Mental health (depression): Massage


To systematically review the research evidence on the effectiveness of aromatherapy and/or massage for depression.

Comprehensive searches of the following databases were conducted between August and October 2004:
• Major biomedical and nursing databases: ClNAHL, CENTRAL, Cochrane Database of Systematic Reviews, DARE, EMBASE, MEDLINE (and PubMed)
• Specialist databases: AMED, CISCOM.
Efforts were also made to identify unpublished and ongoing research via the National Research Register (UK) and (US). Search strategies included terms for aromatherapy, massage, depression and depressive disorders. Relevant research was systematically categorised by study type and appraised according to study design. Clinical commentaries were obtained for each study included in the review.

Four randomised (RCT) and 2 nonrandomised (CCT) controlled trials were included in this review. Four of the studies were of massage (ranging from shoulder/back massage to full body massage), one was of aromatherapy with massage and one of aromatherapy alone (inhalation of essential oils). The RCTs of massage therapy were conducted in hospitalised children and adolescents with depression, adolescent mothers with depressive symptoms and women with postnatal depression. Results of these studies were positive with massage therapy found to compare favourably with relaxing activities such as viewing a videotape, yoga plus progressive muscular relaxation or no treatment. One recent small RCT suggested promising results of individualised aromatherapy massage compared with massage alone in elderly patients with anxiety and/or depression.  Relevant details such as method of randomisation and details of attrition were unreported for most studies. Other problems in interpretation of the results arise from the nature of the intervention which precludes blinding of either patient or carer. Studies in which massage was incorporated into complex interventions were also located but the contribution of the massage component was impossible to assess.

Studies located
Systematic review  0
RCT   4 (3 massage only; 1 aromatherapy only)  
CCT   2 (1 massage only, 1 aromatherapy massage)

The studies located provide limited evidence of positive effects of massage therapy in depression although there is currently insufficient research evidence on any single intervention or patient group for firm conclusions on effectiveness, role or long-term outcomes to be drawn. Massage interventions can be delivered in a number of settings and there may be a potential role for interventions such as these in, for example, mild depression where use of antidepressants as first line treatment is discouraged (NICE 2004) particularly in patient groups in which use of antidepressants is problematic (elderly, depressed mothers, hospitalised children). The added benefits of incorporating essential oils into the massage treatment suggested by the single study require further evaluation. Safety considerations relate to the selection of appropriate massage techniques and of suitable essential oils if these are to be incorporated into therapy.  These aspects of treatment also require further evaluation.

Research recommendations
• The differential effects of the various massage interventions, of incorporating essential oils in massage therapy and of the different essential oils require investigation.
• Future studies should have clear inclusion criteria, be adequately powered and where feasible address longer-term outcomes. 
• Control interventions should address the additional interpersonal interaction and attention receive


Mental health (depression)


Search and Appraisal Methods

The Evidence


Full Report

Created on28 April, 2011 - 17:26