Table 4: Description of the measurement tools, outcomes, and conclusions.

ReferenceOutcome measures
ScaleComparison groupIntervention group(s)OutcomeImprovement of depressive symptoms

Inhalation aromatherapy

[18](i) HADSControl group(i) Carrier oil with fractionated low grade essential oil
(ii) Pure essential oil
Increased outcome measurement when compared to the baseline (18%–22% in HADS) using multivariate analysis. No statistically significant difference observed.No

[19](i) EPDSControl group(i) 2% dilution of a mixture of essential oilsThe mean difference in EPDS scores between the control group and the intervention group at end point was −3.981 but no statistically significant difference was observed. Combined analysis of inhalation aromatherapy and massage aromatherapy showed statistically significant difference with a mean difference of −4.8.Yes

[20](i) POMSNo intervention(i) Pure essential oilDepression-dejection subscale scores before and after test were 2.7 and 1.2 in the comparison group and 1.6 and 0.6 in the intervention group, respectively. No statistically significant difference was observed.No

[21](i) POMS in TMDControl group(i) Pure essential oilChange in TMD score was 0.5 ± 2.2 in the control group and −1.28 ± 2.6 in the intervention group (statistically significant difference).Yes

[22](i) EPDSNo intervention(i) Nonpharmacological methods for pain relief of labor including showering, being in upright position, aromatherapy, and soft music without wordsDepression grades (0–30) before and after delivery were 6.3 and 8.8 in the no intervention group and 6.1 and 7.8 in the intervention group, respectively. No statistically significant difference was observed.No

Aromatherapy massage

[23](i) MADRSControl group(i) Diluted essential oilThe scores in the MADRS at baseline and end point were 19.8 and 21.1 in the control group and 30 and 18.1 in the treatment group. Statistically significant difference was observed between the test and control group.Yes

[24](i) HADSNo intervention(i) Aromatherapy massage
(ii) Massage with inert carrier oil
The median change in HADS at baseline and end point was 0.5 in the no intervention group, 0 in the aromatherapy massage group, and −1.5 in the massage group. No statistically significant difference among the groups.No

[25](i) CES-DActive control (usual supportive care)(i) Usual supportive care and aromatherapy massageThe scores using CES-D at baseline and end point were 26.0 and 4.6 in the active control group and 25.9 and 6.2 in the intervention group, respectively. No statistically significant difference observed between the 2 groups.No

[26](i) POMSNo intervention(i) Aromatherapy massageStatistically significant difference between the 2 groups when comparing the pre- and postsessions in all the POMS subscales including depression-dejection.Yes

[19](i) EPDSControl group(i) m’technique (hand massage)The mean difference between the baseline and end point using EPDS was −6.031.Yes

[27](i) POMS-TMSActive control (cognitive behavior therapy)(i) Aromatherapy massageThe POMS-TMS decreased in both groups after intervention from 46.3 to 26.5 in the active control group and 44.5 to 29 in the intervention group.Yes

[28](i) MRSNo intervention(i) Aromatherapy massage
(ii) Massage
The mean difference in psychological symptoms (including depressive mood) was −0.379 in the no intervention group (no statistically significant difference), −3.49 in the aromatherapy massage group (statistically significant difference), and −1.20 in the massage group (statistically significant difference).Yes

[29](i) BDINo intervention(i) Aromatherapy massageThe BDI score before and after test was 8.6 and 8.5 in the control group and 10.8 and 6.5 in the intervention group (statistically significant difference).Yes

In this study, both aromatherapy modalities were tested, inhalation aromatherapy and aromatherapy massage. Therefore, the study was included in both categories in the table. CES-D, Center of Epidemiological Studies Depression (self-reported depression); BDI, Beck Depression Inventory; DSM-IV, modified Diagnostic and Statistical Manual of Mental Disorder criteria; EPDS, Edinburgh Postnatal Depression Scale; HADS, Hospital Anxiety and Depression Scale; MADRS, Montgomery-Asberg Depression Rating Scale; MRS, Menopause Rating Scale; POMS, Profile of Mood States; TMD, Total Mood Disturbance; TMS, Total Mood Score (shortened version of the profile of mood states).