Preparing for future pandemics: enhancing serotonin activation and interpersonal warmth through music therapy to aid in adolescent depression recovery post-COVID-19: a randomized controlled trial

BACKGROUND: This study aims to evaluate the effectiveness of music therapy as an alternative therapy for depression recovery and prevention in adolescents with a history of COVID-19 infection. To this end, we aim to investigate the effects of music therapy interventions designed to enhance interpersonal warmth on changes in mean body temperature (mTb) as measured by local skin temperature, social connectedness, serum serotonin (5-HT) levels, and recovery from depression. METHODS: This study is designed based on a randomization method (1:1). Participants were divided into two groups: the Music Therapy Group (MT G, n = 22) and the Non-Music Therapy Group (Non-MT G, n = 21). The MT group engaged in a total of 24 sessions. Physiological indicators, such as mTb and serum 5-HT levels, along with psychological indicators, including the Social Connectedness Scale-Revised (SCS-R) and the Beck Depression Inventory-II (BDI-II), were measured, and analysis was performed after the application of the Bonferroni correction. Additionally, correlational analyses were conducted within the MT group to examine the relationships between physiological and psychological factors contributing to improvements in depression. RESULTS: After 24 sessions of music therapy intervention, the MT group exhibited statistically significant increases in mTb (+ 0.18 °C), serum 5-HT levels (+ 22.09%), and SCS-R scores (+ 9.97%), along with a statistically significant decrease in BDI-II scores (-29.56%), indicating positive changes. Conversely, no such changes were observed in the Non-MT group. Within the MT group, correlational analyses revealed positive correlations between increases in mTb, serum 5-HT levels, and SCS-R scores. Additionally, the increase in serum 5-HT levels demonstrated a statistically significant negative correlation with the reduction in BDI-II scores. CONCLUSIONS: In conclusion, this study showed that music therapy improved depression in adolescents with a history of COVID-19 infection, and this may suggest therapeutic benefits associated with the mind-body connection. These findings suggest the potential of music therapy as an alternative therapy for adolescent depression recovery and its applicability for psychophysiological adaptation to abrupt environmental change. The study was retrospectively registered with the Clinical Research Information Service (CRIS) (registration number: KCT 0010161) on January 24, 2025.