Effect of Traditional Raga Therapy on Depression, Anxiety, and Stress Level in Preoperative Patients Undergoing Cataract Surgeries

Asha Achar; Badrinath Talwar; Ashok Kumar; Purna Singh Addanki

doi:10.4103/mamcjms.mamcjms_89_21

ORIGINAL ARTICLE

Year : 2021 | Volume : 7 | Issue : 3 | Page : 251-253

Effect of Traditional Raga Therapy on Depression, Anxiety, and Stress Level in Preoperative Patients Undergoing Cataract Surgeries

Asha Achar¹, Badrinath Talwar¹, Ashok Kumar², Purna Singh Addanki³
¹ Department of Ophthalmology, Kanachur Institute of Medical Sciences, Deralakatte, Mangalore, Karnataka, India
² Department of ENT, Kanachur Institute of Medical Sciences, Deralakatte, Mangalore, Karnataka, India
³ Department of Physiology, Mamata Medical College, Khammam, Telangana, India

Date of Submission	28-Jul-2021
Date of Decision	30-Oct-2021
Date of Acceptance	08-Nov-2021
Date of Web Publication	24-Dec-2021

Correspondence Address:
Dr. Ashok Kumar
Department of ENT, Kanachur Institute of Medical Sciences, Deralakatte, Mangalore 575018, Karnataka
India

Source of Support: None, Conflict of Interest: None

Check

DOI: 10.4103/mamcjms.mamcjms_89_21

Abstract

Background: Psychologic behavior plays a key role in the outcome of any treatment or therapy. It was recommended to assess the psychologic status of the patient along with the clinical examination and also counsel him with adequate management therapies. Ragas have a high impact on mental well-being. Listening to ragas was reported to be highly effective in regulating the blood pressure and heart rate. Methods: The present study involved 30 (10 males and 20 females) preoperative patients who will be undergoing cataract surgery in 2 days and within the age group of 55 to 60 years from the ophthalmology department. The patients were subjected to listen to Raga Bhairavi for 30 minutes for 2 days. Results: There is a significant decrease in depression anxiety and stress levels followed by raga therapy. Conclusion: There is a significant decrease in depression anxiety and stress levels followed by raga therapy. There is a strong need for further studies with multiple centers and a higher sample size to recommend raga therapy in the management of mental health problems in the patients.

Keywords: Anxiety, depression, patients, raga therapy, stress

How to cite this article:
Achar A, Talwar B, Kumar A, Addanki PS. Effect of Traditional Raga Therapy on Depression, Anxiety, and Stress Level in Preoperative Patients Undergoing Cataract Surgeries. MAMC J Med Sci 2021;7:251-3

How to cite this URL:
Achar A, Talwar B, Kumar A, Addanki PS. Effect of Traditional Raga Therapy on Depression, Anxiety, and Stress Level in Preoperative Patients Undergoing Cataract Surgeries. MAMC J Med Sci [serial online] 2021 [cited 2022 Aug 19];7:251-3. Available from: https://www.mamcjms.in/text.asp?2021/7/3/251/333608

Introduction

Psychologic behavior plays a key role in the outcome of any treatment or therapy. It was recommended to assess the psychologic status of the patient along with the clinical examination and also counsel him with adequate management therapies. This not only relieves the stress but also improves the outcome of the treatment. Patients become stress when they were explained about the surgical process. Excessive stress will have an adverse effect on an outcome. Stress raises blood pressure and it is mandated to regulate blood pressure before the surgery. Pharmacologic treatment is effective but involved side effects and cannot prescribe long-term use.^[1],[2] Hence, the present study used traditional music for the management of stress in patients.

Ragas have a high impact on mental well-being. Listening to ragas was reported to be highly effective in regulating blood pressure and heart rate. This effect may be due to the effect on sympathetic and vagal systems. Ragas were found to be very powerful in the Indian context. It was proven that there are certain ragas by which person can control the nature such as make the clouds to rain. Listening to ragas on regular basis is very helpful as it can activate all the chakras in the body. Further, it increases the quality and quantity of life. Raga Bhairavi is one of the ancient ragas which is highly effective in the management of mental health problems. Hence, the present study selected the raga for management of depression, anxiety, and stress levels in preoperative patients undergoing cataract surgeries.^{[3],[4],[5],[6]}

Materials and Methods

Study design: Experimental study

Study setting: The present study was conducted at Kanachur Institute of Medical Sciences, Deralakatte, Mangalore, Karnataka, India.

Study population

The present study involved 30 (10 males and20 females) preoperative patients who will be undergoing cataract surgery in 2 days and within the age group of 55 to 60 years from the ophthalmology department. Both males and females were included in the study. Informed consent was obtained from all the patients before the study. Willing participants were included in the study. Patients with severe complications were excluded from the study.

Raga therapy

The patients were subjected to listen to Raga Bhairavi for 30 minutes for 2 days. The timing of listening was adjusted to 9 am as per the convenience of patients. A standard music system from Philips Company (BTM2180/37 Micro Music System by Philips company, Amsterdam. Netherlands) was used to deliver the music in the ward.^[7]

Assessment of depression, anxiety, and stress

The psychologic parameters were assessed using the DASS 21 scale. This is a standardized and free scale to assess negative psychologic emotions such as depression, anxiety, and stress.^[8]

Ethical consideration

The study protocol was approved by an institutional human ethical committee. Informed consent was obtained from all the participants. Confidentiality of data was maintained.

Data analysis

Data were analyzed using SPSS 20.0 version [Statistical Package for the Social Sciences (SPSS) for Windows, Version 20, SPSS Inc. by International Business Machines Corporation (IBM), Chicago, Illinois, USA]. Student t test was used to assess the significance of the difference between the groups. A probability value of less than 0.05 was considered significant.

Results

The results are summarized in [Table 1]. The two-tailed P-value is less than 0.0001 for depression score. By conventional criteria, this difference is considered to be extremely statistically significant. The mean of group 1 minus group 2 equals 5.00 (95% confidence interval: 3.37–6.63). The two-tailed P-value is less than 0.0001 for anxiety scores. By conventional criteria, this difference is considered to be extremely statistically significant. The mean of group 1 minus group 2 equals 6.00 (95% confidence interval: 3.69–8.31). The two-tailed P-value is less than 0.0001 for the stress score. By conventional criteria, this difference is considered to be extremely statistically significant. The mean of group 1 minus group 2 equals 9.00 (95% confidence interval: 6.55–11.45).

Table 1 Depression, anxiety, and stress patients before and after interventions

Click here to view

Discussion

The present study aimed to observe the effect of raga therapy for the management of depression, anxiety, and stress levels in preoperative patients undergoing cataract surgeries. There is a significant decrease in depression anxiety and stress levels followed by raga therapy. The healing effects of raga therapy are well explained. In the Indian context of view, the music was believed to be originated from Vedas that is Samaveda. There was a significant increase in the power of overall alpha, delta, and theta power of EEG waves followed by listening to ragas.^[9] Ragas were reported to improve overall health.^[10] Music therapy influences the cognition, emotional, physiologic functions, and social well-being of an individual.^[11] Music influences the cortical network associated with the emotions and regulates emotions.^[12] It was reported that listening to music also influences mood.^[13]

Listening to music improves the positive self-image and improves coping skills.^[14] Concentration, meditation, and breathing exercises take place simultaneously when singing or listening to music.^[15] Music influences relaxation and it is the best to example that baby sleep listening to music.^[16] Music has always positive impact on health and disease conditions.^[17] It was reported that music has used to heal the adolescents who were substance abused.^[18] Music also heals the neurodevelopment delays.^[19] Music therapy was reported to prevent cognitive decline.^[20] Interestingly, music was used in the management of pain and palliative care.^[21] There were structural changes in the front limbic region which is associated with the cognitive and emotional functions followed by music therapy.^[22],[23] The present study results agree with earlier studies as there was a significant reduction in the scores of depression, anxiety, and stress.

Conclusion

There is a significant decrease in depression anxiety and stress levels followed by raga therapy. There is a strong need for further studies with multiple centers and a higher sample size to recommend raga therapy in the management of mental health problems in the patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Shalev AY. Posttraumatic stress disorder and stress-related disorders. Psychiatr Clin North Am 2009;32:687-704.
2.	Jang KL, Thordarson DS, Stein MB, Cohan SL, Taylor S. Coping styles and personality: a biometric analysis. Anxiety Stress Coping 2007;20:17-24.
3.	Monroe SM. Modern approaches to conceptualizing and measuring human life stress. Annu Rev Clin Psychol 2008;4:33-52.
4.	Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behavior, and cognition. Nat Rev Neurosci 2009;10:434-45.
5.	Raj K, Rinchhen CZ, Ringe VV. Stress reduction through listening to Indian classical music during gastroscopy. Diagn Ther Endosc 1989;4:191-7.
6.	Taylor SE, Stanton AL. Coping resources, coping, processes, and mental health. Annu Rev Clin Psychol 2007;3:377-401.
7.	Balaji Deekshitulu PV. Stress management for mantra techniques. MOJ Yoga Physical Ther 2017;2:1-4.
8.	Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995.
9.	Hegde S, Aucouturier JJ, Ramanujam B, Bigand E. Variations in emotional experience during phases of the elaboration of North Indian raga performance. Cambourpoulos E, Tsougras E, Mavromatis P, Pastiadis K. (Editors) Proceedings of 12th International Conference on Music Perception and Cognition and the 8th Triennial Conference of the Cognitive Sciences of Music, July 23–28, 2012, pp. 412-3. 10, Thessaloniki, Greece.
10.	Hegde S. Music-based cognitive remediation therapy for patients with traumatic brain injury. Front Neurol 2014;5:34.
11.	Zatorre R. Music, the food of neuroscience? Nature 2005;434:312-5.
12.	Bruscia K. Definindo Musicoterapia [Defining Music Therapy]. Enelivros.
13.	Chandrashekaran N. Musical Deficits in Schizophrenia − Its Relation with Deficits in Cognition and Emotion Recognition. MPhil thesis in clinical psychology, National Institute of Mental Health and Neurosciences, Bangalore, India; 2015.
14.	Sairam TV. Can music replace medicine? Bhavan J 2015;61:64-70.
15.	Ravi M. Music and spirituality. In: Balodhi JP, ed. Application of Oriental Philosophical Thoughts in Mental Health. Bangalore: NIMHANS Publication 2002. pp. 89-98.
16.	Sambamoorthy P. South Indian Music Book 5. 8th ed. Chennai: The Indian Music Publishing House; 2002..
17.	MacDonald RA. Music, health, and well-being: a review. Int J Qual Stud Health Well-being 2013;8:20635
18.	Maratos A, Crawford MJ, Procter S. Music therapy for depression: it seems to work, but how? Br J Psychiatry 2011;199:92-3.
19.	Pasiali V, LaGasse AB, Penn SL. The effect of musical attention control training (MACT) on attention skills of adolescents with neurodevelopmental delays: a pilot study. J Music Ther 2014;51:333-54.
20.	Guétin S, Giniès P, Siou DK et al. The effects of music intervention in the management of chronic pain: a single-blind, randomized, controlled trial. Clin J Pain 2012;28:329-37.
21.	Gutgsell KJ, Schluchter M, Margevicius S et al. Music therapy reduces pain in palliative care patients: a randomized controlled trial. J Pain Symptom Manage 2013;45:822-31.
22.	Särkämö T, Ripollés P, Vepsäläinen H et al. Structural changes induced by daily music listening in the recovering brain after middle cerebral artery stroke: a voxel-based morphometry study. Front Hum Neurosci 2014;8:245.
23.	Särkämö T, Tervaniemi M, Laitinen S, Forsblom A, Soinila S, Mikkonen M et al. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 2008;131:866-76.