
Journal of Shanghai Jiao Tong University (Medical Science) >
Advances in music therapy for the treatment of agitation
Received date: 2025-04-15
Accepted date: 2025-10-20
Online published: 2026-01-30
Supported by
National Science and Technology Innovation 2030-Major Project of Brain Science and Brain-like Research(2021ZD0200800);Shanghai“Science and Technology Innovation Action Plan”Medical Innovation Research(21Y11905600);Research-Oriented Physician Training and Capacity-Building Program of Shanghai Mental Health Center(2021-YJXYS-06)
Agitation is a common symptom in psychiatric clinical practice, typically accompanied by emotional fluctuations and aggressive behaviors, which significantly impair patients′ treatment outcomes and pose safety risks to healthcare providers. Abnormal prefrontal cortex function and various neurotransmitter imbalances are considered the primary biological mechanisms underlying the onset of agitation. Music therapy, as a non-pharmacological intervention, has been shown to effectively alleviate agitation by enhancing brain functional connectivity, modulating neurotransmitter activity, and regulating physiological stress responses. Furthermore, music therapy has demonstrated positive therapeutic effects in clinical applications for patients with specific psychiatric conditions, such as Alzheimer′s disease, traumatic brain injury, and schizophrenia. Future research should focus on further elucidating the neurobiological mechanisms by which music therapy mitigates agitation, exploring the integration of multimodal interventions, and evaluating long-term efficacy, in order to facilitate its widespread clinical implementation and continuous optimization.
Key words: music therapy; agitation; emotional accommodation; mental disorder
Yang Vivien , Chen Yiming , Hong Wu . Advances in music therapy for the treatment of agitation[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026 , 46(1) : 100 -106 . DOI: 10.3969/j.issn.1674-8115.2026.01.012
| [1] | Vieta E, Garriga M, Cardete L, et al. Protocol for the management of psychiatric patients with psychomotor agitation[J]. BMC Psychiatry, 2017, 17(1): 328. |
| [2] | Zhou J S, Zhong B L, Xiang Y T, et al. Prevalence of aggression in hospitalized patients with schizophrenia in China: a meta-analysis[J]. Asia Pac Psychiatry, 2016, 8(1): 60-69. |
| [3] | Garriga M, Pacchiarotti I, Kasper S, et al. Assessment and management of agitation in psychiatry: expert consensus[J]. World J Biol Psychiatry, 2016, 17(2): 86-128. |
| [4] | MartíNez-Raga J, Amore M, Di Sciascio G, et al. 1st international experts′ meeting on agitation: conclusions regarding the current and ideal management paradigm of agitation[J]. Front Psychiatry, 2018, 9: 54. |
| [5] | Cohen-Mansfield J, Thein K, Marx M S. Predictors of the impact of nonpharmacologic interventions for agitation in nursing home residents with advanced dementia[J]. J Clin Psychiatry, 2014, 75(7): e666-e671. |
| [6] | San L, Marksteiner J, Zwanzger P, et al. State of acute agitation at psychiatric emergencies in Europe: the STAGE study[J]. Clin Pract Epidemiol Ment Health, 2016, 12(1): 75-86. |
| [7] | Goyer P F, Andreason P J, Semple W E, et al. Positron-emission tomography and personality disorders[J]. Neuropsychopharmacology, 1994, 10(1): 21-28. |
| [8] | Delli Pizzi S, Padulo C, Brancucci A, et al. GABA content within the ventromedial prefrontal cortex is related to trait anxiety[J]. Soc Cogn Affect Neurosci, 2016, 11(5): 758-766. |
| [9] | Lindenmayer J P. The pathophysiology of agitation[J]. J Clin Psychiatry, 2000, 61: 5-10. |
| [10] | Miller C, Hodzic V, Weintraub E. Current understanding of the neurobiology of agitation[J]. WestJEM, 2020, 21(4): 841-848. |
| [11] | New A S, Trestman R L, Mitropoulou V, et al. Serotonergic function and self-injurious behavior in personality disorder patients[J]. Psychiatry Res, 1997, 69(1): 17-26. |
| [12] | Siever L, Trestman R L. The serotonin system and aggressive personality disorder[J]. Int Clin Psychopharmacol, 1993, 8: 33-40. |
| [13] | Geniole S N, Bird B M, Mcvittie J S, et al. Is testosterone linked to human aggression? A meta-analytic examination of the relationship between baseline, dynamic, and manipulated testosterone on human aggression[J]. Horm Behav, 2020, 123: 104644. |
| [14] | Namkung H, Yukitake H, Fukudome D, et al. The miR-124-AMPAR pathway connects polygenic risks with behavioral changes shared between schizophrenia and bipolar disorder[J]. Neuron, 2023, 111(2): 220-235.e9. |
| [15] | Sun H R, Zhang X Q, Kong Y J, et al. Maternal separation-induced histone acetylation correlates with BDNF-programmed synaptic changes in an animal model of PTSD with sex differences[J]. Mol Neurobiol, 2021, 58(4): 1738-1754. |
| [16] | Wang L J, Wang L J, Chen J X, et al. Five-week music therapy improves overall symptoms in schizophrenia by modulating theta and gamma oscillations[J]. Front Psychiatry, 2024, 15: 1358726. |
| [17] | Pompili M, Ducci G, Galluzzo A, et al. The management of psychomotor agitation associated with schizophrenia or bipolar disorder: a brief review[J]. Int J Environ Res Public Health, 2021, 18(8): 4368. |
| [18] | de Souza T L, de Oliveira Azzolin K, Fernandes V R. Cuidados multiprofissionais para pacientes em delirium em terapia intensiva: revis?o integrativa[J]. Rev Gaúcha Enferm, 2018, 39: e2017-0157. |
| [19] | Khan S H, Kitsis M, Golovyan D, et al. Effects of music intervention on inflammatory markers in critically ill and post-operative patients: a systematic review of the literature[J]. Heart Lung, 2018, 47(5): 489-496. |
| [20] | Gustavson D E, Coleman P L, Iversen J R, et al. Mental health and music engagement: review, framework, and guidelines for future studies[J]. Transl Psychiatry, 2021, 11: 370. |
| [21] | 农金梅, 李均锐, 梁頔, 等. 团体音乐治疗对康复期精神分裂症患者激越症状及神经营养因子水平的影响[J]. 反射疗法与康复医学, 2024, 5(12): 187-190. |
| Nong J M, Li J R, Liang D, et al. The effect of group music therapy on agitation symptoms and neurotrophic factor levels in patients with schizophrenia during the recovery phase [J].Reflexology and Rehabilitation Medicine, 2024, 5(12): 187-190. | |
| [22] | Schuldt M R P, Silverman M J. Lyric analysis in adult mental health settings: an exploratory interpretivist study of music therapists' clinical decision-making processes[J]. Arts Psychother, 2020, 71: 101712. |
| [23] | Kong E H, Park M. Effects of music therapy on agitation in dementia: systematic review and meta-analysis[J]. Korean J Adult Nurs, 2015, 27(1): 106-116. |
| [24] | Pedersen S K A, Andersen P N, Lugo R G, et al. Effects of music on agitation in dementia: a meta-analysis[J]. Front Psychol, 2017, 8: 742. |
| [25] | Lee S N, Chan L, Maddison J. Can a personalised music listening intervention decrease agitation in hospitalised patients with dementia A feasibility trial[J]. Front Psychiatry, 2023, 14: 1186043. |
| [26] | Gerdner L A. Evidence-based guideline: Individualized music for persons with dementia[M]. Ann Arbor: National Nursing Practice Network, 2013. |
| [27] | Pant U, Frishkopf M, Park T, et al. A neurobiological framework for the therapeutic potential of music and sound interventions for post-traumatic stress symptoms in critical illness survivors[J]. Int J Environ Res Public Health, 2022, 19(5): 3113. |
| [28] | Park S, Williams R A, Lee D. Effect of preferred music on agitation after traumatic brain injury[J]. West J Nurs Res, 2016, 38(4): 394-410. |
| [29] | Huang C, Gu S Y. Effectiveness of music therapy in enhancing empathy and emotional recognition in adolescents with intellectual disabilities[J]. Acta Psychol, 2024, 243: 104152. |
| [30] | de Witte M, Lindelauf E, Moonen X, et al. Music therapy interventions for stress reduction in adults with mild intellectual disabilities: perspectives from clinical practice[J]. Front Psychol, 2020, 11: 572549. |
| [31] | Rossetti A, Chadha M, Torres B N, et al. The impact of music therapy on anxiety in cancer patients undergoing simulation for radiation therapy[J]. Int J Radiat Oncol Biol Phys, 2017, 99(1): 103-110. |
| [32] | Cho E, Lee J Y, Yang M, et al. Symptom-specific non-pharmacological interventions for behavioral and psychological symptoms of dementia: an umbrella review[J]. Int J Nurs Stud, 2024, 159: 104866. |
| [33] | Paul N, Lotter C, van Staden W. Patient reflections on individual music therapy for a major depressive disorder or acute phase schizophrenia spectrum disorder[J]. J Music Ther, 2020, 57(2): 168-192. |
| [34] | Nwokenna E N, Sewagegn A A, Falade T A. Effect of educational music intervention on college students′ aggressive behaviour[J]. Medicine, 2023, 102(1): e32472. |
| [35] | Mao X H, Cai D D, Lou W. Music alleviates pain perception in depression mouse models by promoting the release of glutamate in the hippocampus of mice to act on GRIK5[J]. Nucleos Nucleot Nucl Acid, 2022, 41(5/6): 463-473. |
| [36] | Tseng H H, Wu C Y, Chang H H, et al. Posterior cingulate and medial prefrontal excitation-inhibition balance in euthymic bipolar disorder[J]. Psychol Med, 2024, 54(11): 3168-3176. |
| [37] | Giorgioni G, Del Bello F, Pavleti? P, et al. Recent findings leading to the discovery of selective dopamine D4 receptor ligands for the treatment of widespread diseases[J]. Eur J Med Chem, 2021, 212: 113141. |
| [38] | da Silva A C P, de Oliveira M L, Carvalho L C, et al. Efeitos da música clássica aplicada em crian?as hospitalizadas[J]. Acervo Saúde, 2020(48): e3215. |
| [39] | Beatty J, Prasun M A, Su Y. The effect of music on postoperative agitation, pain, and opioid use among patients undergoing total knee replacement[J]. Pain Manag Nurs, 2024, 25(6): 571-575. |
| [40] | Yearsley S. Striking a balance: improving practice as a student doing group music therapy with adults with substance abuse and dependence[D]. Wellington: Victoria University of Wellington, 2010. |
| [41] | Kuot A, Barton E, Tiri G, et al. Personalised music for residents with dementia in an Australian rural aged-care setting[J]. Aust J Rural Health, 2021, 29(1): 71-77. |
/
| 〈 |
|
〉 |