How music may support perinatal mental health: an overview.

There is strong evidence that engaging with music can improve our health and well-being. Music-based interventions, approaches and practices, such as group music-making (singing or playing musical instruments), listening to music and music therapy, have all been shown to reduce symptoms of depression and anxiety. Although the existing literature needs expanding, mounting evidence suggests that music-based interventions, approaches and practices may help support maternal mental health prenatally and postnatally. The purpose of this descriptive overview is to provide a broad view of this area by bringing together examples of research across different practices and research disciplines. Selected evidence is examined, showing how music-based interventions, approaches and practices can reduce labour anxiety and pain, anxiety symptoms in pregnancy, postnatal depression symptoms and support maternal-infant bonding. The examined research includes single studies and reviews that use both qualitative and quantitative methods. Drawing on animal and human models, the effect of music on foetal behaviour and various possible biological, psychological and social mechanisms are discussed. The potential preventive effect of music-based interventions, approaches and practices and their possible use across different cultures are also considered. Overall, we highlight how music, employed in a variety of ways, may support perinatal mental health with the aim of stimulating more interest and research in this area.

Community psychosocial music intervention (CHIME) to reduce antenatal common mental disorder symptoms in The Gambia: a feasibility trial.

OBJECTIVES: Examine the feasibility of a Community Health Intervention through Musical Engagement (CHIME) in The Gambia to reduce common mental disorder (CMD) symptoms in pregnant women. DESIGN: Feasibility trial testing a randomised stepped-wedge cluster design. SETTING: Four local antenatal clinics. PARTICIPANTS: Women who were 14-24 weeks pregnant and spoke Mandinka or Wolof were recruited into the intervention (n=50) or control group (n=74). INTERVENTION: Music-based psychosocial support sessions designed and delivered by all-female fertility societies. Sessions lasted 1 hour and were held weekly for 6 weeks. Delivered to groups of women with no preselection. Sessions were designed to lift mood, build social connection and provide health messaging through participatory music making. The control group received standard antenatal care. OUTCOMES: Demographic, feasibility, acceptability outcomes and the appropriateness of the study design were assessed. Translated measurement tools (Self-Reporting Questionnaire (SRQ-20); Edinburgh Postnatal Depression Scale (EPDS)) were used to assess CMD symptoms at baseline, post-intervention and 4-week follow-up. RESULTS: All clinics and 82% of women approached consented to take part. A 33% attrition rate across all time points was observed. 72% in the intervention group attended at least three sessions. Audio and video analysis confirmed fidelity of the intervention and a thematic analysis of participant interviews demonstrated acceptability and positive evaluation. Results showed a potential beneficial effect with a reduction of 2.13 points (95% CI (0.89 to 3.38), p<0.01, n=99) on the SRQ-20 and 1.98 points (95% CI (1.06 to 2.90), p<0.01, n=99) on the EPDS at the post-intervention time point for the intervention group compared with standard care. CONCLUSION: Results demonstrate that CHIME is acceptable and feasible in The Gambia. To our knowledge, CHIME is the first example of a music-based psychosocial intervention to be applied to perinatal mental health in a low- and middle-income country context. TRIAL REGISTRATION NUMBER: Pan African Clinical Trials Registry (PACTR201901917619299).

Prenatal listening to songs composed for pregnancy and symptoms of anxiety and depression: a pilot study.

BACKGROUND: Prenatal anxiety and depression are distressing for the expectant mother and can have adverse effects on her fetus and subsequently, her child. This study aimed to determine whether listening to specially composed songs would be an effective intervention for reducing symptoms of prenatal anxiety and depression. METHODS: Pregnant women were recruited online and randomly assigned to one of two groups: the music group (daily listening to specially composed songs) or control group (daily relaxation) for 12 weeks each. Self-report questionnaires were used to assess symptoms of State and Trait anxiety (Spielberger) and depression (Edinburgh Postnatal Depression Scale (EPDS)). Trait anxiety was measured as the primary outcome, while State anxiety and depression were the secondary outcomes. 111 participants were randomised to each group. 20 participants in the intervention group and 16 participants in the active control group completed the study. RESULTS: The music group demonstrated lower Trait Anxiety (p = .0001) (effect size 0.80), State Anxiety (p = .02) (effect size 0.64), and EPDS (p = .002) (effect size 0.92) scores at week 12 compared to baseline, by paired t test. There were no such changes in the control group. CONCLUSIONS: Though this pilot study had high levels of attrition, the results do suggest that regular listening to relaxing music should be explored further as an effective non-pharmacological means for reducing prenatal anxiety and depression. TRIAL REGISTRATION: ClinicalTrials.gov NCT02776293 LV-001. Registered 17 May 2016. Retrospectively registered.

Isatin binding proteins in rat brain: in situ imaging, quantitative characterization of specific [3H]isatin binding, and proteomic profiling.

Isatin (indole-2,3-dione) is an endogenous indole that has a distinct and discontinuous distribution in the brain and in other mammalian tissues and body fluids. Its output is increased under conditions of stress and anxiety. Its biological targets remain poorly characterized, although [(3)H]isatin binding sites have been demonstrated in various brain structures. In this study, by using a real-time beta-imager, [(3)H]isatin radioligand binding analysis, and proteomic identification of proteins specifically bound to the affinity sorbent 5-aminocaproyl-isatin-Sepharose, we have investigated the distribution of [(3)H]isatin specific binding sites in the rat brain, characterized their K(d) and B(max), and identified some individual brain isatin binding proteins. The binding of [(3)H]isatin to rat brain sections was saturable and characterized by K(d) values (of 0.2-0.3 microM) consistent with physiological concentrations. The highest B(max) was found in the hypothalamus, consistent with a role in stress. In most brain regions, the homologous inhibition of [(3)H]isatin binding by increasing concentrations of cold isatin demonstrated complex behavior suggesting involvement of various binding proteins characterized by different affinity to isatin. Affinity chromatography of Triton X-100 lysates of whole-brain homogenates on 5-aminocaproyl-isatin-Sepharose followed by subsequent proteomic analysis resulted in identification of 25 individual proteins, including glyceraldehyde-3-phosphate dehydrogenase, one of few previously reported isatin binding proteins, and a group of cytoskeleton-related proteins. These binding sites may be related to the known antiproliferative and proapoptotic activities of isatin.

Benefits of infant massage for mothers with postnatal depression.

Infant massage by the mother has been popular in many cultures, especially India, and is growing in popularity in the West. Mothers with postnatal depression often have problems interacting with their infants. A small controlled study has shown that attending a massage class can help such mothers relate better to their babies. The mechanisms by which this is achieved are not clear but may include learning to understand their babies' cues and the release of oxytocin.