The Mediating Effects of Digital Music Therapy on Depressive Symptoms in Youth During the COVID-19 Pandemic: A Randomized Controlled Trial.

Abstract

The COVID-19 pandemic has become a major psychosocial stressor, exacerbating depressive symptoms among youth. Amid escalating environmental stressors, early intervention is essential. Digital music therapy (dMT) shows promise; however, stress-context randomized controlled trials examining its effectiveness and mechanisms are lacking. A total of 1581 youths were identified with depressive symptoms via survey. In a randomized trial, 105 participants were 1:1 assigned to the dMT or control (CON) group. The dMT group received 3 weeks of intervention, while the CON group received none. The primary outcome will assess depression changes ( $\Delta$ ) of pre- and post-intervention, compared to CON group. Secondary outcomes will evaluate $\Delta$ Stress and $\Delta$ Insomnia, compared to CON group. Mediation analysis examined depressive symptoms' role in mediating stress and insomnia, further assessed dMT efficacy's mediating role in these outcomes. There were significant differences in $\Delta$ Depression, $\Delta$ Stress, and $\Delta$ Insomnia between dMT group (n = 30) and CON group (n = 30). Depressive symptoms directly and indirectly mediated the relationship between stress and insomnia among depressive youth identified via survey. The therapeutic effect of the dMT intervention on $\Delta$ Depression indirectly mediated the relationship between $\Delta$ Stress and $\Delta$ Insomnia. Digital MT-driven depression improvement mediates stress and insomnia alleviation, filling a crucial gap in early-stage mental health interventions with potential social and clinical impact. TRIAL REGISTRATION: The clinical trial registration was ClinicalTrials.gov NCT05949736.