Abstract
This study attempted to assess the influence of music therapy combined with progressive muscle relaxation on relieving anxiety and depression symptoms in methamphetamine-dependent adult women. It was a randomized controlled trial including 133 methamphetamine-dependent adult women recruited to participate in an 8-week rehabilitation program in the rehabilitation center of a psychiatric hospital. Participants in the control group were only treated by routine medical care, while participants in the study group received music therapy combined with progressive muscle relaxation based on routine medical care. Demographic and clinical data of these participants were collected at baseline, and anxiety and depression scores were collected at baseline and after 8 weeks intervention. Seven participants left halfway of the study, and the final available data in the study group and the control group were both 63. After 8-week intervention, anxiety and depression scores in the study group were less than those of the control group (p < 0.001). In addition, the decline of anxiety and depression scores after 8 weeks intervention in the study group was more than those in the control group (p < 0.001). These findings recommended that the music therapy combined with progressive muscle relaxation would be considered as a safe, noninvasive, and effective rehabilitation therapy for adult women with methamphetamine dependence. Trial registration number: ChiCTR-ROC-15006327. Date of registration: 2015/03/20.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abrams, B. (2010). Evidence-based music therapy practice: An integral understanding. Journal of Music Therapy, 47(4), 351–379. https://doi.org/10.1093/jmt/47.4.351
Aksu, N. T., Erdogan, A., & Ozgur, N. (2018). Effects of progressive muscle relaxation training on sleep and quality of life in patients with pulmonary resection. Sleep & breathing = Schlaf & Atmung, 22(3), 695–702. https://doi.org/10.1007/s11325-017-1614-2
Aletraris, L., Paino, M., Edmond, M. B., Roman, P. M., & Bride, B. E. (2014). The use of art and music therapy in substance abuse treatment programs. Journal of Addictions Nursing, 25(4), 190–196. https://doi.org/10.1097/JAN.0000000000000048
Bagheri, M., Mokri, A., Khosravi, A., & Kabir, K. (2015). Effect of abstinence on depression, anxiety, and quality of life in chronic methamphetamine users in a therapeutic community. International Journal of High Risk Behaviors & Addiction, 4(3), e23903. https://doi.org/10.5812/ijhrba.23903
Barbosa, D. J., Capela, J. P., Feio-Azevedo, R., Teixeira-Gomes, A., Bastos, M., & Carvalho, F. (2015). Mitochondria: Key players in the neurotoxic effects of amphetamines. Archives of Toxicology, 89(10), 1695–1725. https://doi.org/10.1007/s00204-015-1478-9
Boso, M., Politi, P., Barale, F., & Enzo, E. (2006). Neurophysiology and neurobiology of the musical experience. Functional Neurology, 21(4), 187–191.
Brecht, M. L., O’Brien, A., von Mayrhauser, C., & Anglin, M. D. (2004). Methamphetamine use behaviors and gender differences. Addictive Behaviors, 29(1), 89–106. https://doi.org/10.1016/s0306-4603(03)00082-0
Cougle, J. R., Wilver, N. L., Day, T. N., Summers, B. J., Okey, S. A., & Carlton, C. N. (2020). Interpretation bias modification versus progressive muscle relaxation for social anxiety disorder: A web-based controlled trial. Behavior Therapy, 51(1), 99–112. https://doi.org/10.1016/j.beth.2019.05.009
De Paolis, G., Naccarato, A., Cibelli, F., D’Alete, A., Mastroianni, C., Surdo, L., Casale, G., & Magnani, C. (2019). The effectiveness of progressive muscle relaxation and interactive guided imagery as a pain-reducing intervention in advanced cancer patients: A multicentre randomised controlled non-pharmacological trial. Complementary Therapies in Clinical Practice, 34, 280–287. https://doi.org/10.1016/j.ctcp.2018.12.014
Eslami-Shahrbabaki, M., Fekrat, A., & Mazhari, S. (2015). A study of the prevalence of psychiatric disorders in patients with methamphetamine-induced psychosis. Addiction & Health, 7(1–2), 37–46.
Feng, F., Zhang, Y., Hou, J., Cai, J., Jiang, Q., Li, X., Zhao, Q., & Li, B. A. (2018). Can music improve sleep quality in adults with primary insomnia? A systematic review and network meta-analysis. International Journal of Nursing Studies, 77, 189–196. https://doi.org/10.1016/j.ijnurstu.2017.10.011
Fujáková-Lipski, M., Kaping, D., Šírová, J., Horáček, J., Páleníček, T., Zach, P., Klaschka, J., Kačer, P., Syslová, K., Vrajová, M., Bubenikova-Valešová, V., Beste, C., & Šlamberová, R. (2017). Trans-generational neurochemical modulation of methamphetamine in the adult brain of the Wistar rat. Archives of Toxicology, 91(10), 3373–3384. https://doi.org/10.1007/s00204-017-1969-y
Gallego-Gómez, J. I., Balanza, S., Leal-Llopis, J., García-Méndez, J. A., Oliva-Pérez, J., Doménech-Tortosa, J., Gómez-Gallego, M., Simonelli-Muñoz, A. J., & Rivera-Caravaca, J. M. (2020). Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in nursing students: A randomized trial. Nurse Education Today, 84, 104217. https://doi.org/10.1016/j.nedt.2019.104217
Georgiou, P., Zanos, P., Garcia-Carmona, J. A., Hourani, S., Kitchen, I., Laorden, M. L., & Bailey, A. (2016). Methamphetamine abstinence induces changes in μ-opioid receptor, oxytocin and CRF systems: Association with an anxiogenic phenotype. Neuropharmacology, 105, 520–532. https://doi.org/10.1016/j.neuropharm.2016.02.012
Geretsegger, M., Mössler, K. A., Bieleninik, Ł, Chen, X. J., Heldal, T. O., & Gold, C. (2017). Music therapy for people with schizophrenia and schizophrenia-like disorders. The Cochrane Database of Systematic Reviews, 5(5), CD004025. https://doi.org/10.1002/14651858.CD004025.pub4
Hanson, G. R., Sandoval, V., Riddle, E., & Fleckenstein, A. E. (2004). Psychostimulants and vesicle trafficking: A novel mechanism and therapeutic implications. Annals of the New York Academy of Sciences, 1025, 146–150. https://doi.org/10.1196/annals.1316.019
Hao, J., Jiang, K., Wu, M., Yu, J., & Zhang, X. (2020). The effects of music therapy on amino acid neurotransmitters: Insights from an animal study. Physiology & Behavior, 224, 113024. https://doi.org/10.1016/j.physbeh.2020.113024
Huang, J., Zheng, Y., Gao, D., Hu, M., & Yuan, T. (2020). Effects of exercise on depression, anxiety, cognitive control, craving, physical fitness and quality of life in methamphetamine-dependent patients. Frontiers in Psychiatry, 10, 999. https://doi.org/10.3389/fpsyt.2019.00999
Iudicello, J. E., Woods, S. P., Vigil, O., Scott, J. C., Cherner, M., Heaton, R. K., Atkinson, J. H., Grant, I., HIV Neurobehavioral Research Center (HNRC) Group. (2010). Longer term improvement in neurocognitive functioning and affective distress among methamphetamine users who achieve stable abstinence. Journal of Clinical and Experimental Neuropsychology, 32(7), 704–718. https://doi.org/10.1080/13803390903512637
Kalueff, A. V., & Nutt, D. J. (2007). Role of GABA in anxiety and depression. Depression and Anxiety, 24(7), 495–517. https://doi.org/10.1002/da.20262
Kim, K. J., Lee, S. N., & Lee, B. H. (2018). Music therapy inhibits morphine-seeking behavior via GABA receptor and attenuates anxiety-like behavior induced by extinction from chronic morphine use. Neuroscience Letters, 674, 81–87. https://doi.org/10.1016/j.neulet.2018.03.035
Klainin-Yobas, P., Oo, W. N., Suzanne Yew, P. Y., & Lau, Y. (2015). Effects of relaxation interventions on depression and anxiety among older adults: A systematic review. Aging & Mental Health, 19(12), 1043–1055. https://doi.org/10.1080/13607863.2014.997191
Lake, C. R., & Quirk, R. S. (1984). CNS stimulants and the look-alike drugs. The Psychiatric Clinics of North America, 7(4), 689–701.
Leung, J. W., & Xue, H. (2003). GABAergic functions and depression: From classical therapies to herbal medicine. Current drug targets. CNS and Neurol Disorders, 2(6), 363–374. https://doi.org/10.2174/1568007033482715
Li, K. X., & Loshak, H. (2019). Treatment for methamphetamine addiction: A review of guidelines. Canadian Agency for Drugs and Technologies in Health.
Li, W. J., Yu, H., Yang, J. M., Gao, J., Jiang, H., Feng, M., Zhao, Y. X., & Chen, Z. Y. (2010). Anxiolytic effect of music exposure on BDNFMet/Met transgenic mice. Brain Research, 1347, 71–79. https://doi.org/10.1016/j.brainres.2010.05.080
Li, Y., Wang, R., Tang, J., Chen, C., Tan, L., Wu, Z., Yu, F., & Wang, X. (2015). Progressive muscle relaxation improves anxiety and depression of pulmonary arterial hypertension patients. Evidence-Based Complementary and Alternative Medicine : Ecam, 2015, 792895. https://doi.org/10.1155/2015/792895
Li, J., Zhou, L., & Wang, Y. (2017). The effects of music intervention on burn patients during treatment procedures: A systematic review and meta-analysis of randomized controlled trials. BMC Complementary and Alternative Medicine, 17(1), 158. https://doi.org/10.1186/s12906-017-1669-4
Liddle, H. A., Rowe, C. L., Dakof, G. A., Ungaro, R. A., & Henderson, C. E. (2004). Early intervention for adolescent substance abuse: Pretreatment to posttreatment outcomes of a randomized clinical trial comparing multidimensional family therapy and peer group treatment. Journal of Psychoactive Drugs, 36(1), 49–63. https://doi.org/10.1080/02791072.2004.10399723
Ma, J., Sun, X. J., Wang, R. J., Wang, T. Y., Su, M. F., Liu, M. X., Li, S. X., Han, Y., Meng, S. Q., Wu, P., Shi, J., Bao, Y. P., & Lu, L. (2018). Profile of psychiatric symptoms in methamphetamine users in China: Greater risk of psychiatric symptoms with a longer duration of use. Psychiatry Research, 262, 184–192. https://doi.org/10.1016/j.psychres.2018.02.017
Mander, J., Blanck, P., Neubauer, A. B., Kröger, P., Flückiger, C., Lutz, W., Barnow, S., Bents, H., & Heidenreich, T. (2019). Mindfulness and progressive muscle relaxation as standardized session-introduction in individual therapy: A randomized controlled trial. Journal of Clinical Psychology, 75(1), 21–45. https://doi.org/10.1002/jclp.22695
Mayo, L. M., Paul, E., DeArcangelis, J., Van Hedger, K., & de Wit, H. (2019). Gender differences in the behavioral and subjective effects of methamphetamine in healthy humans. Psychopharmacology (berl), 236(8), 2413–2423. https://doi.org/10.1007/s00213-019-05276-2
McHugh, R. K., Votaw, V. R., Sugarman, D. E., & Greenfield, S. F. (2018). Sex and gender differences in substance use disorders. Clinical Psychology Review, 66, 12–23. https://doi.org/10.1016/j.cpr.2017.10.012
Meng, B., Zhu, S., Li, S., Zeng, Q., & Mei, B. (2009). Global view of the mechanisms of improved learning and memory capability in mice with music-exposure by microarray. Brain Research Bulletin, 80(1–2), 36–44. https://doi.org/10.1016/j.brainresbull.2009.05.020
Miller, D. R., Lebowitz, J. J., Guenther, D. T., Refowich, A. J., Hansen, C., Maurer, A. P., & Khoshbouei, H. (2019). Methamphetamine regulation of activity and topology of ventral midbrain networks. PLoS ONE, 14(9), e0222957. https://doi.org/10.1371/journal.pone.0222957
Nasiri, S., Akbari, H., Tagharrobi, L., & Tabatabaee, A. S. (2018). The effect of progressive muscle relaxation and guided imagery on stress, anxiety, and depression of pregnant women referred to health centers. Journal of Education and Health Promotion, 7, 41. https://doi.org/10.4103/jehp.jehp_158_16
Nemeroff, C. B. (2003). The role of GABA in the pathophysiology and treatment of anxiety disorders. Psychopharmacology Bulletin, 37(4), 133–146.
Ozgundondu, B., & Gok Metin, Z. (2019). Effects of progressive muscle relaxation combined with music on stress, fatigue, and coping styles among intensive care nurses. Intensive & Critical Care Nursing, 54, 54–63. https://doi.org/10.1016/j.iccn.2019.07.007
Padgett, C. L., Lalive, A. L., Tan, K. R., Terunuma, M., Munoz, M. B., Pangalos, M. N., Martínez-Hernández, J., Watanabe, M., Moss, S. J., Luján, R., Lüscher, C., & Slesinger, P. A. (2012). Methamphetamine-evoked depression of GABA(B) receptor signaling in GABA neurons of the VTA. Neuron, 73(5), 978–989. https://doi.org/10.1016/j.neuron.2011.12.031
Pang, Z., Tu, D., & Cai, Y. (2019). Psychometric properties of the SAS, BAI, and S-AI in Chinese university students. Frontiers in Psychology, 10, 93. https://doi.org/10.3389/fpsyg.2019.00093
Papadakakis, A., Sidiropoulou, K., & Panagis, G. (2019). Music exposure attenuates anxiety- and depression-like behaviors and increases hippocampal spine density in male rats. Behavioural Brain Research, 372, 112023. https://doi.org/10.1016/j.bbr.2019.112023
Parás-Bravo, P., Salvadores-Fuentes, P., Alonso-Blanco, C., Paz-Zulueta, M., Santibañez-Margüello, M., Palacios-Ceña, D., Boixadera-Planas, E., & Fernández-de-Las-Peñas, C. (2017). The impact of muscle relaxation techniques on the quality of life of cancer patients, as measured by the FACT-G questionnaire. PLoS ONE, 12(10), e0184147. https://doi.org/10.1371/journal.pone.0184147
Pierce, R. C., & Kumaresan, V. (2006). The mesolimbic dopamine system: The final common pathway for the reinforcing effect of drugs of abuse? Neuroscience and Biobehavioral Reviews, 30(2), 215–238. https://doi.org/10.1016/j.neubiorev.2005.04.016
Raad, G., Tanios, J., Azoury, J., Daher, A., Fakih, C., & Bakos, H. W. (2021). Neurophysiology of cognitive behavioural therapy, deep breathing and progressive muscle relaxation used in conjunction with ART treatments: A narrative review. Human Reproduction Update, 27(2), 324–338. https://doi.org/10.1093/humupd/dmaa048
Radfar, S. R., & Rawson, R. A. (2014). Current research on methamphetamine: Epidemiology, medical and psychiatric effects, treatment, and harm reduction efforts. Addiction & Health, 6(3–4), 146–154.
Ren, Q., Ma, M., Yang, C., Zhang, J. C., Yao, W., & Hashimoto, K. (2015). BDNF-TrkB signaling in the NAc shell of mice has key role in methamphetamine withdrawal symptoms. Translational Psychiatry, 5(10), e666. https://doi.org/10.1038/tp.2015.157
Ren, W., Tao, J., Wei, Y., Su, H., Zhang, J., Xie, Y., Guo, J., Zhang, X., Zhang, H., & He, J. (2016). Time-dependent serum brain-derived neurotrophic factor decline during methamphetamine withdrawal. Medicine, 95(5), e2604. https://doi.org/10.1097/MD.0000000000002604
Ru, Q., Xiong, Q., Zhou, M., Chen, L., Tian, X., Xiao, H., Li, C., & Li, Y. (2019). Withdrawal from chronic treatment with methamphetamine induces anxiety and depression-like behavior in mice. Psychiatry Research, 271, 476–483. https://doi.org/10.1016/j.psychres.2018.11.072
Sandoval, V., Riddle, E. L., Hanson, G. R., & Fleckenstein, A. E. (2003). Methylphenidate alters vesicular monoamine transport and prevents methamphetamine-induced dopaminergic deficits. The Journal of Pharmacology and Experimental Therapeutics, 304(3), 1181–1187.
Schwinn, T. M., Schinke, S. P., Keller, B., & Hopkins, J. (2019). Two- and three-year follow-up from a gender-specific, web-based drug abuse prevention program for adolescent girls. Addictive Behaviors, 93, 86–92. https://doi.org/10.1016/j.addbeh.2019.01.010
Tao, W. W., Jiang, H., Tao, X. M., Jiang, P., Sha, L. Y., & Sun, X. C. (2016). Effects of acupuncture, Tuina, Tai Chi, Qigong, and traditional Chinese medicine five-element music therapy on symptom management and quality of life for cancer patients: A meta-analysis. Journal of Pain and Symptom Management, 51(4), 728–747. https://doi.org/10.1016/j.jpainsymman.2015.11.027
Thrash, B., Karuppagounder, S. S., Uthayathas, S., Suppiramaniam, V., & Dhanasekaran, M. (2010). Neurotoxic effects of methamphetamine. Neurochemical Research, 35(1), 171–179. https://doi.org/10.1007/s11064-009-0042-5
United Nations Office on Drugs and Crime (UNODC). (2020). World drug report 2020. Retrieved from: https://wdr.unodc.org/wdr2020/en/exsum.html. Accessed 25 Aug 2021.
United Nations Office on Drugs and Crime (UNODC). (2021). World drug report 2021. Retrieved from: https://www.unodc.org/res/wdr2021/field/WDR21_Booklet_1.pdf. Accessed 25 Aug 2021.
Vancampfort, D., Correll, C. U., Scheewe, T. W., Probst, M., De Herdt, A., Knapen, J., & De Hert, M. (2013). Progressive muscle relaxation in persons with schizophrenia: A systematic review of randomized controlled trials. Clinical Rehabilitation, 27(4), 291–298. https://doi.org/10.1177/0269215512455531
Wang, F. Z., Luo, D., Kanb, W., & Wang, Y. (2015). Combined intervention with education and progressive muscle relaxation on quality of life, functional disability, and positive symptoms in patients with acute schizophrenia. Journal of alternative and complementary medicine (New York, N. Y.), 21(3), 159–165. https://doi.org/10.1089/acm.2014.0128
Xing, Y., Chen, W., Wang, Y., Jing, W., Gao, S., Guo, D., Xia, Y., & Yao, D. (2016). Music exposure improves spatial cognition by enhancing the BDNF level of dorsal hippocampal subregions in the developing rats. Brain Research Bulletin, 121, 131–137. https://doi.org/10.1016/j.brainresbull.2016.01.009
Yun, S. M., Lee, S. M., Kim, M. S., Lee, S. N., & Lee, B. H. (2020). Korean meditation music suppressed relapse to methamphetamine in rats. Neuroscience Letters, 715, 134620. https://doi.org/10.1016/j.neulet.2019.134620
Zhang, K., Zhang, Q., Jiang, H., Du, J., Zhou, C., Yu, S., Hashimoto, K., & Zhao, M. (2018). Impact of aerobic exercise on cognitive impairment and oxidative stress markers in methamphetamine-dependent patients. Psychiatry Research, 266, 328–333. https://doi.org/10.1016/j.psychres.2018.03.032
Zung, W. W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12(1), 63–70.
Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12(6), 371–379. https://doi.org/10.1016/S0033-3182(71)71479-0
Acknowledgements
The authors appreciated the staff of the Psychiatric Hospital for their selfless help and support to our study. In addition, the authors sincerely acknowledge the subjects for their participation in our study and their high cooperation in the intervention period.
Funding
This work was supported by the Science &Technology Development Fund of Tianjin Education Commission for Higher Education [grant number: 2017KJ234] and the MOE (Ministry of Education in China) Project of Humanities and Social Sciences [grant number: 20YJA840023].
Author information
Authors and Affiliations
Contributions
Conceptualization: Linan Wang, Shumei Zhuang.
Methodology: Linan Wang
Formal analysis and investigation: Linan Wang
Writing — original draft preparation: Linan Wang, Xueying Zhou, Jingjing Liu
Funding acquisition: Shumei Zhuang.
Supervision: Shumei Zhuang.
All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethics Approval and Consent to Participate
Informed consent was obtained from all individual participants included in the study. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Chinese Ethics Committee of Registering Clinical Trials, An-Kang Hospital, and Tianjin Medical University) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Linan Wang and Shumei Zhuang contributed to the work equally and should be regarded as co-first authors.
Rights and permissions
About this article
Cite this article
Wang, L., Zhuang, S., Zhou, X. et al. Effects of Music Therapy Combined with Progressive Muscle Relaxation on Anxiety and Depression Symptoms in Adult Women with Methamphetamine Dependence: Study Protocol for a Randomized Controlled Trail. Int J Ment Health Addiction 21, 3215–3232 (2023). https://doi.org/10.1007/s11469-022-00786-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11469-022-00786-1