April 8, 2011 — Teenagers who are avid music listeners have a significantly increased risk for major depressive disorder (MDD), whereas those who are avid readers appear to have a much reduced risk for MDD, new research suggests.
In a study of more than 100 adolescents, investigators found that teenagers who listened to the most music were 8.3 times more likely to have MDD than those exposed to the least amounts. In contrast, teenagers who read the most were the least likely to have MDD.
"It wasn't a surprise that that we found an association between music and depression, but it was surprising that it was such a strong association," lead study author Brian A. Primack, MD, assistant professor of medicine and pediatrics at the University of Pittsburgh School of Medicine in Pennsylvania, told Medscape Medical News.
The investigators note that the findings do not answer whether increased music use increases the risk of developing MDD or if those already depressed may listen to more music. This latter possibility is especially feasible because those with MDD often lack the concentration needed to read or perform other tasks requiring high cognitive involvement.
The study is published in the April issue of Archives of Pediatric and Adolescent Medicine.
Marker of Mental Illness?
"In no way should this study be interpreted as music is bad. It's actually very likely to be the opposite. With the study's design, we weren't able to test which direction the relationship goes," added Dr. Primack.
|Dr. Brian A. Primack|
"Still, I think use of these media can be markers for mental health, especially when one is being used to excess and other activities are being shunned. This may be a sign for parents and clinicians to pay attention to. We need all the help we can get in diagnosing adolescent depression, which is just a really terrible condition.
"Current total media exposure for youth aged 8 to 18 years is estimated at more than 10 hours per day," write the researchers, who note in a release that MDD is thought to affect 1 in 12 teenagers.
"Since media exposure is now so high, we think it's important to figure out what kind of associations there are between it and health outcomes," said Dr. Primack.
In a previous study reported by Medscape Medical News, Dr. Primack and colleagues found that extremely high television use by adolescents participating in the National Longitudinal Survey of Adolescent Health significantly increased their odds of developing MDD in young adulthood.
However, "large survey measurements can be imprecise and subject to recall bias," the investigators write.
For this study, they evaluated data on 106 adolescents (mean age, 12.7 years; 63.2% female; 88.7% white) who participated in the Child and Adolescent Depression and Anxiety Study between 2003 and 2008. Of these, 46 were diagnosed as having MDD at baseline and 60 were included as healthy controls.
All participants were given answer-only cell phones and received as many as 60 calls during an 8-week period. During these calls, the teens were asked what media they were currently using, including music, television or movies, the Internet, video games, and print media — which could be magazines, newspapers, and/or books.
The investigators did not ask specific questions about the media, such as what types of music they were listening to.
Results showed that 26.3% of all calls occurred when participants were watching a movie or television, 9.1% while listening to music, 6.1% while on the Internet, 6.0% while playing video games, and 0.2% while reading print media.
Although it had the most use, movies/television were not associated with significantly increased likelihood of having MDD (P = .37 for trend).
However, there was an 80% increase in the odds of having MD "for each increasing quartile of audio use" (95% confidence interval [CI], 1.2 – 2.8; P = .01), whereas each increasing quartile of print media was associated with a 50% decrease in the odds (95% CI, 0.3 – 0.9: P = .009), report the researchers.
There were no other significant associations with MDD found for any of the other media evaluated.
"Sadness is a common theme in popular music, and it may be that individuals with depression turn to these messages to make themselves feels less alone in their sadness. Conversely, it may also be that individuals with MDD turn to happy music to 'tune out' their negative moods or to elevate their moods," write the study authors.
"Other researchers have suggested that heavy exposure to the sometimes dark themes of popular music may contribute to the development of conditions such as MDD. Whatever the mechanism, this empirical study suggests that this association may be stronger than previously considered," they add.
Dr. Primack said he hopes that future studies are able to parse out specific types of media exposure involved. This limitation in the current study may explain why there was not an association found for high Internet use, which has been shown in past studies.
"All of the conversations you've heard about possible 'Facebook depression' was discussing a very specific type of exposure. Those in our study could have been playing a relaxing game or something violent or been reading an electronic book. It really is such a grab-bag, a varied source of material. And we hope to get more specific next time."
He noted that they also hope to launch a longitudinal study to evaluate the directionality of these associations.
"I thought this was an interesting study, and it's been creating a kind of buzz from child psychiatrists," Kathryn R. Cullen, MD, assistant professor in the Division of Child and Adolescent Psychiatry at the University of Minnesota Medical School in Minneapolis and director of the Child and Adolescent Mood Disorders Clinical and Research Program, told Medscape Medical News.
"It confirms what we've already seen, that reading seems to be a protective factor for depression. And then the music finding being so strong was quite interesting, especially that it was for music and not television use," said Dr. Cullen, who was not involved with this research.
She noted that parents of adolescents with MDD that have been treated at her clinic often tell her that the type of music their children are listening to is depressing and they are concerned that it is making the depression worse.
"They come to me as a psychiatrist and ask what they should do and if they should be fighting this. So it's nice that there are studies like this that are looking at this question. The only problem is, it didn't look at type of music. So we still don't know," said Dr. Cullen.
"This was also more of an in-the-moment study, not a longitudinal one, and we don't know what's causal. It would be interesting to say that music somehow causes the depression, but we really can't make that statement at this point."
She said that wondering whether high use of any media is "causing problems in our kids today" is a question that has been going on for a long time.
"As clinicians, we want a study that says 'yes, you need to get in there and turn off that TV or music' or 'you need to make them listen to Mozart' or a study that says it doesn't really matter; let them listen to their music because it's helping them. That's the kind of information that would be helpful for parents," said Dr. Cullen.
"I think the takeaway from this study is that it's added evidence that there's an association between media choices and major depression. Because it doesn't answer any questions on causality, it's really just reinforcing that concept and that kids with depression listen to music more and read less."
The study was funded by grants from the National Institute of Mental Health, the National Cancer Institute, the RAND-University of Pittsburgh Health Institute, and the Maurice Falk Foundation. The study authors and Dr. Cullen have disclosed no relevant financial relationships.
Arch Pediatr Adolesc Med. 2011;165:360-365. Abstract
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Cite this: Popular Music Linked to Teenage Blues - Medscape - Apr 08, 2011.