The Effectiveness of Aromatherapy for Depressive Symptoms: A Systematic Review

Table 2

Characteristics of the participants included in the selected studies.

Ref.	Type of study	Subjects
		Total number of subjects	Mean subject age (range)	Gender ()	Type of subject	Diagnostic systems/inclusion criteria	Baseline score for depressive symptoms
Inhalation aromatherapy
[18]	Placebo-controlled randomized double blind RCT	313	65 (33–90)	Female (150); Male (163)	Individuals with cancer receiving radiotherapy treatment	Patients prescribed with 8 or more fractions of radiotherapy	Baseline depression status: odds ratio of 29 using HADS.
[19]	Randomized observational pilot study with repeated measures	28	32 (25–43)	Female (28)	Postpartum women	0–18-month postpartum women with scores of 10 or higher on either the Edinburgh Postnatal Depression Scale or the Generalized Anxiety Disorder Scale	The baseline score using the Edinburgh Postnatal Depression Scale for the control group was 15.9 and 16.1 for the intervention group.
[20]	Prospective RCT	13	27.3 for the control group (NA); 29.3 for the treatment group (NA)	Female (13)	Pregnant women	28-week-pregnant women, singleton pregnancy	Depression-dejection scale baseline score using POMS was 2.7 in the control group and 1.6 in the treatment group.
[21]	Randomized controlled crossover study	20	20.5	Female (20)	College students	Healthy volunteers	The depression-dejection scale baseline score using POMS was not provided, but the change difference between pre- and posttreatment was reported. The change in depression-dejection score was lower than −1 in the treatment group and statistically significant when compared to the change in the control group.
[22]	Controlled double-blinded RCT	320	20–30, average age NA	Female (320)	Pregnant women	Women between 18–35 years, with a pregnancy age between 38 and 42 weeks, a score of 12 or less in the Edinburgh test	Depression grade baseline in the Edinburgh test was 6.3 in the control group and 6.1 in the intervention group.
Aromatherapy massage
[23]	RCT	32	32.9 (23–53) in the treatment group	Female (10 in the treatment group); Male (4 in the treatment group); No information provided on the number of female and male subjects in the control group	Patients with depression and/or anxiety	Patients scoring more than 7 in the Montgomery-Asberg Depression Rating Scale and/or the Tyrer Brief Anxiety Scale	The baseline using the Montgomery-Asberg Depression Rating Scale was 19.8 in the control group and 30 in the treatment group. The baseline using the HADS was 14.6 and 15.3 in the control and treatment group, respectively.
[24]	Double blind RCT	42	73, (44–85)	Female (32), male (10)	Individuals with cancer	Individuals with cancer with a wide variety of levels of physical and psychological symptoms	Baseline score using HADS was not stated. Only the median change in HADS was provided being 0 for the aromatherapy group, −1.5 for the massage group, −0.5 for the aromatherapy massage group, and 0.5 for the control.
[25]	RCT	288	52.1; 52.8 for the usual care group; and 51.5 for the usual care plus aromatherapy group	Female (250), male (38)	Individuals with cancer	Patients diagnosed with cancer, a prognosis of more than 3 months, with clinical anxiety or depression	The baseline score using the Center for Epidemiological Studies Depression Scale was 26.1 for the aromatherapy group and 26 for the group receiving usual care (control).
[26]	Nonblinded randomized crossover trial	16	46.1 (37.9–54.3)	Female (15),; male (1)	Patients diagnosed with idiopathic environmental intolerance	Clinical examination by a physician and scoring above 26 for men and 30 for women in the Chemical Odor Sensitivity Scale	Depression subscale baseline score using POMS was around 2.8 in the control period.
[19]	Randomized observational pilot study with repeated measures	28	NA	Female (28)	Postpartum women	0–18-month postpartum women with scores of 10 or higher on either the Edinburgh Postnatal Depression Scale or the Generalized Anxiety Disorder Scale	The baseline score using the Edinburgh Postnatal Depression Scale for the control group was 15.9 and 16.1 for the intervention group.
[27]	Single blind RCT	39	52.5; 51.1 for the aromatherapy group; and 54 for the cognitive behavior therapy group	Female (31), male (8)	Individuals with cancer	Patients diagnosed for at least one month, who also had at least a predicted survival of 6 months and score 11 or more in the HADS for anxiety or depression	The baseline score in the depression-dejection subscale of POMS was 11.2 for the aromatherapy massage group and 13.4 for the control group.
[28]	RCT	90	53.70 for the control group (49.42–57.98), 52 (47.12–56.88) for the massage therapy group, and 53.35 (49.01–57.69)	Female (90)	Women who entered their menopausal period naturally	Woman, age between 45 and 60 years, with amenorrhea for at least 1 year	At baseline, according to the Menopause Rating Scale, the frequency of the severity of the depressive mood was reported as mild (14.9%), moderate (36.8%), severe (20.7%), and very severe (2.3%). No difference was found among the groups at baseline.
[29]	RCT	25	34–48, average age NA	Female (25)	Women with children	Women whose children were diagnosed with attention deficit hyperactivity disorder	Baseline using the Beck Depression Inventory was 8.6 in the control group and 10.8 in the treatment group.

In this study, both aromatherapy modalities were tested, inhalation aromatherapy and aromatherapy massage. Therefore, the study was included in both categories in the table. NA, not available; HADS, Hospital Anxiety and Depression Scale; POMS, Profile of Mood States.