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Mobile technologies and music are recognized as opportunities to address mental health challenges (1–3), while clinical and economic benefits of mobile health (mHealth) are currently studied (4–6). Herein, we describe feasibility of repurposing music streaming services as therapies for affective disorders. According to the World Health Organization, there are 350 million people worldwide suffering from depression, and 60 million people living with bipolar disorder. Patients with affective disorders such as depression, anxiety, or bipolar spectrum, and their caregivers are challenged with managing disease symptoms, long-term treatments, and disabilities. Between 1990 and 2010, there has been a 41% increase in public health burden of mental, neurological, and substance use disorders, as measured by disability-adjusted life years (7). Depression accounts for 40.5% of total disability-adjusted life years among mental and substance-use disorders, whereas anxiety and bipolar disorder account for 14.6 and 7%, respectively (8). A long-term morbidity in bipolar spectrum disorders emphasizes the needs to improve treatments for depression (9). Treatments of affective disorders include mainly antidepressant, antipsychotic medications, and cognitive behavioral therapy (CBT). The efficacy of antidepressants for children and adolescent patients (10), medication adherence, and limited access to CBT in many countries continue to be a challenge for public health.  Treatments of depression, anxiety, and bipolar symptoms comprise CBT, psychosocial, and self-care interventions, also delivered via online and digital technologies (7, 11, 12). Opportunities for developing mobile apps and web-based interventions for neurological and mental disorders are economically feasible and coincide with the global adoption rates for smartphones (6, 13–16). Promising findings from clinical testing of mobile apps, e.g., in depression (17), are accompanied by challenges in patient engagement (18) and alignment of clinical and digital contents (19). Converting a mobile phone into low-cost virtual reality devices (exemplified by a Google VR cardboard) extends its potential medical applications (20, 21). Growing number of health-related wearables and devices measuring electrodermal activity (EDA), heart rate variability, or mobile electroencephalogram (EEG) systems, expand the use of digital technologies in medicine, including mental health [a 5-week treatment with EEG-based musical neurofeedback improved depression scores by 17% (22)]. Companies like Apple, Samsung, LG, Microsoft, Fitbit, Empatica, Emotiv, NeuroSky, or Muse develop smart watches and mobile EEG systems with health/wellness applications, whereas WellDoc, Akili Interactive, or Pear Therapeutics are engaged in converting mobile apps and games into medical device-based therapies for specific chronic diseases. Given accessibility of smartphones and the internet, we discuss opportunities for music streaming services to be developed as adjunct therapies and prevention of depressive, anxiety, and bipolar spectrum symptoms.

frontiers in public health

Music Streaming Services as Adjunct Therapies for Depression, Anxiety, and Bipolar Symptoms: Convergence of Digital Technologies, Mobile Apps, Emotions, and Global Mental Health