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Introduction: There is evidence from earlier trials for the efficacy of music therapy in the treatment of depression among working-age people. Starting therapy sessions with relaxation and revisiting therapeutic themes outside therapy have been deemed promising for outcome enhancement. However, previous music therapy trials have not investigated this issue.Objective: To investigate the efficacy of two enhancers, resonance frequency breathing (RFB) and listening homework (LH), when combined with an established music therapy model (trial registration number ISRCTN11618310).Methods: In a 2 × 2 factorial randomised controlled trial, working-age individuals with depression were allocated into groups based on four conditions derived from either the presence or absence of two enhancers (RFB and LH). All received music therapy over 6 weeks. Outcomes were observed at 6 weeks and 6 months. The primary outcome was the Montgomery Åsberg Depression Rating Scale (MADRS) score.Results: There was a significant overall effect of treatment for the primary outcome favouring the breathing group (d = 0.50, 95% CI 0.07 to 0.93, p = 0.02). The effect was larger after adjustment for potential confounders (d = 0.62, 95% CI 0.16 to 1.08, p = 0.009). Treatment effects for secondary outcomes, including anxiety (anxiety scale of Hospital Anxiety and Depression Scale) and quality of life (RAND-36), were also significant, favouring the breathing group. The homework enhancer did not reach significant treatment effects.Conclusion: We found that the addition of RFB to a music therapy intervention resulted in enhanced therapeutic outcome for clients with depression.

Interoceptive sensitivity is a biologically determined, constitutional trait of an individual. High interoceptive sensitivity has been often associated with proneness to anxiety. This association has been explained by elevated autonomic responsiveness in anxious individuals. However, in a heartbeat discrimination task (discrimination of heartbeats’ simultaneity to an external stimulus) low cardiac responsiveness has accompanied enhanced performance. The relation between these factors seems task dependent, and cannot comprehensively explain the link between interoceptive sensitivity and anxiety. We explored for additional explanatory factors for this link. More specifically, we studied which anxiety-related temperamental traits most strongly predict interoceptive sensitivity in the discrimination task. Compatibly with earlier findings, interoceptive sensitivity was positively associated with individual trait anxiety and also other related traits such as negative affect, emotional intensity, and introversion. Interestingly, behavioral inhibition was the temperamental trait that most strongly predicted high interoceptive sensitivity, and, in fact, accounted for its significant associations with the other anxiety-related temperamental traits. Good performance on heartbeat discrimination task may reflect adaptive attentional control abilities in behaviorally inhibited individuals. These results can improve our understanding of how interoceptive sensitivity and other traits together determine the personality and wellbeing of a human individual.