin and neurotransmitter imbalances in the development of depression.
• The impact of a poor diet on depression rates.
• Depression and anxiety run in the family .
• The effects of childhood poverty and socioeconomic status on depression rates in adults.
• The impact of divorce on depression rates.
• The relationship between traumatic life events and the risk of developing depression.
• The influence of personality traits on susceptibility to depression.
• The impact of workplace stress on depression rates.
• Depression in older adults: causes and treatment.
• The impact of parental depression on children’s mental health outcomes.
• The effects of social isolation on the prevalence and severity of depression.
• The role of cultural factors in the manifestation and treatment of depression.
• The relationship between childhood bullying victimization and future depressive symptoms.
• The impact of early intervention and prevention programs on reducing the risk of postpartum depression.
• Treating mood disorders and depression .
• How do hormonal changes during pregnancy contribute to the development of depression?
• The effects of sleep deprivation on the onset and severity of postpartum depression.
• The impact of social media on depression rates among teenagers.
• The role of genetics in the development of depression.
• The impact of bullying on adolescent depression rates.
• Mental illness, depression, and wellness issues .
• The effects of a sedentary lifestyle on depression symptoms.
• The correlation between academic pressure and depression in students.
• The relationship between perfectionism and depression.
• The correlation between trauma and depression in military veterans.
• Anxiety and depression during childhood and adolescence .
• The impact of racial discrimination on depression rates among minorities.
• The relationship between chronic pain and depression.
• The impact of social comparison on depression rates among young adults.
• The effects of childhood abuse on adult depression rates.

Depression Argumentative Essay Topics

• The role of social media in contributing to depression among teenagers.
• The effectiveness of antidepressant medication: an ongoing debate.
• Depression treatment: therapy or medications?
• Should depression screening be mandatory in schools and colleges?
• Is there a genetic predisposition to depression?
• The stigma surrounding depression: addressing misconceptions and promoting understanding.
• Implementation of depression screening in primary care .
• Is psychotherapy more effective than medication in treating depression?
• Is teenage depression overdiagnosed or underdiagnosed: a critical analysis.
• The connection between depression and substance abuse: untangling the relationship.
• Humanistic therapy of depression .
• Should ECT (electroconvulsive therapy) be a treatment option for severe depression?
• Where is depression more prevalent: in urban or rural communities? Analyzing the disparities.
• Is depression a result of chemical imbalance in the brain? Debunking the myth.
• Depression: a serious mental and behavioral problem.
• Should depression medication be prescribed for children and adolescents?
• The effectiveness of mindfulness-based interventions in managing depression.
• Should depression in the elderly be considered a normal part of aging?
• Is depression hereditary? Investigating the role of genetics in depression risk.
• Different types of training in managing the symptoms of depression .
• The effectiveness of online therapy platforms in treating depression.
• Should psychedelic therapy be explored as an alternative treatment for depression?
• The connection between depression and cardiovascular health: Is there a link?
• The effectiveness of cognitive-behavioral therapy in preventing depression relapse.
• Depression as a bad a clinical condition.
• Should mind-body interventions (e.g., yoga, meditation) be integrated into depression treatment?
• Should emotional support animals be prescribed for individuals with depression?
• The effectiveness of peer support groups in decreasing depression symptoms.
• The use of antidepressants: are they overprescribed or necessary for treating depression?
• Adult depression and anxiety as a complex problem .
• The effectiveness of therapy versus medication in treating depression.
• The stigma surrounding depression and mental illness: how can we reduce it?
• The debate over the legalization of psychedelic drugs for treating depression.
• The relationship between creativity and depression: does one cause the other?
• Cognitive-behavioral therapy for generalized anxiety disorder and depression .
• The role of childhood trauma in shaping adult depression: Is it always a causal factor?
• The debate over the medicalization of sadness and grief as forms of depression.
• Alternative therapies, such as acupuncture or meditation, are effective in treating depression.
• Depression as a widespread mental condition .

Controversial Topics about Depression

• The existence of “chemical imbalance” in depression: fact or fiction?
• The over-reliance on medication in treating depression: are alternatives neglected?
• Is depression overdiagnosed and overmedicated in Western society?
• Measurement of an individual’s level of depression .
• The role of Big Pharma in shaping the narrative and treatment of depression.
• Should antidepressant advertisements be banned?
• The inadequacy of current diagnostic criteria for depression: rethinking the DSM-5.
• Is depression a biological illness or a product of societal factors?
• Literature review on depression .
• The overemphasis on biological factors in depression treatment: ignoring environmental factors.
• Is depression a normal reaction to an abnormal society?
• The influence of cultural norms on the perception and treatment of depression.
• Should children and adolescents be routinely prescribed antidepressants?
• The role of family in depression treatment .
• The connection between depression and creative genius: does depression enhance artistic abilities?
• The ethics of using placebo treatment for depression studies.
• The impact of social and economic inequalities on depression rates.
• Is depression primarily a mental health issue or a social justice issue?
• Depression disassembling and treating.
• Should depression screening be mandatory in the workplace?
• The influence of gender bias in the diagnosis and treatment of depression.
• The controversial role of religion and spirituality in managing depression.
• Is depression a result of individual weakness or societal factors?
• Abnormal psychology: anxiety and depression case .
• The link between depression and obesity: examining the bidirectional relationship.
• The connection between depression and academic performance : causation or correlation?
• Should depression medication be available over the counter?
• The impact of internet and social media use on depression rates: harmful or beneficial?
• Interacting in the workplace: depression.
• Is depression a modern epidemic or simply better diagnosed and identified?
• The ethical considerations of using animals in depression research.
• The effectiveness of psychedelic therapies for treatment-resistant depression.
• Is depression a disability? The debate on workplace accommodations.
• Polysubstance abuse among adolescent males with depression .
• The link between depression and intimate partner violence : exploring the relationship.
• The controversy surrounding “happy” pills and the pursuit of happiness.
• Is depression a choice? Examining the role of personal responsibility.

Good Titles for Depression Essays

• The poetic depictions of depression: exploring its representation in literature.
• The melancholic symphony: the influence of depression on classical music.
• Moderate depression symptoms and treatment.
• Depression in modern music: analyzing its themes and expressions.
• Cultural perspectives on depression: a comparative analysis of attitudes in different countries.
• Contrasting cultural views on depression in Eastern and Western societies.
• Diagnosing depression in the older population.
• The influence of social media on attitudes and perceptions of depression in global contexts.
• Countries with progressive approaches to mental health awareness.
• From taboo to acceptance: the evolution of attitudes towards depression.
• Depression screening tool in acute settings.
• The Bell Jar : analyzing Sylvia Plath’s iconic tale of depression .
• The art of despair: examining Frida Kahlo’s self-portraits as a window into depression.
• The Catcher in the Rye : Holden Caulfield’s battle with adolescent depression.
• Music as therapy: how jazz artists turned depression into art.
• Depression screening tool for a primary care center.
• The Nordic paradox: high depression rates in Scandinavian countries despite high-quality healthcare.
• The Stoic East: how Eastern philosophies approach and manage depression.
• From solitude to solidarity: collective approaches to depression in collectivist cultures.
• The portrayal of depression in popular culture: a critical analysis of movies and TV shows.
• The depression screening training in primary care.
• The impact of social media influencers on depression rates among young adults.
• The role of music in coping with depression: can specific genres or songs help alleviate depressive symptoms?
• The representation of depression in literature: a comparative analysis of classic and contemporary works.
• The use of art as a form of self-expression and therapy for individuals with depression.
• Depression management guidelines implementation.
• The role of religion in coping with depression: Christian and Buddhist practices.
• The representation of depression in the video game Hellblade: Senua’s Sacrifice .
• The role of nature in coping with depression: can spending time outdoors help alleviate depressive symptoms?
• The effectiveness of dance/movement therapy in treating depression among older adults.
• The National Institute for Health: depression management.
• The portrayal of depression in stand-up comedy: a study of comedians like Maria Bamford and Chris Gethard.
• The role of spirituality in coping with depression: Islamic and Hindu practices .
• The portrayal of depression in animated movies : an analysis of Inside Out and The Lion King .
• The representation of depression by fashion designers like Alexander McQueen and Rick Owens.
• Depression screening in primary care .
• The portrayal of depression in documentaries: an analysis of films like The Bridge and Happy Valley .
• The effectiveness of wilderness therapy in treating depression among adolescents.
• The connection between creativity and depression: how art can help heal.
• The role of Buddhist and Taoist practices in coping with depression.
• Mild depression treatment research funding sources.
• The portrayal of depression in podcasts: an analysis of the show The Hilarious World of Depression .
• The effectiveness of drama therapy in treating depression among children and adolescents.
• The representation of depression in the works of Vincent van Gogh and Edvard Munch.
• Depression in young people: articles review.
• The impact of social media on political polarization and its relationship with depression.
• The role of humor in coping with depression: a study of comedians like Ellen DeGeneres.
• The portrayal of depression in webcomics: an analysis of the comics Hyperbole and a Half .
• The effect of social media on mental health stigma and its relationship with depression.
• Depression and the impact of human services workers.
• The masked faces: hiding depression in highly individualistic societies.

💭 Depression Speech Topics

Informative speech topics about depression.

• Different types of depression and their symptoms.
• The causes of depression: biological, psychological, and environmental factors.
• How depression and physical issues are connected.
• The prevalence of depression in different age groups and demographics.
• The link between depression and anxiety disorders.
• Physical health: The effects of untreated depression.
• The role of genetics in predisposing individuals to depression.
• What you need to know about depression .
• How necessary is early intervention in treating depression?
• The effectiveness of medication in treating depression.
• The role of exercise in managing depressive symptoms.
• Depression in later life: overview.
• The relationship between substance abuse and depression.
• The impact of trauma on depression rates and treatment.
• The effectiveness of mindfulness meditation in managing depressive symptoms.
• Enzymes conversion and metabolites in major depression.
• The benefits and drawbacks of electroconvulsive therapy for severe depression.
• The effect of gender and cultural norms on depression rates and treatment.
• The effectiveness of alternative therapies for depression, such as acupuncture and herbal remedies.
• The importance of self-care in managing depression.
• Symptoms of anxiety, depression, and peritraumatic dissociation.
• The role of support systems in managing depression.
• The effectiveness of cognitive-behavioral therapy in treating depression.
• The benefits and drawbacks of online therapy for depression.
• The role of spirituality in managing depression.
• Depression among minority groups.
• The benefits and drawbacks of residential treatment for severe depression.
• What is the relationship between childhood trauma and adult depression?
• How effective is transcranial magnetic stimulation (TMS) for treatment-resistant depression?
• The benefits and drawbacks of art therapy for depression.
• Mood disorder: depression and bipolar .
• The impact of social media on depression rates.
• The effectiveness of dialectical behavior therapy (DBT) in treating depression.
• Depression in older people.
• The impact of seasonal changes on depression rates and treatment options.
• The impact of depression on daily life and relationships, and strategies for coping with the condition.
• The stigma around depression and the importance of seeking help.

Persuasive Speech Topics about Depression

• How important is it to recognize the signs and symptoms of depression ?
• How do you support a loved one who is struggling with depression?
• The importance of mental health education in schools to prevent and manage depression.
• Social media: the rise of depression and anxiety .
• Is there a need to increase funding for mental health research to develop better treatments for depression?
• Addressing depression in minority communities: overcoming barriers and disparities.
• The benefits of including alternative therapies, such as yoga and meditation, in depression treatment plans.
• Challenging media portrayals of depression: promoting accurate representations.
• Two sides of depression disease.
• How social media affects mental health: the need for responsible use to prevent depression.
• The importance of early intervention: addressing depression in schools and colleges.
• The benefits of seeking professional help for depression.
• There is a need for better access to mental health care, including therapy and medication, for those suffering from depression.
• Depression in adolescents and suitable interventions .
• How do you manage depression while in college or university?
• The role of family and friends in supporting loved ones with depression and encouraging them to seek help.
• The benefits of mindfulness and meditation for depression.
• The link between sleep and depression, and how to improve sleep habits.
• How do you manage depression while working a high-stress job?
• Approaches to treating depression.
• How do you manage depression during pregnancy and postpartum?
• The importance of prioritizing employee mental health and providing resources for managing depression in the workplace.
• How should you manage depression while caring for a loved one with a chronic illness?
• How to manage depression while dealing with infertility or pregnancy loss.
• Andrew Solomon: why we can’t talk about depression .
• Destigmatizing depression: promoting mental health awareness and understanding.
• Raising funds for depression research: investing in mental health advances.
• The power of peer support: establishing peer-led programs for depression.
• Accessible mental health services: ensuring treatment for all affected by depression.
• Evidence-based screening for depression in acute care .
• The benefits of journaling for mental health: putting your thoughts on paper to heal.
• The power of positivity: changing your mindset to fight depression .
• The healing power of gratitude in fighting depression.
• The connection between diet and depression: eating well can improve your mood.
• Teen depression and suicide in Soto’s The Afterlife .
• The benefits of therapy for depression: finding professional help to heal.
• The importance of setting realistic expectations when living with depression.

📝 How to Write about Depression: Essay Structure

We’ve prepared some tips and examples to help you structure your essay and communicate your ideas.

Essay about Depression: Introduction

An introduction is the first paragraph of an essay. It plays a crucial role in engaging the reader, offering the context, and presenting the central theme.

A good introduction typically consists of 3 components:

• Hook. The hook captures readers’ attention and encourages them to continue reading.
• Background information. Background information provides context for the essay.
• Thesis statement. A thesis statement expresses the essay’s primary idea or central argument.

Hook : Depression is a widespread mental illness affecting millions worldwide.

Background information : Depression affects your emotions, thoughts, and behavior. If you suffer from depression, engaging in everyday tasks might become arduous, and life may appear devoid of purpose or joy.

Depression Essay Thesis Statement

A good thesis statement serves as an essay’s road map. It expresses the author’s point of view on the issue in 1 or 2 sentences and presents the main argument.

Thesis statement : The stigma surrounding depression and other mental health conditions can discourage people from seeking help, only worsening their symptoms.

Essays on Depression: Body Paragraphs

The main body of the essay is where you present your arguments. An essay paragraph includes the following:

• a topic sentence,
• evidence to back up your claim,
• explanation of why the point is essential to the argument;
• a link to the next paragraph.

Topic sentence : Depression is a complex disorder that requires a personalized treatment approach, comprising both medication and therapy.

Evidence : Medication can be prescribed by a healthcare provider or a psychiatrist to relieve the symptoms. Additionally, practical strategies for managing depression encompass building a support system, setting achievable goals, and practicing self-care.

Depression Essay: Conclusion

The conclusion is the last part of your essay. It helps you leave a favorable impression on the reader.

The perfect conclusion includes 3 elements:

• Rephrased thesis statement.
• Summary of the main points.
• Final opinion on the topic.

Rephrased thesis: In conclusion, overcoming depression is challenging because it involves a complex interplay of biological, psychological, and environmental factors that affect an individual’s mental well-being.

Summary: Untreated depression heightens the risk of engaging in harmful behaviors such as substance abuse and can also result in negative thought patterns, diminished self-esteem, and distorted perceptions of reality.

We hope you’ve found our article helpful and learned some new information. If so, feel free to share it with your friends. You can also try our free online topic generator !

• Pain, anxiety, and depression – Harvard Health | Harvard Health Publishing
• Depression-related increases and decreases in appetite reveal dissociable patterns of aberrant activity in reward and interoceptive neurocircuitry – PMC | National Library of Medicine
• How to Get Treatment for Postpartum Depression – The New York Times
• What Is Background Information and What Purpose Does It Serve? | Indeed.com
• Thesis | Harvard College Writing Center
• Topic Sentences: How Do You Write a Great One? | Grammarly Blog

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Effects of music therapy on depression: A meta-analysis of randomized controlled trials

Qishou tang.

1 Bengbu Medical University, Bengbu, Anhui, China

Zhaohui Huang

2 Anhui Provincial Center for Women and Child Health, Hefei, Anhui, China

3 National Drug Clinical Trial Institution, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China

Associated Data

All relevant data are within the manuscript and its Supporting Information files.

We aimed to determine and compare the effects of music therapy and music medicine on depression, and explore the potential factors associated with the effect.

PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies evaluating the effectiveness of music-based intervention on depression from inception to May 2020. Standardized mean differences (SMDs) were estimated with random-effect model and fixed-effect model.

A total of 55 RCTs were included in our meta-analysis. Music therapy exhibited a significant reduction in depressive symptom (SMD = −0.66; 95% CI = -0.86 to -0.46; P <0.001) compared with the control group; while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P <0.001). Among the specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P <0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P <0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P <0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively. Music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods.

Conclusions

A different effect of music therapy and music medicine on depression was observed in our present meta-analysis, and the effect might be affected by the therapy process.

Introduction

Depression was reported to be a common mental disorders and affected more than 300 million people worldwide, and long-lasting depression with moderate or severe intensity may result in serious health problems [ 1 ]. Depression has become the leading causes of disability worldwide according to the recent World Health Organization (WHO) report. Even worse, depression was closely associated with suicide and became the second leading cause of death, and nearly 800 000 die of depression every year worldwide [ 1 , 2 ]. Although it is known that treatments for depression, more than 3/4 of people in low and middle-income income countries receive no treatment due to a lack of medical resources and the social stigma of mental disorders [ 3 ]. Considering the continuously increased disease burden of depression, a convenient effective therapeutic measures was needed at community level.

Music-based interventions is an important nonpharmacological intervention used in the treatment of psychiatric and behavioral disorders, and the obvious curative effect on depression has been observed. Prior meta-analyses have reported an obvious effect of music therapy on improving depression [ 4 , 5 ]. Today, it is widely accepted that the music-based interventions are divided into two major categories, namely music therapy and music medicine. According to the American Music Therapy Association (AMTA), “music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program” [ 6 ]. Therefore, music therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals, and includes the triad of music, clients and qualified music therapists. While, music medicine is defined as mainly listening to prerecorded music provided by medical personnel or rarely listening to live music. In other words, music medicine aims to use music like medicines. It is often managed by a medical professional other than a music therapist, and it doesn’t need a therapeutic relationship with the patients. Therefore, the essential difference between music therapy and music medicine is about whether a therapeutic relationship is developed between a trained music therapist and the client [ 7 – 9 ]. In the context of the clear distinction between these two major categories, it is clear that to evaluate the effects of music therapy and other music-based intervention studies on depression can be misleading. While, the distinction was not always clear in most of prior papers, and no meta-analysis comparing the effects of music therapy and music medicine was conducted. Just a few studies made a comparison of music-based interventions on psychological outcomes between music therapy and music medicine. We aimed to (1) compare the effect between music therapy and music medicine on depression; (2) compare the effect between different specific methods used in music therapy; (3) compare the effect of music-based interventions on depression among different population [ 7 , 8 ].

Materials and methods

Search strategy and selection criteria.

PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies assessing the effectiveness of music therapy on depression from inception to May 2020. The combination of “depress*” and “music*” was used to search potential papers from these databases. Besides searching for electronic databases, we also searched potential papers from the reference lists of included papers, relevant reviews, and previous meta-analyses. The criteria for selecting the papers were as follows:(1) randomised or quasi-randomised controlled trials; (2) music therapy at a hospital or community, whereas the control group not receiving any type of music therapy; (3) depression rating scale was used. The exclusive criteria were as follows: (1) non-human studies; (2) studies with a very small sample size (n<20); (3) studies not providing usable data (including sample size, mean, standard deviation, etc.); (4) reviews, letters, protocols, etc. Two authors independently (YPJ, HZH) searched and screened the relevant papers. EndNote X7 software was utilized to delete the duplicates. The titles and abstracts of all searched papers were checked for eligibility. The relevant papers were selected, and then the full-text papers were subsequently assessed by the same two authors. In the last, a panel meeting was convened for resolving the disagreements about the inclusion of the papers.

Data extraction

We developed a data abstraction form to extract the useful data: (1) the characteristics of papers (authors, publish year, country); (2) the characteristics of participators (sample size, mean age, sex ratio, pre-treatment diagnosis, study period); (3) study design (random allocation, allocation concealment, masking, selection process of participators, loss to follow-up); (4) music therapy process (music therapy method, music therapy period, music therapy frequency, minutes per session, and the treatment measures in the control group); (5) outcome measures (depression score). Two authors independently (TQS, ZH) abstracted the data, and disagreements were resolved by discussing with the third author (YPJ).

Assessment of risk of bias in included studies

Two authors independently (TQS, ZH) assessed the risk of bias of included studies using Cochrane Collaboration’s risk of bias assessment tool, and disagreements were resolved by discussing with the third author (YPJ) [ 10 ].

Music therapy and music medicine

Music Therapy is defined as the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Music medicine is defined as mainly listening to prerecorded music provided by medical personnel or rarely listening to live music. In other words, music medicine aims to use music like medicines.

Music therapy mainly divided into active music therapy and receptive music therapy. Active music therapy, including improvisational, re-creative, and compositional, is defined as playing musical instruments, singing, improvisation, and lyrics of adaptation. Receptive music therapy, including music-assisted relaxation, music and imagery, guided imagery and music, lyrics analysis, and so on, is defined as music listening, lyrics analysis, and drawing with musing. In other words, in active methods participants are making music, and in receptive music therapy participants are receiving music [ 6 , 7 , 9 , 11 – 13 ].

Evaluation of depression

Depression was evaluated by the common psychological scales, including Beck Depression Inventory (BDI), Children’s Depression Inventory (CDI), Center for Epidemiologic Studies Depression (CES-D), Cornell Scale (CS), Depression Mood Self-Report Inventory for Adolescence (DMSRIA), Geriatric Depression Scale-15 (GDS-15); Geriatric Depression Scale-30 (GDS-30), Hospital Anxiety and Depression Scale (HADS), Hamilton Rating Scale for Depression (HRSD/HAMD), Montgomery-sberg Depression Rating Scale (MADRS), Patient Reported Outcomes Measurement Information System (PROMIS), Self-Rating Depression Scale (SDS), Short Version of Profile of Mood States (SV-POMS).

Statistical analysis

The pooled effect were estimated by using the standardized mean differences (SMDs) and its 95% confidence interval (95% CI) due to the different depression rate scales were used in the included papers. Heterogeneity between studies was assessed by I-square ( I 2 ) and Q-statistic (P<0.10), and a high I 2 (>50%) was recognized as heterogeneity and a random-effect model was used [ 14 – 16 ]. We performed subgroup analyses and meta-regression analyses to study the potential heterogeneity between studies. The subgroup variables included music intervention categories (music therapy and music medicine), music therapy methods (active music therapy, receptive music therapy), specific receptive music therapy methods (music-assisted relaxation, music and imagery, and guided imagery and music (Bonny Method), specific active music therapy methods (recreative music therapy and improvisational music therapy), music therapy mode (group therapy, individual therapy), music therapy period (weeks) (2–4, 5–12, ≥13), music therapy frequency (once weekly, twice weekly, ≥3 times weekly), total music therapy sessions (1–4, 5–8, 9–12, 13–16, >16), time per session (minutes) (15–40, 41–60, >60), inpatient settings (secure [locked] unit at a mental health facility versus outpatient settings), sample size (20–50, ≥50 and <100, ≥100), female predominance(>80%) (no, yes), mean age (years) (<50, 50–65, >65), country having music therapy profession (no, yes), pre-treatment diagnosis (mental health, depression, severe mental disease/psychiatric disorder). We also performed sensitivity analyses to test the robustness of the results by re-estimating the pooled effects using fixed effect model, using trim and fill analysis, excluding the paper without information on music therapy, excluding the papers with more high biases, excluding the papers with small sample size (20< n<30), excluding the papers using an infrequently used scale, excluding the studies focused on the people with a severe mental disease. We investigated the publication biases by a funnel plot as well as Egger’s linear regression test [ 17 ]. The analyses were performed using Stata, version 11.0. All P-values were two-sided. A P-value of less than 0.05 was considered to be statistically significant.

Characteristics of the eligible studies

Fig 1 depicts the study profile, and a total of 55 RCTs were included in our meta-analysis [ 18 – 72 ]. Of the 55 studies, 10 studies from America, 22 studies from Europe, 22 studies from Asia, and 1 study from Australia. The mean age of the participators ranged from 12 to 86; the sample size ranged from 20 to 242. A total of 16 different scales were used to evaluate the depression level of the participators. A total of 25 studies were conducted in impatient setting and 28 studies were in outpatients setting; 32 used a certified music therapist, 15 not used a certified music therapist (for example researcher, nurse), and 10 not reported relevent information. A total of 16 different depression rating scales were used in the included studies, and HADS, GDS, and BDI were the most frequently used scales ( Table 1 ).

PRISMA diagram showing the different steps of systematic review, starting from literature search to study selection and exclusion. At each step, the reasons for exclusion are indicated. Doi: 10.1371/journal.pone.0052562.g001.

Note: BDI = Beck Depression Inventory; CDI = Children’s Depression Inventory; CDSS = depression scale for schizophrenia; CES-D = Center for Epidemiologic Studies Depression; CS = Cornell Scale; DMSRIA = Depression Mood Self-Report Inventory for Adolescence; EPDS = Edinburgh Postnatal Depression Scale; GDS-15 = Geriatric Depression Scale-15; GDS-30 = Geriatric Depression Scale-30; HADS = Hospital Anxiety and Depression Scale; HRSD (HAMD) = Hamilton Rating Scale for Depression; MADRS = Montgomery-sberg Depression Rating Scale; PROMIS = Patient Reported Outcomes Measurement Information System; SDS = Self-Rating Depression Scale; State-Trait Depression Questionnaire = ST/DEP; SV-POMS = short version of Profile of Mood States; NA = not available.

Of the 55 studies, only 2 studies had high risks of selection bias, and almost all of the included studies had high risks of performance bias ( Fig 2 ).

The overall effects of music therapy

Of the included 55 studies, 39 studies evaluated the music therapy, 17 evaluated the music medicine. Using a random-effects model, music therapy was associated with a significant reduction in depressive symptoms with a moderate-sized mean effect (SMD = −0.66; 95% CI = -0.86 to -0.46; P <0.001), with a high heterogeneity across studies ( I 2 = 83%, P <0.001); while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P <0.001) ( Fig 3 ).

Twenty studies evaluated the active music therapy using a random-effects model, and a moderate-sized mean effect (SMD = −0.57; 95% CI = -0.90 to -0.25; P <0.001) was observed with a high heterogeneity across studies ( I 2 = 86.3%, P <0.001). Fourteen studies evaluated the receptive music therapy using a random-effects model, and a moderate-sized mean effect (SMD = −0.73; 95% CI = -1.01 to -0.44; P <0.001) was observed with a high heterogeneity across studies ( I 2 = 76.3%, P <0.001). Five studies evaluated the combined effect of active and receptive music therapy using a random-effects model, and a moderate-sized mean effect (SMD = −0.88; 95% CI = -1.32 to -0.44; P <0.001) was observed with a high heterogeneity across studies ( I 2 = 70.5%, P <0.001) ( Fig 4 ).

Among specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P <0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P <0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P <0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), and music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively ( Fig 5 ).

Sub-group analyses and meta-regression analyses

We performed sub-group analyses and meta-regression analyses to study the homogeneity. We found that music therapy yielded a superior effect on reducing depression in the studies with a small sample size (20–50), with a mean age of 50–65 years old, with medium intervention frequency (<3 times weekly), with more minutes per session (>60 minutes). We also found that music therapy exhibited a superior effect on reducing depression among people with severe mental disease /psychiatric disorder and depression compared with mental health people. While, whether the country have the music therapy profession, whether the study used group therapy or individual therapy, whether the study was in the outpatients setting or the inpatient setting, and whether the study used a certified music therapist all did not exhibit a remarkable different effect ( Table 2 ). Table 2 also presents the subgroup analysis of music medicine on reducing depression.

In the subgroup analysis by total session, music therapy and music medicine both exhibited a stronger effects of short (1–4 sessions) and medium length (5–12 sessions) compared with long intervention periods (>13sessions) ( Fig 6 ). Meta-regression demonstrated that total music intervention session was significantly associated with the homogeneity between studies ( P = 0.004) ( Table 3 ).

A, evaluating the effect of music therapy; B, evaluating the effect of music medicine.

Sensitivity analyses

We performed sensitivity analyses and found that re-estimating the pooled effects using fixed effect model, using trim and fill analysis, excluding the paper without information regarding music therapy, excluding the papers with more high biases, excluding the papers with small sample size (20< n<30), excluding the studies focused on the people with a severe mental disease, and excluding the papers using an infrequently used scale yielded the similar results, which indicated that the primary results was robust ( Table 4 ).

Evaluation of publication bias

We assessed publication bias using Egger’s linear regression test and funnel plot, and the results are presented in Fig 7 . For the main result, the observed asymmetry indicated that either the absence of papers with negative results or publication bias.

A, evaluating the publication bias of music therapy; B, evaluating the publication bias of music medicine; BDI = Beck Depression Inventory; CDI = Children’s Depression Inventory; CDSS = depression scale for schizophrenia; CES-D = Center for Epidemiologic Studies Depression; CS = Cornell Scale; DMSRIA = Depression Mood Self-Report Inventory for Adolescence; EPDS = Edinburgh Postnatal Depression Scale; GDS-15 = Geriatric Depression Scale-15; GDS-30 = Geriatric Depression Scale-30; HADS = Hospital Anxiety and Depression Scale; HRSD (HAMD) = Hamilton Rating Scale for Depression; MADRS = Montgomery-sberg Depression Rating Scale; PROMIS = Patient Reported Outcomes Measurement Information System; SDS = Self-Rating Depression Scale; State-Trait Depression Questionnaire = ST/DEP; SV-POMS = short version of Profile of Mood Stat.

Our present meta-analysis exhibited a different effect of music therapy and music medicine on reducing depression. Different music therapy methods also exhibited a different effect, and the recreative music therapy and guided imagery and music yielded a superior effect on reducing depression compared with other music therapy methods. Furthermore, music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods. The strength of this meta-analysis was the stable and high-quality result. Firstly, the sensitivity analyses performed in this meta-analysis yielded similar results, which indicated that the primary results were robust. Secondly, considering the insufficient statistical power of small sample size, we excluded studies with a very small sample size (n<20).

Some prior reviews have evaluated the effects of music therapy for reducing depression. These reviews found a significant effectiveness of music therapy on reducing depression among older adults with depressive symptoms, people with dementia, puerpera, and people with cancers [ 4 , 5 , 73 – 76 ]. However, these reviews did not differentiate music therapy from music medicine. Another paper reviewed the effectiveness of music interventions in treating depression. The authors included 26 studies and found a signifiant reduction in depression in the music intervention group compared with the control group. The authors made a clear distinction on the definition of music therapy and music medicine; however, they did not include all relevant data from the most recent trials and did not conduct a meta-analysis [ 77 ]. A recent meta-analysis compared the effects of music therapy and music medicine for reducing depression in people with cancer with seven RCTs; the authors found a moderately strong, positive impact of music intervention on depression, but found no difference between music therapy and music medicine [ 78 ]. However, our present meta-analysis exhibited a different effect of music therapy and music medicine on reducing depression, and the music medicine yielded a superior effect on reducing depression compared with music therapy. The different effect of music therapy and music medicine might be explained by the different participators, and nine studies used music therapy to reduce the depression among people with severe mental disease /psychiatric disorder, while no study used music medicine. Furthermore, the studies evaluating music therapy used more clinical diagnostic scale for depressive symptoms.

A meta-analysis by Li et al. [ 74 ] suggested that medium-term music therapy (6–12 weeks) was significantly associated with improved depression in people with dementia, but not short-term music therapy (3 or 4 weeks). On the contrary, our present meta-analysis found a stronger effect of short-term (1–4 weeks) and medium-term (5–12 weeks) music therapy on reducing depression compared with long-term (≥13 weeks) music therapy. Consistent with the prior meta-analysis by Li et al., no significant effect on depression was observed for the follow-up of one or three months after music therapy was completed in our present meta-analysis. Only five studies analyzed the therapeutic effect for the follow-up periods after music therapy intervention therapy was completed, and the rather limited sample size may have resulted in this insignificant difference. Therefore, whether the therapeutic effect was maintained in reducing depression when music therapy was discontinued should be explored in further studies. In our present meta-analysis, meta-regression results demonstrated that no variables (including period, frequency, method, populations, and so on) were significantly associated with the effect of music therapy. Because meta-regression does not provide sufficient statistical power to detect small associations, the non-significant results do not completely exclude the potential effects of the analyzed variables. Therefore, meta-regression results should be interpreted with caution.

Our meta-analysis has limitations. First, the included studies rarely used masked methodology due to the nature of music therapy, therefore the performance bias and the detection bias was common in music intervention study. Second, a total of 13 different scales were used to evaluate the depression level of the participators, which may account for the high heterogeneity among the trials. Third, more than half of those included studies had small sample sizes (<50), therefore the result should be explicated with caution.

Our present meta-analysis of 55 RCTs revealed a different effect of music therapy and music medicine, and different music therapy methods also exhibited a different effect. The results of subgroup analyses revealed that the characters of music therapy were associated with the therapeutic effect, for example specific music therapy methods, short and medium-term therapy, and therapy with more time per session may yield stronger therapeutic effect. Therefore, our present meta-analysis could provide suggestion for clinicians and policymakers to design therapeutic schedule of appropriate lengths to reduce depression.

Supporting information

S1 checklist, funding statement.

The Key Project of University Humanities and Social Science Research in Anhui Province (SK2017A0191) was granted by Education Department of Anhui Province; the Research Project of Anhui Province Social Science Innovation Development (2018XF155) was granted by Anhui Provincial Federation of Social Sciences; the Ministry of Education Humanities and Social Sciences Research Youth fund Project (17YJC840033) was granted by Ministry of Education of the People’s Republic of China. These funders had a role in study design, text editing, interpretation of results, decision to publish and preparation of the manuscript.

Data Availability

• PLoS One. 2020; 15(11): e0240862.

Decision Letter 0

PONE-D-20-17706

Effects of music therapy on depression: a meta-analysis of randomized controlled trials

Dear Dr. Ye,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Additional Editor Comments:

Dear Author,

Thank you for your valuable submission. I think it would be appropriate to emphasize the main problem first. Various musical interventions are used in medical settings to improve the patient's well-being, and of course, there are many publications on this subject. However, it is important to properly differentiate between these interventions for some important reasons I have pointed out below.

The music therapy definition you made, as "Music therapy was defined as music therapy provided by a qualified music teacher, psychological therapist, or nurse" is not universally accepted specific definition for music therapy. Moreover, the specific methods used in receptive music therapy include music-assisted relaxation, music and imagery, and Guided Imagery and Music (Bonny Method). Each of these may have different levels of effects on depression. It is not clear that which receptive music therapy studies in your review have used which of these methods. So, the majority of studies that you accepted as the receptive music therapy seems to be music medicine studies indeed. Similar critiques may also be apply to some of the studies you describe as active music therapy. Today, it is widely accepted that these music-based interventions should be divided into two major categories, namely music therapy (MT) and music medicine (MM). MM mainly based on patients' pre-recorded or rarely listening to live music and the direct effects of the music they listen to. In other words, MM aims to use music like medicines. It often managed by a medical professional other than a music therapist, and not needed a therapeutic relationship with the patients. Conversely, music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed music therapist who has completed an approved music therapy program. So, music therapy is a relational, interaction based form of therapy within a therapeutic relationship between the therapist and the client, and includes the triad of the music, the client and the music therapist. Since music therapy interventions is an evidence-based procedure using special music therapy methods of interventions and a more pragmatic approach than other music-based interventions, their effect levels and results are also different.

In the context of the above mentioned explanations, it is clear that to evaluate the effects of music therapy and other music based intervention studies together on depression can be misleading. The subjects I have mentioned so far have never been addressed in the introduction and discussion sections of your manuscript. I think that will be perceived as a major deficiency at least by the readers who are closer to the subject. In this sense, I think that an attentive revision considering the following views will be valuable and needed:

- The universally accepted definitions of music therapy (including active and receptive music therapy) and music medicine should be taken into account.

- It should be clarified that how many studies in your review did included a certified music therapist.

- Analyses, results and discussion should be submitted to the readers in accordance with all this distinctions and definitions. (The way to this seems to be to compare the effects of music medicine and music therapy on depression in parallel with the possible differences of music interventions used, and to discuss their possible implications on the results.)

- Another important point is that you did not mention nor discuss any of important reviews on same subject (for example please see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858. {"type":"entrez-nucleotide","attrs":{"text":"CD004517","term_id":"30321255","term_text":"CD004517"}} CD004517 .pub3/epdf/full or https://www.frontiersin.org/articles/10.3389/fpsyg.2017.01109/full or https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858. {"type":"entrez-nucleotide","attrs":{"text":"CD006911","term_id":"30323649","term_text":"CD006911"}} CD006911 .pub3/full)

I am aware that such a major revision will, in a sense, be a challenging way that may require a new analysis of your data. However, I believe you would appreciate that a study aimed at shedding light on potential music-based interventions in an important public health problem such as depression should not be misleading.

Thank you for your effort in advance.

Besides, according to the statistical reviewer who only reviewed the statistical approach used in this paper, there are two caveats:

1. The authors state that they excluded studies with fewer than 20 participants in one place in the paper (page 4), but fewer than 30 participants in another place in the paper (Table 4). This needs to be corrected for consistency.

2. The authors mention stronger effects of short and medium length vs. long music therapy periods in their results but there is no accompanying figure. I think it would be beneficial to show these findings in a figure (Forest plot).

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Research in Anhui Province (SK2017A0191), Research Project of Anhui Province Social Science

Innovation Development (2018XF155), Ministry of Education Humanities and Social Sciences

Research Youth fund Project (17YJC840033)."

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Partly

Reviewer #3: Yes

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: No

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Reviewer #2: Yes

4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Thank you for conducting this research and submitting it for publication consideration.

I recognize that English may not be the primary language of the authors. There are a few instances where the language could be improved, but that is mostly a copy-editing issue. There is also a lot of passive voice in the paper. I recommend making the voice active. This will enhance the readability of the paper.

I have a few comments that I hope will improve the paper.

1. Not all countries have an established music therapy profession. I recognize that this creates challenges for the authors! I'm wondering if the authors might consider including this as a factor in the analysis? For example, if a nurse provides "music therapy" in a country that does not have music therapy as a profession, is the effect equivalent as when a qualified music therapist in a country that has music therapy as a profession provides it? This might provide some incentive for occupational regulation and establishing professional music therapy associations.

2. please fix the "short title" (oxygen)

3. Music therapy with fewer minutes might yield superior effects. This may be misleading. Is there a minimum number of minutes? How many minutes might be optimal for therapeutic outcome? I believe it does make sense that longer sessions may result in less impact - quantity/duration does not always result in enhanced outcome.

4. I believe a stronger case needs to be made for the study. There are existing meta-analyses of MT for depression (Aalbers et al., 2017 Cochrane Review). What makes the current study unique and different? What are the gaps in the literature that warrant this study? Have there been a lot of recent additions to the literature that warrant a new meta-analysis?

5. A stronger discussion of the limitation of this study. Many studies did not evaluate a group with major depression/major depressive disorder (music therapy for chronic pain is important, but the variance of the populations under study does constitute a limitation). So, this study is not exclusive to adults with a major mental health condition. Might effects be different for people who are depressed versus people who are not depressed?

6. Instead of "blinding/blinded" please use "masking/masked."

7. Is there a citation that supports your classification of active versus receptive? (I would think Bruscia would be a good place to start with that...)

8. One item that I am not seeing is group therapy versus individual therapy. Did the authors screen for that? If so, is there an optimal group size? Are effects stronger when in a group format versus an individual format? This would have serious implications for clinical practice.

9. What about inpatient settings (such as a secure [locked] unit at a mental health facility) versus outpatient settings?

10. One item that I believe is missing is the dose. Not necessarily the duration (number of minutes) of each session, but the total number of sessions a participant has received. Gold has done some work in this area. Is there is a certain number of sessions that are needed to reach a therapeutic outcome? The number of sessions/week is good, but the number of total sessions is important.

11. Table 1 has the mean age. I recommend including the SD as well.

Thank you for taking the time to consider these suggestions. While receiving critical feedback can be difficult, please understand that my intentions are to improve the paper and ensure it has maximum impact. This is an important addition to the literature and I am grateful to the authors for their scholarship. I wish you the best!

Reviewer #2: This article addresses an important topic that is of interest to music therapists, psychiatrists and teachers and metal health practitioners. The statistics look promising. However, the major concern is that the definition of music therapy is theoretically and practically incorrect and misleading:

"7 Music therapy was defined as music therapy provided by a qualified music teacher, psychological

8 therapist, or nurse. " The study is missing several research studies that I am aware of and this makes its content suspicious. Also missing is a more depth-ful analysis of what active and passive music therapy is, and if it is indeed performed by those in other professions who have no training in 'musuc therapy;'-than the contents and findings are misleading and irrelevant.

Reviewer #3: I only reviewed the statistical approach used in this paper, which appeared appropriate for the research question under study. There are two caveats:

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Reviewer #1: No

Reviewer #3: No

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Author response to Decision Letter 0

29 Sep 2020

Response to Reviewers

Dear Editors and Reviewers:

Thank you for your letter and for the reviewers’ comments concerning our manuscript entitled " Effects of music therapy on depression: a meta-analysis of randomized controlled trials (PONE-D-20-17706)".

Those comments are all valuable and very helpful for revising and improving our paper, as well as the important guiding significance to our researches. We have studied comments carefully and have made revision which we hope meet with approval. All the revised portions were marked in red font in the new document. The main corrections in the paper and the responds to the reviewer’s comments are as flowing:

Response：We have studied comments carefully and revised the manuscript extensively according to the reviewer’s comments.

Firstly, We have amended the music therapy definition mainly based on the World Federation of Music Therapy (WFMT) and The American Music Therapy Association (AMTA), WFMT defines music therapy as “the professional use of music and its elements as an intervention inmedical, educational, and everyday environments with individuals, groups, families, or communities who seek to optimize their quality of life and improve their physical, social,communicative, emotional, intellectual, and spiritual health and wellbeing”. AMTA defines music therapy as “Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).][van der Steen, J. T., et al. (2017). "Music-based therapeutic interventions for people with dementia." Cochrane Database Syst Rev 5: {"type":"entrez-nucleotide","attrs":{"text":"CD003477","term_id":"30320215","term_text":"CD003477"}} CD003477 .]

Secondly, we have re-studed all included papers carefully and added the specific intervention methods of each paper in table 1 (Table 1. Characteristics of clinical trials included in this meta-analysis). Two main types of music therapy were distinguished in our present study - receptive (or passive) and active music therapy. The specific methods used in receptive music therapy in our included papers including music-assisted relaxation, music and imagery, and guided imagery and music (Bonny Method), while the specific methods used in active music therapy included recreative music therapy, improvisational music therapy, song writing, and so on.

Thirdly, we have added some contents regarding the distinction between music therapy and music medicine in introduction and discussion sections of our manuscript.

The following contents are added in introduction section, “Today, it is widely accepted that the music-based interventions should be divided into two major categories, namely music therapy and music medicine. According to the American Music Therapy Association (AMTA), “music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”. Therefore, music therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individualst, and includes the triad of the music, the client and the qualified music therapist. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).] While, music medicine is defined as mainly listening to prerecorded music provided by medical personnel or rarely listening to live music. In other words, music medicine aims to use music like medicines. It often managed by a medical professional other than a music therapist, and not needed a therapeutic relationship with the patients. Therefore, the essential difference of music therapy and music medicine is whether a therapeutic relationship is developed between a trained music therapist and the client.

[Bradt, J., et al. (2015). "The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 23(5): 1261-1271.

[Yinger, O. S. and L. Gooding (2014). "Music therapy and music medicine for children and adolescents." Child and adolescent psychiatric clinics of North America 23(3): 535-553.]

【Tony Wigram．Inge Nyggard Pedersen＆Lars Ole Bonde，A Compmhensire Guide to Music Therapy．London and Philadelphia：Jessica Kingsley Publishen．2002：143．】

In the context of the clear distinction between these two major cagerories, it is clear that to evaluate the effects of music therapy and other music based intervention studies together on depression can be misleading. While, the distinction was not always clear in most of prior papers, and we found that no meta-analysis comparing the effects of music therapy and music medicine was conducted. Just a few studies made a comparison of music-based interventions on psychological outcomes between music therapy and music medicine. We aimed to (1) compare the effect between music therapy and music medicine on depression; (2) compare the effect between different specific methods used inmusic therapy on depression; (3) compare the effect of music-based interventions on depression among different population.

[Bradt, J., et al. (2015). "The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 23(5): 1261-1271.[Yinger, O. S. and L. Gooding (2014). "Music therapy and music medicine for children and adolescents." Child and adolescent psychiatric clinics of North America 23(3): 535-553.]

The last, we have made a new analysis of our data. 1) including three new papers and re-analying of our data, 2) adding the comparison of music therapy and music medicine, 3) adding the comparison of impatient setting and outpatients setting, 4) adding the comparison of depressed people and not depressed people, 5）adding the comparison of countries have having music therapy profession and not, 6) adding the comparison of group therapy and individual therapy, 7) added the comparison of different intervention dose, and so on.

Response: (1)We have amended the of definitions of music therapy. The revised difinitons of music therapy was “Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).]

We have added some contents on the distinction between music therapy (MT) and music medicine (MM) in introduction and discussion sections of our manuscript.

We have added the analysis of the comparion of music therapy (MT) and music medicine (MM) in Methord and Results sections

Response: we have re-studed all included papers carefully and added a new varible (Intervenor or therapist) into table 1, and the corresponding description was addded in the results section. Of 55 studies, 32 used a certified music therapist, 15 not used a certified music therapist (for example researcher, nurse), and 10 not reported relevent information.

Response: We have divided music-based interventions into two major categories, namely music therapy and music medicine according to the difinition. With respect to specific methods used in music therapy, we also have divided music therapy into receptive (or passive) and active music therapy. The specific methods used in receptive music therapy in our included papers including music-assisted relaxation, music and imagery, and guided imagery and music (Bonny Method), and the specific methods used in active music therapy included recreative music therapy and improvisational music therapy.

We have added some sub-group analyses by different music intervention categories, different music therapy categories, and specific music therapy methords.

The the above mentioned content have been added to Intruduction Analyses, results and discussion section.

Response: we are very sorry for not mentioning these important reviews. We have studied these reviews carefully and discussed these reviews in Discussion sections.

Some prior reviews have evaluated the effects of music therapy for reducing depression. Aalbers and colleagues included nine studies in their review; they concluded that music therapy provides short-term benefificial effects for people with depression, and suggested that high-quality trials with large sample size were needed. However, this review was limited to studies of individuals with a diagnosis of depression, and did not differentiate music therapy from music medicine. Another paper reviewed the effectiveness of music interventions in treating depression. The authors included 26 studies and found a signifiant reduction in depression in the music intervention group compared with the controp group. The authors made a clear distincition on the definition of music therapy and music medicine; however, they did not include all relevant data from the most recent trials and did not conduct a meta-analysis. A recent meta-analysis compared the effects of music therapy and music medicine for reducing depression in people with cancer with seven RCTs; the authors found a moderately strong, positive impact of music intervention on depression , but found no difference between music therapy and music medicine.

【Aalbers, S., et al. (2017). "Music therapy for depression." Cochrane Database Syst Rev 11: {"type":"entrez-nucleotide","attrs":{"text":"CD004517","term_id":"30321255","term_text":"CD004517"}} CD004517 .】

【Leubner, D. and T. Hinterberger (2017). "Reviewing the Effectiveness of Music Interventions in Treating Depression." Front Psychol 8: 1109.】

【Bradt, J., et al. (2016). "Music interventions for improving psychological and physical outcomes in cancer patients." Cochrane Database Syst Rev(8): {"type":"entrez-nucleotide","attrs":{"text":"CD006911","term_id":"30323649","term_text":"CD006911"}} CD006911 .】

To date, many new trials focued on music therapy and depression in differnt poupulation (such as people with cancer, people with dementia, people with chronic disease, and so on ) have been performed, but they have not yet been systematically reviewed.

Response: Those comments are all valuable and very helpful for revising and improving our paper, as well as the important guiding significance to our researches. We have studied comments carefully and have made revision according to the comments.

Response: We are sorry for making this mistake. In the Methord section, we defined exclusive criteria as studies with a very small sample size (n<20),while in table 4 we performed the sensitivity analyses by excluding the papers with smale sample size ( 20< n<30). We have amended the table 4.

Response: We have added these findings with a forest plot (figure 6) according to the comment.

 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

Response: We have amended our manuscript according to PLOS ONE's style requirements

Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files.

Response: We have adjusted these content according to the comment.

 3. Thank you for stating the following in the Acknowledgments Section of your manuscript:

Response: We would like to update our funding statement as follows: The funders had a role in study design, text editing, interpretation of results, decision to publish and preparation of the manuscript.

4.LOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ

Response: We have created a new ORCID iD accordingly to your instructions.

Response: we are sorry for making this mistake, we have amended our list of authors on the manuscript accordingly.

Response: We have checked the refer to Figure 5 and found that the refer to figure 5 was a mistake, and we have amended it.

7. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information:  http://journals.plos.org/plosone/s/supporting-information .

 Response: we only have a Supporting Information files (PRISMA-2009-Checklist), and we have added the captions for this Supporting Information files accordingly. We also have updated in-text citations to match accordingly.

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Response: Thinks very much for your comment.

Response: Thinks very much for your comment. Our manuscript have been edited for proper English language, grammar, punctuation, spelling, and overall style by one qualified native English speaking editors.

Response: This suggestion is valuable and we have tried to judge if the countries in our inluded papers have an established music therapy profession by checking the author's work address, literature review, visiting the important website about music therapy, and consulting to some famous music therapist via emails. The following table showed that four countries may be not have a music therapy profession. We have added the comparison of the country having music therapy profession and not.

https://erikdalton.com/find-a-certified-therapist/

https://www.musictherapy.org/about/listserv/

Table 1. The information on the music therapy profession in the inluded papers

Country Country having music therapy profession

Korea Korean Music Therapy Association

South Korea Korean Music Therapy Association

UK British Association for Music Therapy

Australia Australian Music Therapy Association

Canada Canadian Association of Music Therapists

China Chinese Professional Music Therapist Association

Taiwan China Chinese Professional Music Therapist Association

Denmark Dansk forbund for musikterapie

Finland Finnish Society for Music Therapy

Hong Kong China Hong Kong Music Therapy and Counseling Association

Serbia Music Therapists of Serbia organize workshops

Switzerland Swiss Association of Music Therapy

USA The American Music Therapy Association

Singapore The Association for Music Therapy (Singapore)

Brazil Uniao Braileira Das Associacoes De Musicoterapia

Germany YES

Northern Ireland YES

Spanish YES

Venezuela No

2.please fix the "short title" (oxygen)

Response: We’re sorry for making this mistake, and we have corrected this mistake.

Music therapy with fewer minutes might yield superior effects. This may be misleading. Is there a minimum number of minutes? How many minutes might be optimal for therapeutic outcome? I believe it does make sense that longer sessions may result in less impact - quantity/duration does not always result in enhanced outcome.

Response: In 33 included trials, intervention time each session was different, the mimimum time was 15 minutes in only one study (Burrai et al., 2019b), followed by 20 minuters in four studies (Chirico et al., 2020; Guétin et al., 2009; Hanser et al., 1994; Sigurdardóttir et al., 2019). In our subgroup analysis by time per session (minutes), we divided time per session into three groups, namely 15-40, 41-60, >60, and this presentation might be unclear.

In order to respond this comment, we have re-divided the time per session into four groups, namely 15-40, 41-60, 61-120, to explore the optimal minuter per session for therapeutic outcome.

I believe a stronger case needs to be made for the study. There are existing meta-analyses of MT for depression (Aalbers et al., 2017 Cochrane Review). What makes the current study unique and different? What are the gaps in the literature that warrant this study? Have there been a lot of recent additions to the literature that warrant a new meta-analysis?

Response: Some prior reviews have evaluated the effects of music therapy for reducing depression. Aalbers and colleagues (Aalbers et al., 2017）included nine studies in their review; they concluded that music therapy provides short-term benefificial effects for people with depression, and suggested that high-quality trials with large sample size were needed. However, this review was limited to studies of individuals with a diagnosis of depression, and did not differentiate music therapy from music medicine.

Another paper reviewed the effectiveness of music interventions in treating depression. The authors (Leubner D., 2017) included 26 studies and found a signifiant reduction in depression in the music intervention group compared with the controp group. The authors made a clear distincition on the definition of music therapy and music medicine; however, they did not include all relevant data from the most recent trials and did not conduct a meta-analysis. A recent meta-analysis (Bradt et al., 2016) compared the effects of music therapy and music medicine for reducing depression with seven RCTs; the authors found a moderately strong, positive impact of music intervention on depression , but found no difference between music therapy and music medicine. However, this review was limited to studies of individuals with a diagnosis of cancer.

Figure 1 presents the number of published paper ( search from Pubmed) focued on music therapy and depression from 1983 to 2020, the published paper was in the rapidly growing stage during the past five years. While, the above mentioned reviews all included papers published before 2017. To date, many new trials focued on music therapy and depression in differnt poupulation (such as people with cancer, people with dementia, people with chronic disease, and so on ) have been performed, but they have not yet been systematically reviewed.

While, no meta-analysis compared the the difference of music therapy on depression in differnt poupulation (such as people with depression, people with dementia, people with chronic disease, health people, and so on ) have been performed.

Figure 1 The pubished papers from 1983 to 2020 focused on music therapy and depression (searched from Pubmed)

In our persent meta-analysis, we aimed to (1) compare the effect between music therapy and music medicine on depression; (2) compare the effect between different specific methods used inmusic therapy on depression; (3) compare the effect of music-based interventions on depression among different population.

We have added the above content to Intruduction and Dissussion sections.

5.A stronger discussion of the limitation of this study. Many studies did not evaluate a group with major depression/major depressive disorder (music therapy for chronic pain is important, but the variance of the populations under study does constitute a limitation). So, this study is not exclusive to adults with a major mental health condition. Might effects be different for people who are depressed versus people who are not depressed?

Response: This is a very important comment. According to this comment, we have made some revision.

Firstly, we have added a sensitivity analysis by excluding the studes focused on the people with a major mental health condition.

Secondly, we have re-grouped the populations into three groups, namely mental health, severe mental disease /psychiatric disorder, and depression and we have added the subgroup analysis (table 2 in revised manuscript)..

Thirdly, we have added the analysis of the difference between people who are depressed versus people who are not depressed accordingly (table 2 in revised manuscript).

6.Instead of "blinding/blinded" please use "masking/masked."

Response: We have replaced "blinding/blinded" with "masking/masked" according to this comment.

Response: In active methods (improvisational, re-creative, compositional), participants are ‘making music’ , and in receptive music therapy (music-assisted relaxation, music and imagery, guided imagery and music, lyrics analysis ), participants are ‘receiving’ (e.g. listening to) music (Bruscia 2014; Wheeler 2015).

We have amended the difinition and added the citation to the Result section according to this commment.

[Bruscia KE. Defining Music Therapy. 3rd Edition.University Park, Illinois, USA: Barcelona Publishers, 2014.]

[Wheeler BL. Music Therapy Handbook. New York, New York, USA: Guilford Publications, 2015.]

Response: Of the 55 studies, 38 used group therapy, 17 used individual therapy, and 2 not reported. We have added the comparison of group therapy versus individual therapy according to this comment (table 2 in revised manuscript).

Response: Of 55 studies, a total of 25 studies were conducted in impatient setting,28 studies were in outpatients setting setting, and 2 studies not repoted the setting. We have added the subgroup analysis by inpatient settings (secure [locked] unit at a mental health facility versus outpatient settings) according to this comment (table 2 in revised manuscript).

Response: We have added the subgroup analysis by total sessions a participant has received according to this comment.

Response: We have added the SD in table 1

Response: Thanks very much for your important comments, these comments are all valuable and very helpful for revising and improving our paper, as well as the important guiding significance to our researches.

Response: (1) We have amendded the difinition of music therapy. According to the American Music Therapy Association (AMTA), “music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”.. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).]

(2)We are very sorry for missing several research studies in our present meta-analysis. According to this comment, we have performed more extensive electronic search using the following terms: depression or mood disorders or affective disorders and music. We also performed manual search for the reference of all relevent reviews. In order to ensure the study quality of included papers, we excluded the studies with a very small sample size (n<20), we also excluded the non-english papers due to our language barrier. We included 23 new papers and deleted 1 old paper, in the last a total of 55 paper were included in our present analysis. The following are the new included papers and some excluded papers:

New-included papers

1)Albornoz Y. The effects of group improvisational music therapy on depression in adolescents and adults with substance abuse: a randomised controlled trial. Nordic Journal of Music Therapy 2011;20(3):208–24.

2)Hendricks CB, Robinson B, Bradley B, Davis K. Using music techniques to treat adolescent depression. Journal of Humanistic Counseling, Education and Development 1999; 38:39–46. （unavaliable）

3)Hendricks CB. A study of the use of music therapy techniques in a group for the treatment of adolescent depression. Dissertation Abstracts International 2001;62(2-A):472.

4)Radulovic R. The using of music therapy in treatment of depressive disorders. Summary of Master Thesis. Belgrade: Faculty of Medicine University of Belgrade, 1996.

5)Zerhusen JD, Boyle K, Wilson W. Out of the darkness: group cognitive therapy for depressed elderly. Journal of Military Nursing Research 1995;1:28–32. PUBMED: 1941727]

6)Chen SC, Yeh ML, Chang HJ, Lin MF. Music, heart rate variability, and symptom clusters: a comparative study. Support Care Cancer. 2020;28(1):351-360. doi:10.1007/s00520-019-04817-x

7)Chang, M. Y., Chen, C. H., and Huang, K. F. (2008). Effects of music therapy on psychological health of women during pregnancy. J. Clin. Nurs. 17, 2580–2587. doi: 10.1111/j.1365-2702.2007.02064.x

8)Chen XJ, Hannibal N, Gold C. Randomized Trial of Group Music Therapy With Chinese Prisoners: Impact on Anxiety, Depression, and Self-Esteem. Int J Offender Ther Comp Criminol. 2016;60(9):1064-1081. doi:10.1177/0306624X15572795

9)Esfandiari, N., and Mansouri, S. (2014). The effect of listening to light and heavy music on reducing the symptoms of depression among female students. Arts Psychother. 41, 211–213. doi: 0.1016/j.aip.2014.02.001

10)Fancourt, D., Perkins, R., Ascenso, S., Carvalho, L. A., Steptoe, A., and Williamon, A. (2016). Effects of group drumming interventions on anxiety, depression, social resilience and inflammatory immune response among mental health service users. PLoS ONE 11:e0151136. doi: 10.1371/journal.pone.0151136

11)Giovagnoli AR, Manfredi V, Parente A, Schifano L, Oliveri S, Avanzini G. Cognitive training in Alzheimer's disease: a controlled randomized study. Neurol Sci. 2017;38(8):1485-1493. doi:10.1007/s10072-017-3003-9

12)Harmat, L., Takács, J., and Bodizs, R. (2008). Music improves sleep quality in students. J. Adv. Nurs. 62, 327–335. doi: 10.1111/j.1365-2648.2008.04602.x

13)Liao J, Wu Y, Zhao Y, et al. Progressive Muscle Relaxation Combined with Chinese Medicine Five-Element Music on Depression for Cancer Patients: A Randomized Controlled Trial. Chin J Integr Med. 2018;24(5):343-347. doi:10.1007/s11655-017-2956-0

14)Lu, S. F., Lo, C. H. K., Sung, H. C., Hsieh, T. C., Yu, S. C., and Chang, S. C. (2013). Effects of group music intervention on psychiatric symptoms and depression in patient with schizophrenia. Complement. Ther. Med. 21, 682–688. doi: 10.1016/j.ctim.2013.09.002

15)Mahendran R, Gandhi M, Moorakonda RB, et al. Art therapy is associated with sustained improvement in cognitive function in the elderly with mild neurocognitive disorder: findings from a pilot randomized controlled trial for art therapy and music reminiscence activity versus usual care. Trials. 2018;19(1):615. Published 2018 Nov 9. doi:10.1186/s13063-018-2988-6

16)Nwebube C, Glover V, Stewart L. Prenatal listening to songs composed for pregnancy and symptoms of anxiety and depression: a pilot study. BMC Complement Altern Med. 2017;17(1):256. Published 2017 May 8. doi:10.1186/s12906-017-1759-3

17)Porter S, McConnell T, McLaughlin K, et al. Music therapy for children and adolescents with behavioural and emotional problems: a randomised controlled trial. J Child Psychol Psychiatry. 2017;58(5):586-594. doi:10.1111/jcpp.12656

18)Raglio A, Giovanazzi E, Pain D, et al. Active music therapy approach in amyotrophic lateral sclerosis: a randomized-controlled trial. Int J Rehabil Res. 2016;39(4):365-367. doi:10.1097/MRR.0000000000000187

19)Torres E, Pedersen IN, Pérez-Fernández JI. Randomized Trial of a Group Music and Imagery Method (GrpMI) for Women with Fibromyalgia. J Music Ther. 2018;55(2):186-220. doi:10.1093/jmt/thy005

20)Verrusio, W., Andreozzi, P., Marigliano, B., Renzi, A., Gianturco, V., Pecci, M. T., et al. (2014). Exercise training and music therapy in elderly with depressive syndrome: a pilot study. Complement. Ther. Med. 22, 614–620. doi: 10.1016/j.ctim.2014.05.012

21)Wang, J. , Wang, H. and Zhang, D. (2011) Impact of group music therapy on the depression mood of college students. Health, 3, 151-155

22)Yap AF, Kwan YH, Tan CS, Ibrahim S, Ang SB. Rhythm-centred music making in community living elderly: a randomized pilot study. BMC Complement Altern Med. 2017 Jun 14;17(1):311. doi: 10.1186/s12906-017-1825-x. PMID: 28615007; PMCID: PMC5470187.

23)Koelsch, S., Offermanns, K., and Franzke, P. (2010). Music in the treatment of affective disorders: an exploratory investigation of a new method for music-therapeutic research. Music Percept. Interdisc. J. 27, 307–316. doi: 10.1525/mp.2010.27.4.307

Excluded papers：

24)Bally, K., Campbell, D., Chesnick, K., and Tranmer, J. E. (2003). Effects of patient controlled music therapy during coronary angiography on procedural pain and anxiety distress syndrome. Crit. Care Nurse 23, 50–58. （not provide useable data）

25)Atiwannapat P, Thaipisuttikul P, Poopityastaporn P, Katekaew W. Active versus receptive group music therapy for major depressive disorder - a pilot study. Complementary Therapies in Medicine 2016;26:141–5. (sample size<20)

26)Garrido S, Stevens CJ, Chang E, Dunne L, Perz J. Music and Dementia: Individual Differences in Response to Personalized Playlists. J Alzheimers Dis. 2018;64(3):933-941. doi:10.3233/JAD-180084 （not randomised or quasi-randomised controlled trials）

27)Sánchez A, Maseda A, Marante-Moar MP, de Labra C, Lorenzo-López L, Millán-Calenti JC. Comparing the Effects of Multisensory Stimulation and Individualized Music Sessions on Elderly People with Severe Dementia: A Randomized Controlled Trial. J Alzheimers Dis. 2016;52(1):303-315. doi:10.3233/JAD-151150 （the control group also received music intervention）

28)Mondanaro JF, Homel P, Lonner B, Shepp J, Lichtensztein M, Loewy JV. Music Therapy Increases Comfort and Reduces Pain in Patients Recovering From Spine Surgery. Am J Orthop (Belle Mead NJ). 2017;46(1):E13-E22. (No full text available)

29)Castillo-Pérez, S., Gómez-Pérez, V., Velasco, M. C., Pérez-Campos, E., and Mayoral, M. A. (2010). Effects of music therapy on depression compared with psychotherapy. Arts Psychother. 37, 387–390. doi: 0.1016/j.aip.2010.07.001 （not provide useable data)

30)Alcântara-Silva TR, de Freitas-Junior R, Freitas NMA, et al. Music Therapy Reduces Radiotherapy-Induced Fatigue in Patients With Breast or Gynecological Cancer: A Randomized Trial. Integr Cancer Ther. 2018;17(3):628-635. doi:10.1177/1534735418757349（not provide useable data)

31)Cheung CWC, Yee AWW, Chan PS, et al. The impact of music therapy on pain and stress reduction during oocyte retrieval - a randomized controlled trial. Reprod Biomed Online. 2018;37(2):145-152. doi:10.1016/j.rbmo.2018.04.049（not provide useable data)

32)Pezzin LE, Larson ER, Lorber W, McGinley EL, Dillingham TR. Music-instruction intervention for treatment of post-traumatic stress disorder: a randomized pilot study. BMC Psychol. 2018;6(1):60. Published 2018 Dec 19. doi:10.1186/s40359-018-0274-8 (the control group also received music intervention)

33)Silverman, M. J. (2011). Effects of music therapy on change and depression on clients in detoxification. J. Addict. Nurs. 22, 185–192. doi: 10.3109/10884602.2011.616606 （the control group also received music intervention）

34)Särkämö T, Laitinen S, Numminen A, Kurki M, Johnson JK, Rantanen P. Clinical and Demographic Factors Associated with the Cognitive and Emotional Efficacy of Regular Musical Activities in Dementia. J Alzheimers Dis. 2016;49(3):767-81. doi: 10.3233/JAD-150453. PMID: 26519435.

35)Tuinmann G, Preissler P, Böhmer H, Suling A, Bokemeyer C. The effects of music therapy in patients with high-dose chemotherapy and stem cell support: a randomized pilot study. Psychooncology. 2017 Mar;26(3):377-384. doi: 10.1002/pon.4142. Epub 2016 May 5. PMID: 27146798.（not provide useable data)

36)Hsu, W. C., and Lai, H. L. (2004). Effects of music on major depression in psychiatric inpatients. Arch. Psychiat. Nurs. 18, 193–199. doi: 10.1016/j.apnu.2004.07.007（not provide useable data)

（3）We have added some new analyses of our data. 1) including three new papers and re-analying of our data, 2) adding the comparison of music therapy and music medicine (figure 3 in revised manuscript) , 3) adding some subgroup analyses by country having music therapy profession, intervention settings, therapy mode, specific music therapy methord, intervenor /therapist, and total intervention session (table 2 in revised manuscript) .

Response: We are sorry for making this mistake. In the Methord section, we defined exclusive criteria as studies with a very small sample size (n<20),while in table4 we performed the sensitivity analyses by excluding the papers with smale sample size ( 20< n<30). We have amended the table 4.

Response: We have added these findings with a forest plot (figure 6 in revised manuscript) according to the comment.

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Submitted filename: Response to Reviewers.docx

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Acceptance letter

30 Oct 2020

Dear Dr. Ye:

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• About Adverse Childhood Experiences
• Risk and Protective Factors
• Program: Essentials for Childhood: Preventing Adverse Childhood Experiences through Data to Action
• Adverse childhood experiences can have long-term impacts on health, opportunity and well-being.
• Adverse childhood experiences are common and some groups experience them more than others.

What are adverse childhood experiences?

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). Examples include: 1

• Experiencing violence, abuse, or neglect.
• Witnessing violence in the home or community.
• Having a family member attempt or die by suicide.

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding. Examples can include growing up in a household with: 1

• Substance use problems.
• Mental health problems.
• Instability due to parental separation.
• Instability due to household members being in jail or prison.

The examples above are not a complete list of adverse experiences. Many other traumatic experiences could impact health and well-being. This can include not having enough food to eat, experiencing homelessness or unstable housing, or experiencing discrimination. 2 3 4 5 6

Quick facts and stats

ACEs are common. About 64% of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six (17.3%) adults reported they had experienced four or more types of ACEs. 7

Preventing ACEs could potentially reduce many health conditions. Estimates show up to 1.9 million heart disease cases and 21 million depression cases potentially could have been avoided by preventing ACEs. 1

Some people are at greater risk of experiencing one or more ACEs than others. While all children are at risk of ACEs, numerous studies show inequities in such experiences. These inequalities are linked to the historical, social, and economic environments in which some families live. 5 6 ACEs were highest among females, non-Hispanic American Indian or Alaska Native adults, and adults who are unemployed or unable to work. 7

ACEs are costly. ACEs-related health consequences cost an estimated economic burden of $748 billion annually in Bermuda, Canada, and the United States. 8

ACEs can have lasting effects on health and well-being in childhood and life opportunities well into adulthood. 9 Life opportunities include things like education and job potential. These experiences can increase the risks of injury, sexually transmitted infections, and involvement in sex trafficking. They can also increase risks for maternal and child health problems including teen pregnancy, pregnancy complications, and fetal death. Also included are a range of chronic diseases and leading causes of death, such as cancer, diabetes, heart disease, and suicide. 1 10 11 12 13 14 15 16 17

ACEs and associated social determinants of health, such as living in under-resourced or racially segregated neighborhoods, can cause toxic stress. Toxic stress, or extended or prolonged stress, from ACEs can negatively affect children’s brain development, immune systems, and stress-response systems. These changes can affect children’s attention, decision-making, and learning. 18

Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, jobs, and depression throughout life. 18 These effects can also be passed on to their own children. 19 20 21 Some children may face further exposure to toxic stress from historical and ongoing traumas. These historical and ongoing traumas refer to experiences of racial discrimination or the impacts of poverty resulting from limited educational and economic opportunities. 1 6

Adverse childhood experiences can be prevented. Certain factors may increase or decrease the risk of experiencing adverse childhood experiences.

Preventing adverse childhood experiences requires understanding and addressing the factors that put people at risk for or protect them from violence.

Creating safe, stable, nurturing relationships and environments for all children can prevent ACEs and help all children reach their full potential. We all have a role to play.

• Merrick MT, Ford DC, Ports KA, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:999-1005. DOI: http://dx.doi.org/10.15585/mmwr.mm6844e1 .
• Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Science Direct. 2022; 22:7; 1105-1114. DOI: https://doi.org/10.1016/j.acap.2022.04.010 .
• Smith-Grant J, Kilmer G, Brener N, Robin L, Underwood M. Risk Behaviors and Experiences Among Youth Experiencing Homelessness—Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts. Journal of Community Health. 2022; 47: 324-333.
• Experiencing discrimination: Early Childhood Adversity, Toxic Stress, and the Impacts of Racism on the Foundations of Health | Annual Review of Public Health https://doi.org/10.1146/annurev-publhealth-090419-101940 .
• Sedlak A, Mettenburg J, Basena M, et al. Fourth national incidence study of child abuse and neglect (NIS-4): Report to Congress. Executive Summary. Washington, DC: U.S. Department of Health an Human Services, Administration for Children and Families.; 2010.
• Font S, Maguire-Jack K. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions. Child Abuse Negl. 2016;51:390-399.
• Swedo EA, Aslam MV, Dahlberg LL, et al. Prevalence of Adverse Childhood Experiences Among U.S. Adults — Behavioral Risk Factor Surveillance System, 2011–2020. MMWR Morb Mortal Wkly Rep 2023;72:707–715. DOI: http://dx.doi.org/10.15585/mmwr.mm7226a2 .
• Bellis, MA, et al. Life Course Health Consequences and Associated Annual Costs of Adverse Childhood Experiences Across Europe and North America: A Systematic Review and Meta-Analysis. Lancet Public Health 2019.
• Adverse Childhood Experiences During the COVID-19 Pandemic and Associations with Poor Mental Health and Suicidal Behaviors Among High School Students — Adolescent Behaviors and Experiences Survey, United States, January–June 2021 | MMWR
• Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics. 2004 Feb;113(2):320-7.
• Miller ES, Fleming O, Ekpe EE, Grobman WA, Heard-Garris N. Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes. Obstetrics & Gynecology . 2021;138(5):770-776. https://doi.org/10.1097/AOG.0000000000004570 .
• Sulaiman S, Premji SS, Tavangar F, et al. Total Adverse Childhood Experiences and Preterm Birth: A Systematic Review. Matern Child Health J . 2021;25(10):1581-1594. https://doi.org/10.1007/s10995-021-03176-6 .
• Ciciolla L, Shreffler KM, Tiemeyer S. Maternal Childhood Adversity as a Risk for Perinatal Complications and NICU Hospitalization. Journal of Pediatric Psychology . 2021;46(7):801-813. https://doi.org/10.1093/jpepsy/jsab027 .
• Mersky JP, Lee CP. Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample. BMC pregnancy and childbirth. 2019;19(1). https://doi.org/10.1186/s12884-019-2560-8 .
• Reid JA, Baglivio MT, Piquero AR, Greenwald MA, Epps N. No youth left behind to human trafficking: Exploring profiles of risk. American journal of orthopsychiatry. 2019;89(6):704.
• Diamond-Welch B, Kosloski AE. Adverse childhood experiences and propensity to participate in the commercialized sex market. Child Abuse & Neglect. 2020 Jun 1;104:104468.
• Shonkoff, J. P., Garner, A. S., Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, & Section on Developmental and Behavioral Pediatrics (2012). The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1), e232–e246. https://doi.org/10.1542/peds.2011-2663
• Narayan AJ, Kalstabakken AW, Labella MH, Nerenberg LS, Monn AR, Masten AS. Intergenerational continuity of adverse childhood experiences in homeless families: unpacking exposure to maltreatment versus family dysfunction. Am J Orthopsych. 2017;87(1):3. https://doi.org/10.1037/ort0000133 .
• Schofield TJ, Donnellan MB, Merrick MT, Ports KA, Klevens J, Leeb R. Intergenerational continuity in adverse childhood experiences and rural community environments. Am J Public Health. 2018;108(9):1148-1152. https://doi.org/10.2105/AJPH.2018.304598 .
• Schofield TJ, Lee RD, Merrick MT. Safe, stable, nurturing relationships as a moderator of intergenerational continuity of child maltreatment: a meta-analysis. J Adolesc Health. 2013;53(4 Suppl):S32-38. https://doi.org/10.1016/j.jadohealth.2013.05.004 .

Adverse Childhood Experiences (ACEs)

ACEs can have a tremendous impact on lifelong health and opportunity. CDC works to understand ACEs and prevent them.

Fans Dissect Grayson Murray's Final Putt And Notice Something Off

Grayson Murray , who tragically took his own lie on May 25, 2024, withdrew from the Charles Schwab Challenge one day earlier, citing an illness.

After learning of his death, his final putt went viral, and fans noticed something they hadn't noticed before.

Grayson Murray Passes Away

The world learned of Muray's passing, after PGA Tour commissioner Jay Monahan released a statement.

"We were devastated to learn – and are heartbroken to share – that PGA TOUR player Grayson Murray passed away this morning. I am at a loss for words," he said. "The PGA TOUR is a family, and when you lose a member of your family, you are never the same. We mourn Grayson and pray for comfort for his loved ones."

One day later, the Murray family confirmed the cause of death to be suicide .

"He was loved and he will be missed,” the family said. “We would like to thank the PGA Tour and the entire world of golf for the outpouring of support. Life wasn’t always easy for Grayson, and although he took his own life, we know he rests peacefully now."

The world is now raising awareness for those struggling with mental health as they continue to share old videos of Murray discussing depression and anxiety , as well as dissecting his final putt.

Watch Grayson Murray's Emotional Final Putt Before His Tragic Death

After watching his final putt, social media users began advocating for mental health.

"You can sense his discomfort and inability to focus because of it. I know that feeling and how corrosive it can be," one user pointed out.

"No sign of emotion and quick to exit… his mind was made. Rest in peace," another said.

Grayson Murray's Death Raises Mental Health Awareness

"Men's mental health is so hard. We act strong for everyone to see. But deep down we are so weak," one user said. "I feel the pain.. and I'm sorry to all his loved ones. And I'm sorry to you, Grayson."

"No one will understand the pain of mental trauma until they’ve been there. At least he is free now. Rest in paradise, Grayson," another commented.

"For anyone struggling.. yesterday needed you, today was happy to have you, and tomorrow patiently awaits your arrival," a third user expressed.

"Don’t really watch golf, but his mind was definitely somewhere else. People are overwhelmed nowadays with just living R..P. to the guy," another said.

Social Media Users Share Their Condolences

Another user wrote, "RIP Grayson. I hope you found the peace you couldn't find here. Sending love and light to his family and friends."

"Please be kind to all people. Everyone goes through tough times.. my heart aches for his family. Parents aren’t supposed to bury their child," one TikToker commented.

Meanwhile, one social media user shared their own experience with mental health struggles. "I feel for this guy so much," they wrote. "I struggle mightily daily, I used drugs and alcohol to mask my mental Illness." The user added that they are now sober.

"RIP I’m so sorry you felt that was the best choice I’ve struggled myself and it can take you to some very dark places I pray you are at peace now," another shared.

Grayson Murray Struggled With Depression And Anxiety

In 2023, Grayson Murray spoke out about his mental health struggles.

“Everyone has their battles and sometimes people are able to hide them and function, and sometimes you’re not. I think our society now is getting better about accepting that, you know, it’s OK to not be OK,” he said at the time.

“I’m not ashamed that I go through depression and anxiety. I know I’ve helped people out in the past just through my social media DMs – people messaging me – and I can use my platform to continue to help with things like that," Murray added.

Last year, he also revealed that he was sober.