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Performance anxiety in professional musicians: a systematic review on prevalence, risk factors and clinical treatment effects

Published online by Cambridge University Press:  02 September 2019

I. Fernholz ,
J. L. M. Mumm ,
J. Plag ,
K. Noeres ,
G. Rotter ,
S. N. Willich ,
A. Ströhle ,
A. Berghöfer  and
A. Schmidt
I. Fernholz
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians‘ Medicine (BCMM), Berlin, Germany Kurt Singer Institute for Music Physiology and Musicians’ Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany
J. L. M. Mumm
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians‘ Medicine (BCMM), Berlin, Germany
J. Plag
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians‘ Medicine (BCMM), Berlin, Germany
K. Noeres
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
G. Rotter
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians‘ Medicine (BCMM), Berlin, Germany Kurt Singer Institute for Music Physiology and Musicians’ Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
S. N. Willich
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians‘ Medicine (BCMM), Berlin, Germany Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
A. Ströhle
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Mitte, Berlin, Germany
A. Berghöfer
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians‘ Medicine (BCMM), Berlin, Germany Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
A. Schmidt*
Affiliation:
Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin Center for Musicians‘ Medicine (BCMM), Berlin, Germany Kurt Singer Institute for Music Physiology and Musicians’ Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Clinic for Audiology and Phoniatrics, Berlin, Germany
*
Author for correspondence: Alexander Schmidt, E-mail: alexander.schmidt@charite.de
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Abstract

Music performance anxiety (MPA) is one of the most common disorders among professional musicians, nevertheless, little is known about the disease. With this systematic review, prevalence, risk factors and treatment procedures for MPA were assessed, and for the first time, quality assessments were carried out for all studies using standardized assessment tools. A systematic literature search was conducted via search algorithms in the databases MEDLINE, EMBASE, CINAHL, PsycArticles, PsycInfo and ERIC. Included were case reports, case–control, cohort, cross-sectional and intervention studies examining professional musicians with MPA. For quality assessment, adapted tools of the National Heart, Lung, and Blood Institute were used. A total of 43 studies were included (10 case reports, 21 intervention, 11 cross-sectional, one cohort study). Quality ratings ranged from −11 to 6 out of a maximum of 15/16 points for cross-sectional/cohort studies and −4 to 11 out of 18 points for intervention studies. The prevalence of MPA was between 16.5% and 60%. More women than men were affected and musicians older than 45–50 years reported less MPA than younger musicians. Regarding treatment cognitive behavioural therapy (CBT) and β-blockers were most often researched with beneficial results for CBT. However, studies with adequate control groups for CBT interventions are needed to clarify its efficacy. Studies showed methodological weaknesses, especially in the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. Recommendations for further research are made.

Keywords

Incidencemusic performance anxietyprevalencerisk factorssocial anxiety disorderstage frighttherapy
Type
Review Article
Information
Psychological Medicine , Volume 49 , Issue 14 , October 2019 , pp. 2287 - 2306
Copyright
Copyright © Cambridge University Press 2019 

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Footnotes

*

Authors contributed equally to this work, shared first authorship.

†

Shared senior authorship.

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