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com J Tradit Chin Med 2014 April 15; 34(2): 159-161 ISSN 0255-2922
© 2014 JTCM. All rights reserved.


Effects of five-element music therapy on elderly people with season-

al affective disorder in a Chinese nursing home

Xifang Liu, Xin Niu, Qianjin Feng, Yaming Liu

Xifang Liu, Xin Niu, Qianjin Feng, Yaming Liu, School of two parts: (a) a qualitative study that used focus
Basic Medical Sciences, Beijing University of Chinese Medi- groups to understand the feelings of the patients
cine, Beijing 100029, China with seasonal affective disorder; (b) a quantitative
Supported by the Assistance Project for the Developing
study that involved administration of the self-rat-
Country Funded by the Ministry of Science and Technology
of China (No. KY201302010); the National Major Foundation-
ing depression scale (SDS) and Hamilton depres-
al Research Development Project (973 project) (No. sion scale (HAMD) before and after treatment.
2011CB505404); the Beijing University of Chinese Medicine
RESULTS: (a) Qualitative analysis results: strength
Innovative Group (No. 2011-CXTD-05); the National Science
and Technology Project in '12th Five Year Plan' Funded by
derived from the five-element group music therapy
the Ministry of Science and Technology (No. and emotional adjustment. The five-element group
2012BA125B05); the National Basic Research Program of Chi- music therapy can reduce patients' psychological
na (No. 81173381) distress and let them feel inner peace and enhance
Correspondence to: Prof. Xin Niu, and Prof. Qianjin Feng, their life satisfaction. (b) No significant difference in
School of Basic Medical Sciences, Beijing University of Chi- SDS and HAMD scores was found between the two
nese Medicine, Beijing 100029, China.; groups (P>0.05) prior to treatment. After treatment,
the mean SDS score of the control group was 49.9±
Telephone: +86-10-57219426; +86-10-57217969
Accepted: December 25, 2013
18.8, while the treatment group's score was 40.2 ±
18.1. The HAMD score of the control group was
11.2±3.1, and the treatment group's score was 8.8±
4.9. Following 8 weeks of music therapy, the SDS
and HAMD scores of the treatment group were
Abstract significantly lower than those for the control
OBJECTIVE: To explore the effects of five-element group (P<0.05).
music therapy on elderly patients with seasonal af-
CONCLUSION: Five-element music therapy alleviat-
fective disorder in a Chinese nursing home.
ed the symptoms of seasonal affective disorder in
METHODS: The patients (n=50) were recruited the elderly patients.
from a Shijingshan district nursing home in Beijing,
China. They were randomly assigned to two © 2014 JTCM. All rights reserved.
groups, a treatment group and a control group,
with 25 participants in each group. The patients re- Key words: Five-element music; Seasonal affective
ceived music therapy for 1-2 h each week over an disorder; Nursing homes
8-week period. The music therapy involved four
phases: introduction, activities, listening to the Chi-
nese five-element music, and a concluding phase.
The participants in the control group did not listen Aging is a worldwide issue in our society. Elderly peo-
to the five-element music. This study consisted of ple living in nursing homes may suffer from sadness,

JTCM | www. journaltcm. com 159 April 15, 2013 | Volume 34 | Issue 2 |
Liu XF et al. / Clinical study

pain and isolation. Many of them may experience sea- content, and every session was divided into four parts:
sonal affective disorder (SAD). SAD is a common con- the beginning period, activities, listening to Chinese
dition where individuals present with depressed five-element music, and the concluding phase. The
mood, loss of interest or pleasure, feelings of guilt, control group did not listen to Chinese five-element
disturbed sleep and/or appetite, low energy and poor music. The researcher took field notes and noted im-
concentration.1,2 portant observations during the music therapy, especial-
While much research has focused on SAD, no studies ly any key words which might lead to further discussions.
have yet investigated the use of five-element music ther-
apy with elderly SAD patients. Music therapy has been Data collection
recognized as an effective method in helping the elder- The Self-rating depression scale (SDS) and Hamilton
ly improve both their physical and mental health. The depression scale (HAMD) were administered before
music therapy used in this study was accredited by the and after the treatment.7 SDS is a 20-item self-report
American Music Therapy Association. instrument. Each item of the scale is associated with de-
Researchers note that music therapy can have a positive pression syndrome including psychological and somat-
influence on the regions of the brain responsible for ic symptoms. The scale yields a total score that ranges
managing anxiety and stress.3 In addition, it has been from 20 to 80, and can be used to indicate the severity
found that music therapy can relieve stress experi- of depression. HAMD is a 17-item scale with factors
enced by elderly people who suffer from neurological including anxiety, cognitive disturbance, diurnal varia-
disorders.4 tion, mental retardation, sleep disturbance and feelings
Many clinicians have adapted and employed music of hopelessness.
therapy with their clients for the last 20 years.5 Never- Data analysis
theless, few published studies have used five-element All data were analyzed using SPSS (version 13.0; IBM,
music therapy with SAD patients. Based on the theory Armonk, NY, USA). Mean scores ± standard deviation
of Traditional Chinese Medicine (TCM), ancient prac- were given. T-tests were used to evaluate the difference
titioners was believed to have used five-element music between group means. A significance level of P<0.05
in China to combat the condition of SAD. The goals was used.
of this research were to evaluate the effect of five-ele-
ment music therapy on elderly people with SAD.
METHODS Quantitative statistical results
No significant difference was found between the mean
Participants ages of the two groups (P>0.05). Before the treatment,
Participants were recruited from a nursing home in Shi- the SDS score of the control group was 56.2 ± 19.3,
jingshan district, Beijing, China, between November while the score of the treatment group was 56.2±19.1.
2012 and February 2013. Participants were recruited There was thus no significant difference in SDS scores
based on the following criteria: (a) aged 50 years or old- between the two groups before treatment (P>0.05).
er; (b) conformed to the SAD diagnostic criteria in the The HAMD score of the control group was 14.7±4.5,
DSM-III-R;6 (c) experienced symptoms of depression and for the treatment group was 15.1±5.9 prior to in-
for at least 2 years, with these symptoms being noted tervention. Again there was no significant difference in
to be more serious in autumn/winter and to ease in the HAMD scores of the two groups before treatment
spring/summer; (d) fond of Chinese classical music (P>0.05). The SDS scores of the two groups were sig-
and willing to be interviewed in a group setting; (e) nificantly different after treatment (control group:
did not suffer from any other mental illnesses or experi- 49.9±18.8; treatment group: 40.2±18.1, P<0.05). The
ence other social/psychological difficulties that would HAMD score of the control group was 11.2±3.1, while
confound the study results. This study was approved the score of the treatment group was 8.8±4.9. After 8
by the ethics committee in Beijing University of Chi- weeks treatment, HAMD scores of the two groups
nese Medicine. Informed consent was obtained from were significantly different (P<0.05).
the participants who were aware that they had the right Qualitative analysis results
to withdraw from the study at any time. Using a ran- Strength derived from the five-element group music
dom numbers table, the participants were assigned to therapy and emotional adjustment. The five-element
either the treatment or control group, with 25 individ- group music therapy can reduce patients' psychological
uals in each. distress and let them feel inner peace and enhance their
life satisfaction.
The treatment group received music therapy for 1-2 h
each week, from November 2012 to February 2013. DISCUSSION
The music therapy comprised both active and passive The findings of our study indicate that Chinese five-el-

JTCM | www. journaltcm. com 160 April 15, 2014 | Volume 34 | Issue 2 |
Liu XF et al. / Clinical study

ement music alleviated the patients' SAD symptoms. ty of SAD symptoms in elderly patients. Five-element
There may be several reasons for this phenomenon. music therapy is a noninvasive and safe treatment
Compared with other music therapy, five-element mu- method for SAD.
sic therapy is not only a kind of musical healing modal-
ity but also a special musical prescription based on
According to Emperor Canon, Chinese classical five-el-
We would like to express our gratitude to all the partici-
ement music can cure disease.8 The five elements in-
pants who provided the information in this study.
clude Gong, Shang, Jue, Zhi and Yu. Each element
links with a specific organ: Gong to the spleen, Shang
to the lung, Jue to the liver, Zhi to the heart, and Yu to REFERENCES
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JTCM | www. journaltcm. com 161 April 15, 2014 | Volume 34 | Issue 2 |