Investigating the health of musicians
Since 2011, the Norwegian Musicians' Health Project has investigated the psychosocial work environment, sleep, mental health and use of healthcare services among Norwegian musicians. The project was the result of a collaboration between the Norwegian Musicians' Union (MFO), Performing Arts Health Norway, Nord University and the Norwegian University of Science and Technology (NTNU). The data collection and initial project were funded by the Norwegian Extra Foundation through Mental Health Norway.
Here is a systematic overview of the results of the articles that has been published internationally from this project.
If you want to know more about the project, contact professor Jonas Rennemo Vaag by e-mail: jonas.vaag@inn.no.
Psychological distress is highly prevalent among musicians.
Symptoms of anxiety and depression among Norwegian musicians compared to the general workforce
Vaag, Bjørngaard & Bjerkeset (2016)
Published in Psychology of Music
Abstract
In order to investigate mental health problems among professional musicians, we estimate the prevalence of symptoms of anxiety and depression (psychological distress) among musicians compared to the general workforce. A total sample of 1,607 musicians from the Norwegian Musicians Union answered an online questionnaire about demographic characteristics, lifestyle and symptoms of anxiety and depression. They were compared to a sample of the Norwegian workforce (n = 2,550) drawn from the Norwegian survey of level of living 2012. Based on logistic regression analysis adjusting for age, sex, education level, smoking status, alcohol usage, use of drugs, physical exercise and financial status, we compared anxiety and depression symptom levels in musicians to a variety of professions. Psychological distress was more prevalent among musicians than in the total workforce sample. Solo/lead performers, vocalists, keyboard instrument players and musicians playing within the traditional music genre reported the highest prevalence. Further research needs to map the psychosocial and personal factors contributing to the higher degree of depression and anxiety symptoms among musicians, as well as establishing evidence-based preventative measures.
Main message: 17.5% of musicians report psychological distress, compared to 8.5% in the general workforce.
Musicians report an increased degree of insomnia and sleep difficulties.
Sleep Difficulties and Insomnia Symptoms in Norwegian Musicians Compared to the General Population and Workforce
Vaag, Saksvik-Lehouillier, Bjørngaard & Bjerkeset (2016)
Published in Behavioral Sleep Medicine
Abstract
Sleep problems are reported as common among performing artists and musicians. However, epidemiological research comparing musicians to different groups of the general population is lacking. For this study, 4,168 members of the Norwegian Musician’s Union were invited to an online survey regarding work and health. Of the 2,121 (51%) respondents, 1,607 were active performing musicians. We measured prevalence of insomnia symptoms using the Bergen Insomnia Scale (BIS), and compared this sample to a representative sample of the general Norwegian population . Overall, musicians had higher prevalence of insomnia symptoms compared to the general population (Prevalence Difference 6.9, 95% Confidence Interval 3.9–10.0). Item response analysis showed that this difference was mainly explained by nonrestorative sleep and dissatisfaction with sleep among musicians. An additional analysis, comparing musicians to the general Norwegian workforce on sleep difficulties, confirmed this tendency (Prevalence Difference 6.2, 95% Confidence Interval 4.3–8.1). Musicians performing classical, contemporary, rock, and country music reported the highest prevalence of insomnia, and these genres might be of special interest when developing preventative measures, treatment strategies, and further research on sleep difficulties among musicians.
Main message: Symptoms of insomnia and sleep difficulties is more prevalent among musicians than in the general population and workforce.
Musicians do not only report higher degrees of symptoms. They do also use more mental healthcare services.
Use of psychotherapy and psychotropic medication among Norwegian musicians compared to the general workforce
Vaag, Bjørngaard & Bjerkeset (2016)
Published in Psychology of Music
Abstract
Previous research has reported higher prevalence rates of anxiety and depression among musicians, compared to the general workforce. We compared the use of psychotherapy and psychotropic medication with other major occupational groups, and expected to find higher use among musicians. Musicians from the Norwegian Musicians’ Union (n = 1,607) answered an online questionnaire about demographic characteristics, mental health, use of healthcare services and use of psychotropic medication. They were compared to a sample of the Norwegian workforce (n = 2,550) from the Norwegian survey of level of living. Based on chi-square and logistic regression analysis, adjusted for age, sex, education, and cohabitation status, we found that musicians reported higher use of psychotherapy and psychotropic medication. Use of psychotherapy was reported most frequently among vocalists, while rock musicians reported the most widespread use of psychotropic medication. Overall, musicians had three-fold higher odds of use of psychotherapy and 50% higher odds of use of psychotropic medication compared to the general workforce. This is consistent with previous findings indicating high rates of sleep-difficulties and psychological distress among musicians. The results underline the importance of investigating both the content and quality of services provided.
Main message: Musicians report a three-fold higher use of psychotherapy, and also a higher degree of psychotropic medication use.
Musicians are high consumers of complementary and alternative healthcare services.
Musicians are High Consumers of Complementary and Alternative Healthcare Services
Vaag & Bjerkeset (2017)
Published in Medical Problems of Performing Artists
Abstract
OBJECTIVE: To estimate the use of analgesic medication and manual and alternative healthcare services among Norwegian musicians compared to the general workforce. METHODS: 1,607 musicians from the Norwegian Musicians Union answered an online questionnaire about demographic characteristics, use of healthcare services, and use of medication. They were compared to a sample of the Norwegian workforce (n=2,610) from the Norwegian survey of level of living. Based on logistic regression analysis, adjusting for age, sex and education, we compared the self-reported use of different forms of healthcare services and medication in musicians to the general workforce. RESULTS: Musicians reported a 2-fold increased use of manual (OR 1.87, CI 1.40-2.33) and complementary and alternative healthcare services (OR 2.58, CI 2.07-3.21) compared to the general workforce. Higher proportions of use of analgesic medication (OR 1.52, CI 1.21-1.89) were also evident in musicians. CONCLUSION: Musicians, as a whole, consistently reported higher use of manual and alternative healthcare services and use of analgesic medication than the general Norwegian workforce.
Main message: Musicians consistently report higher use of manual and alternative healthcare services than the general workforce.
Compared to the general workforce, musicians report different patterns of personality traits.
Five-factor personality profiles among Norwegian musicians compared to the general workforce
Vaag, Sund & Bjerkeset (2017)
Published in Musicae Scientiae
Abstract
The aim of the study was to investigate differences in personality traits between professional musicians and the general workforce, as well as differences in personality traits across subgroups of musicians according to types of employment and instrument group. In 2013, 1,600 members of the Norwegian Musicians’ Union answered a questionnaire regarding type of employment, instrument group and a shortened version of the Big Five Inventory (BFI-20). The musicians were compared to a sample of the general Norwegian workforce (n = 6,372) that answered the same personality questionnaire in the Norwegian Generation and Gender Survey of 2007. Multivariable linear regression, adjusted for age, gender, marital status and education, showed that musicians displayed higher degrees of neuroticism and openness to experience, as well as lower degrees of conscientiousness, than the general workforce. A higher degree of openness to experience was especially evident among freelance musicians and those who combined freelance work with employment. Findings also differed according to musicians’ instrument groups, with vocalists scoring higher on openness to experience and bowed string players scoring higher on neuroticism and introversion. In sum, musicians displayed somewhat different patterns of personality traits compared to the general workforce, but our results did not support some of the previously held notions of a specific distinguishable personality structure of musicians. Somewhat unsurprisingly, the major distinguishable trait of musicians was a heightened degree of openness to experience.
Main message: The major distinguishable trait of musicians is a heightened degree of openness to experience.
There is a relationship between personality and healthcare use.
Personality traits and the use of manual, alternative, and mental healthcare services and medication in Norwegian musicians
Langvik, Bjerkeset & Vaag (2018)
Abstract
To investigate the association between personality traits and use of analgesic medication, anti-depressants and sedatives, mental health services, manual and alternative healthcare services among Norwegian musicians, 1607 musicians from the Norwegian Musicians Union answered an online questionnaire. Based on logistic regression analysis, adjusting for age, sex, education and general health, we investigated a possible dose-response relationship between the personality traits neuroticism, extraversion, openness to experience, agreeableness and conscientiousness and the use of these services and types of medication. As hypothesized, Neuroticism was positively associated with excess use of all types of the before mentioned health care services and medications. A higher score on openness to experience was positively associated with use of alternative and complementary healthcare services. Contrary to our expectations, extraversion was positively associated with the use of mental health care services and unrelated to other type of health care and medication use. Conscientiousness was negatively associated with the use of mental health care services. The results suggest that the relationship between personality and healthcare use cannot be attributed to occupation alone. The findings address the importance of differentiating behavior outcome (i.e. the use of health care services) from other outcome like symptom reporting or attitudes towards help seeking.
Main message: Neuroticism was associated with healthcare services, and openness to experience was associated with alternative and complementary services.
Several reasons exist for why insomnia is common among musicians.
Individual, lifestyle, and psychosocial factors related to insomnia among Norwegian musicians
Saksvik-Lehouillier, Bjerkeset & Vaag (2017)
Published in Scandinavian Psychologist
Abstract
Musicians report a considerably higher prevalence of insomnia symptoms compared to community samples in the general workforce. The aim of this study was to investigate the association between insomnia and health, work-related, and lifestyle factors among musicians. A total of 645 full-time musicians completed a questionnaire measuring insomnia symptoms: personality, psychosocial factors (perceived job demands, job control, effort-reward imbalance, and general social support), and lifestyle (smoking, marijuana use, alcohol use, and physical activity). Multiple regression analysis showed that higher scores on neuroticism and extraversion and on perception of greater work demands were positively related to insomnia symptoms. In contrast, the experience of social support was negatively related to insomnia symptoms in the final model. In sum, neuroticism was the single strongest variable associated with insomnia. Extraversion, however, also seemed to add something unique to the explanation of insomnia among full-time musicians when controlling for work environment variables. Moreover, demands and social support may be more important for musicians’ sleep than control and effort-reward imbalance. Given that our study is cross-sectional, longitudinal studies are still needed to clarify the causal relationships among personal, psychosocial, and lifestyle variables and insomnia.
Main message: Personality factors (neuroticism and extraversion) and social support is related to insomnia among musicians.
Musicians underline the importance of social support from family, band members and audiences.
Specific demands and resources in the career of the Norwegian freelance musician
Vaag, Giæver & Bjerkeset (2014)
Published in Arts & Health
Abstract
Background: Research indicates that there is a higher degree of mental health problems, family/work conflicts and sleep-related problems among workers in creative occupations than in other professions. Research also reveals that musicians have to deal with a relatively high degree of occupational stress. There is, however, a lack of research investigating the qualities of freelance musicians' psychosocial work environment, as well as possible protective factors for maintaining good mental health. Methods: Based on 12 in-depth interviews, we used a template analysis to examine the unique characteristics of the professional life of freelance pop and rock musicians. Results: Using the job demands-resources model as a conceptual framework, we found that an unpredictable future, threats to the family/work balance and significant amounts of external pressure were three broad contextual demands facing freelance musicians. Social support from family, fellow band members, audiences and their professional network, as well as having adequate personal resources such as entrepreneurial skills, value-anchored flexibility, tolerance for ambiguity and dedication to music making were described as important for managing life as a freelance musician. Conclusions: Musicians' psychosocial work environment and health seem to be related to the three overarching protective factors also described in resilience research: namely personal dispositions, family coherence and social resources.
Main message: Musicians' psychosocial work environment and health seem to be related to three overarching protective factors also described in resilience research: namely personal dispositions, family coherence and social resources.
both work-related factors (job demands and social support) and personal resources (personality and sense of mastery) are associated with mental health among musicians.
Demands and Resources Associated with Mental Health among Norwegian Professional Musicians
Aalberg,Saksvik-Lehouillier & Vaag (2019)
Abstract
Background: Previous studies indicate a variety of health challenges among musicians. Despite this, less is known concerning the roles of work-related and personal factors associated with the musicians’ mental health. Objective: We wanted to investigate personal and work-related demands and resources associated with psychological distress in professional musicians. Methods: Based on a sample of 1,607 of professional Norwegian musicians, we conducted a hierarchical multiple regression analysis. Results: We found that personal factors such as level of neuroticism and sense of mastery had the strongest association with PD. Extraversion, openness to experience, conscientiousness, job demands and social support did also contribute to distress in our final statistical model, but to a lesser degree. Somewhat surprisingly, work-family conflict, effort–reward imbalance and job control were not associated with PD in our final model. Conclusions: Our results show that both work-related factors (job demands and social support) and personal resources (personality and sense of mastery) are associated with PD among musicians in this cross-sectional study. Prospective research is needed in order to investigate these associations further. Meanwhile, we suggest to emphasize early development of sense of mastery and social support in music education and industry.
Main message: oth work-related factors (job demands and social support) and personal resources (personality and sense of mastery) are associated with PD among musicians in this cross-sectional study. Prospective research is needed in order to investigate these associations further.
Musicians reported more control over their work; however, they felt less motivation, and perceived their work as more demanding compared to the general workforce.
Psychosocial work environmemt among musicians and in the general workforce in Norway
Detari, Egermann, Bjerkeset & Vaag (2020)
Musicians suffer from physical and mental health symptoms more frequently than the general population. Although their specific demands and challenges have been researched increasingly in the past, explanations still remain somewhat unclear. We use a large epidemiological data set to compare psychosocial work environment among 1,607 members of the Norwegian Musician’s Union with a national sample of 8,517 employees from the general Norwegian workforce. Musicians reported more control over their work; however, they felt less supported and acknowledged, had more work-family conflicts and less motivation, and perceived their work as more demanding compared to the general workforce. In the musician sample, results indicated that classical and contemporary musicians are experiencing a less favorable psychosocial environment in terms of control, demands, and acknowledgment, orchestral players felt less control and soloist less support. Future studies should explore possible interventions to improve musicians’ psychosocial work environment.
Our findings are consistent with studies comparing musicians to the general workforce, and indicate that challenges also exist at student level, and not only after becoming a professional in the performing arts, which is important when planning health-related measures.
Anxiety and Depression Symptom Level and Psychotherapy Use Among Music and Art Students Compared to the General Student Population
Vaag, Bjerkeset & Sivertsen (2021)
Purpose: Previous epidemiological studies have shown higher levels of anxiety and depressive symptoms among professional musicians, compared to the general workforce. Similar findings have been observed for psychotherapy use among musicians. To date, large-scale investigations of prevalence rates among music and arts students are lacking.
Methods: Eight hundred and eighty students from music and arts institutions and faculties were derived from a national health student survey for higher education in Norway (the SHoT study). They were compared to a sample of the general student population (n = 48,729). We used logistic regression analysis, adjusting for age, sex, and semesters of study.
Results: Music and arts students reported higher rates of anxiety [OR 1.60 (1.38–1.85), Prevalence difference (PD) 9.6 (6.3–12.8)] and depression symptoms [OR 1.41 (1.22–1.62), PD 7.9 (4.5–11.2)] compared to the general student force. Similar patterns were observed for self-reported mental disorders [OR 1.71 (1.46–2.01), PD 8.1 (5.3–11.0)], as well as psychotherapy use [OR 1.91 (1.60–2.29), PD 7.4 (4.9–9.9)] in music and arts students.
Conclusions: Our findings are consistent with studies comparing musicians to the general workforce, and indicate that challenges also exist at student level, and not only after becoming a professional in the performing arts, which is important when planning health-related measures. These findings have the potential to inform on health promotion and services in the educational system.
The first study to investigate mental health, sleep and use of healthcare services, using reference groups and validated instruments.
Sleep, mental health and use of mental healthcare services among Norwegian musicians
Vaag (2015)
Published at the Department of Neuroscience (NTNU)
Abstract
This dissertation consists of three studies examining insomnia and sleep difficulties (Study I), anxiety and depression symptoms (Study II) and use of mental healthcare services (Study III) among Norwegian musicians, compared to the general population and the Norwegian workforce (including major occupational groups). The sample of musicians was based on an online survey drawn from the membership register of the Norwegian Musicians' Union (MFO). The data collection period was between 1st of February and 1st of April 2013. A total of 2,121 (51%) members responded; there were 1,016 (48%) women and 1,105 men, with a mean age of 44.5 years (SD=10.7). Of these, 1,607 (76%) members confirmed that they had been working as performing musicians during the last 12 months, and constituted the study group. They were compared to participants in three Norwegian population-based studies (2006-2013), using identical instruments and outcome measures. In addition, logistic regression analyses were performed to adjust for some of the variables known to be related to the outcome measures. Insomnia symptoms (aOR 1.35, CI 1.18-1.54; aPD 6.9, CI 3.9-10.0), sleep difficulties (aOR 1.95, CI 1.64-2.31; aPD 6.2, CI 4.3-8.1), psychological distress (aOR 2.35, CI 1.82-3.03; aPD 8.2, CI 5.6-10.8) and use of psychotherapy (aOR 2.86, CI 2.11-3.88; aPD 5.8, CI 3.2-7.7) were all highly prevalent among musicians, compared to samples from the general population and workforce. Musicians also reported a higher use of psychotropic medication (aOR 1.55, CI 1.19-2.02; aPD 3.5, CI 1.3-5.7). This dissertation is, to the best of our knowledge, the first to investigate these outcomes in different groups of musicians with use of relevant reference groups and validated instruments. However, further longitudinal research is needed to map the incidence and prospective associations of mental health and healthcare use, as well as intervention-based studies, in order to generate occupational and therapeutic measures for this group of workers.
Main message: Musicians report higher degrees of symptoms of psychological distress, sleep difficulties and use of mental healthcare services.