Playlist intervention to reduce anxiety for inpatients in standard electroconvulsive therapy (ECT): An exploratory randomised controlled trial

Introduction: Depression is one of the most frequent and debilitating psychiatric disorders worldwide. A large body of evidence indicates that electroconvulsive therapy (ECT) is an efficient treatment modality, especially in severe depression, however, it is associated with high levels of anxiety in many patients. In 2016, a systematic review of studies on anxiety in ECT showed very few studies using music listening. In the general scientific literature, music listening as a means of alleviating anxiety is ambiguous, showing outcomes from promising to uncertain. A feasibility study in 2016 indicated that playlist listening had a positive effect on patients and staff. More knowledge on non-pharmacological interventions is needed, and this trial tests the efficacy of expert-curated playlists to mollify standard ECT-related anxiety. Method: An exploratory parallel randomised controlled trial design with three research arms was carried out with inpatients diagnosed with depression. A total of thirty adult inpatients between 18 and 74 years were randomised to listen to either expert-curated playlists with music or playlists with nature sounds. Anxiety symptoms were measured using the State Trait Anxiety Inventory (STAI-Y1) and the Anxiety Symptom Scale (ASS). A non-validated questionnaire on the patient’s listening experience (PQ) was applied to lend a voice to the participants. Discussion: The study investigated possible differences in efficacy between the type of playlist and number of treatments. If proven effective in overcoming ECT-related anxiety, the intervention could serve as a non-pharmacologic intervention that does not conflict with the seizure threshold as add-on to standard electroconvulsive therapy. Results: The results will be presented in a forthcoming article.