Abstract
Rising rates of stress, anxiety, and depression-fueled by rapid sociocultural and economic shifts, digital overexposure, and the lasting impact of COVID-19-are accelerating investment in scalable tools aimed at enhancing resilience and wellbeing. Music-based digital therapeutics (MDTs) hold promise given music's unique ability to modulate core dimensions of health-affect, anxiety, and reward, as well as autonomic and social functioning-through a medium that is universal, intuitive, and increasingly accessible. To assess the current state of MDTs targeting stress, anxiety, and depression in adults, we conducted a scoping review using a modified Population, Intervention, Comparison, Outcome (PICO) keyword framework to structure Google search results. Twenty-two commercially available MDTs were identified for inclusion. We organize these MDTs into five principal categories based on underlying treatment strategies: (1) Preference-based music selection; (2) Affective Parameterization; (3) Affect Matching and Compensation; (4) Neural Entrainment; and (5) Biofeedback. We review general evidence supporting each strategy from music neuroscience and therapy research, as well as limited applied research testing specific MDTs. We conclude that, while general evidence supporting musical-based interventions for stress, anxiety, and depression is substantial, evidence for MDTs specifically is presently too limited to draw conclusions about real world effectiveness. Determining whether MDTs are likely to fulfill their potential will require increased focus on rigorous laboratory studies testing specific treatment strategies and randomized double-blind placebo-controlled trials conducted in ecologically valid settings. To support progress in this field, we make recommendations to support the sustainable development of MDTs as evidence-based tools to support mental health and wellbeing.