Music-Based Cognitive Training for Adults with Major Depressive Disorder and Suicide Risk: A Pilot Study

Background/Objectives: Cognitive challenges in attention and executive function worsen over time in individuals with major depressive disorder (MDD) and suicidal risk. These difficulties persist beyond acute episodes, with limited targeted treatments available. Neurologic music therapy (NMT) is effective for cognitive rehabilitation in brain injuries and developmental disabilities, suggesting potential benefits for adults with MDD and suicide risk. This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of short-term NMT on cognitive function in adults with MDD. Methods: Adults aged 18+ with MDD and suicidal ideations participated in an 8-week single-arm open label study with 45-min individual in-person NMT sessions using musical attention control training (MACT) and musical executive function training (MEFT). Participants provided feedback on feasibility and acceptability, and pre- and post-intervention assessments included neurocognitive tasks and questionnaires on suicidal ideation, depressive symptoms, and quality of life. Results: A total of 18 individuals enrolled, and 10 participants completed the study protocol. Of the participants, 100% were satisfied with their experience with NMT, with 100% noting improvements in attention and 80% in executive function. Participants experienced some improvements in short-term memory (Digit Span Forward Test), cognitive flexibility (Trail Making Test B), and inhibitory control (Stroop Task). Significant reduction in suicidal ideation intensity (Beck Suicidal Scale of Ideation) was observed, as well as significant improvements in quality of life. Conclusions: This is the first study using NMT to demonstrate feasibility, acceptability, and effectiveness with respect to cognitive function in adults with MDD and suicide risk, providing preliminary data for future randomized controlled trials.