***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Menopausal symptoms experienced by women vary widely , and while many women transition through menopause with manageable symptoms , others experience severe symptoms , which may impair their quality of life . OBJECTIVES A r and omized clinical trial was conducted to determine the effect of aromatherapy massage on psychological symptoms during menopause . METHODS The study population comprised 90 women . Each subject in the aromatherapy massage group received 30 min aromatherapy sessions with aroma oil , twice a week , for four weeks ; each subject in the massage therapy group received the same treatment with odorless oil , while no treatment was provided to subjects in the control group . The outcome measures were psychological symptoms , as obtained through the psychological subscale of the Menopause Rating Scale . RESULTS A total of 87 women were evaluated . A statistically significant difference was found between the participants ' pre- and post-application psychological score in intervention groups , whereas the score in the control group did not differ significantly . Aromatherapy massage decreased the psychological score MD : -3.49 ( 95 % Confidence Interval of Difference : -4.52 to -2.47 ) . Massage therapy also decreased the psychological score MD : -1.20 ( 95 % Confidence Interval of Difference : -2.19 to -0.08 ) . To distinguish the effect of aromatherapy from massage separately , we compared the reduction in the psychological score .  Aromatherapy massage decreased the psychological score more than massage therapy MD : -2.29 ( 95 % Confidence Interval of Difference : -3.01 to -0.47 ) . CONCLUSION Both aromatherapy massage and massage were effective in reducing psychological symptoms , but , the effect of aromatherapy massage was higher than massage The existing review s of massage therapy ( MT ) research are either limited to infants , adults , or were conducted prior to the publication of the most recent studies using pediatric sample s. R and omized controlled trials ( RCTs ) of pediatric MT are review ed . A literature search yielded 24 RCTs of pediatric MT  , defined as the manual manipulation of soft tissue intended to promote health and well-being in recipients between 2 and 19 years of age . Because RCTs of pediatric MT varied considerably in the amount and types of data reported , quantitative and narrative review methods were both used . Singledose and multiple-dose effects were examined separately . Among single-dose effects , significant reductions of state anxiety were observed at the first session ( g 1⁄4 0.59 , P < 0.05 ) and the last session ( g 1⁄4 1.10 , P < 0.01 ) of a course of treatment . Effects for salivary cortisol ( g 1⁄4 0.28 ) , negative mood ( g 1⁄4 0.52 ) and behavior ( g 1⁄4 0.37 ) were non-significant . Three of eleven multiple-dose effects were statistically significant . These were trait anxiety ( g 1⁄4 0.94 , P < 0.05 ) , muscle tone ( g 1⁄4 0.90 , P < 0.01 ) and arthritis pain ( g1⁄4 1.33 , P < 0.01 ) . Results of studies not permitting effect size calculation were judged to be generally consistent with quantitative results . MT benefits pediatric recipients , though not as universally as sometimes reported . Numerous weaknesses endemic to MT research ( e.g. low statistical power , frequent failure to report basic descriptive statistics ) are identified , and recommendations for future pediatric MT research are discussed Research suggests that patients with cancer , particularly in the palliative care setting , are increasingly using aromatherapy and massage . There is good evidence that these therapies may be helpful for anxiety reduction for short periods , but few studies have looked at the longer term effects . This study was design ed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer . Forty-two patients were r and omly allocated to receive weekly massages with lavender essential oil and an inert carrier oil ( aromatherapy group ) , an inert carrier oil only ( massage group ) or no intervention . Outcome measures included a Visual Analogue Scale ( VAS ) of pain intensity , the Verran and Snyder-Halpern ( VSH ) sleep scale , the Hospital Anxiety and Depression ( HAD ) scale and the Rotterdam Symptom Checklist ( RSCL ) . We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control , anxiety or quality of life . However , sleep scores improved significantly in both the massage and the combined massage ( aromatherapy and massage ) groups . There were also statistically significant reductions in depression scores in the massage group . In this study of patients with advanced cancer , the addition of lavender essential oil did not appear to increase the beneficial effects of massage . Our results do suggest , however , that patients with high levels of psychological distress  respond best to these therapies OBJECTIVE This study investigated the soothing effects of fragrance from yuzu , a Japanese citrus fruit ( Citrus junos Sieb . ex Tanaka ) , with salivary chromogranin A ( CgA ) used as an endocrinologic stress marker reflecting sympathetic nervous system activity . METHODS Twenty healthy women ( mean age , 20.5 ± 0.1 years ) participated in a r and omized , controlled , crossover study . Participants were examined on two separate occasions-once using the yuzu scent and once using unscented water as a control-in the follicular phase . This experiment measured salivary CgA and the Profile of Mood States ( POMS ) as a psychological index before and after the aromatic stimulation . RESULTS Ten-minute inhalation of the yuzu scent significantly decreased salivary CgA. At 30 minutes after the inhalation period , the salivary CgA level further decreased . In addition , POMS revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance , a global measure of affective state , as well as four subscores of emotional symptoms ( tension-anxiety , depression-dejection , anger-hostility , and confusion ) , as long as 30 minutes after the olfactory stimulation . CONCLUSIONS Yuzu 's aromatic effects may alleviate negative emotional stress , which , at least in part , would contribute to the suppression of sympathetic nervous system activity Background The Hamilton Depression Rating Scale ( HAM-D ) and the Montgomery – Asberg Depression Scale ( MADRS ) are used worldwide and considered st and ard scales for evaluating depressive symptoms . This paper aims to investigate the psychometric proprieties ( reliability and validity ) of these scales in a Brazilian sample , and to compare responses in bipolar and unipolar patients . Methods The sample comprised 91 patients with either bipolar I or major depressive disorder from a psychiatric institute at São Paulo , Brazil . Participants were recruited and treated by clinicians through the Structured Interview for DSM-IV criteria  , and had previously been interviewed by a trained , blind tester . Results Both scales indicated good reliability properties ; however , the MADRS reliability statistics were higher than those of the HAM-D for detecting initial symptoms of unipolar depression . Correlation between the tests was moderate . Despite demonstrating adequate validity , neither test achieved the levels of sensitivity and specificity required for identification of a cutoff score to differentiate bipolar I and unipolar patients . Conclusions Both scales demonstrate adequate reliability and validity for assessing depressive symptoms in the Brazilian sample , and are good options to complement psychiatric diagnosis , but are not appropriate for distinguishing between the two affective disorder types Background Yuzu ( Citrus junos Sieb . ex Tanaka ) , a yellow-golden colored citrus fruit , has traditionally been used to promote psychosomatic health in Japan . While the yuzu produces a distinctive , pleasing aroma of citrus and floral , the efficacy of its fragrance remains unknown . The present study investigated the soothing effects of the fragrance of yuzu essential oil from the perspective of autonomic nervous system activity , which plays a crucial role in the integrity of the mind-body connection . Methods Twenty one women in their 20s participated in a single-blind r and omized controlled crossover study . Subjects were examined twice each in the follicular and late-luteal phases . Two kinds of aromatic stimulation ( yuzu and water as a control ) were used . This experiment measured heart rate variability ( HRV ) reflecting autonomic nervous system activity and used the Profile of Mood States ( POMS ) as a psychological index before and after the aromatic stimulation . Results Only a 10-min inhalation of the yuzu scent significantly decreased heart rate and increased high frequency power of HRV reflecting parasympathetic nervous system activity , regardless of menstrual phase . This significant physiological effect continued for at least 25 min . In addition , the POMS tests revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance , a global measure of affective state , together with two POMS subscales — tension-anxiety and fatigue , as long as 35 min after the aroma stimulation , both in the symptomatic late-luteal and non-symptomatic follicular phases . Conclusions The present study provides the novel information that yuzu ’s aromatic effects could serve to alleviate negative emotional stress , which , at least in part , would contribute to the improvement of parasympathetic nervous system activity OBJECTIVES The aim of this study was to determine if aromatherapy improves anxiety and /or depression in the high risk postpartum woman and to provide a complementary therapy tool for healthcare practitioners . DESIGN The pilot study was observational with repeated measures . SETTING Private consultation room in a Women 's center of a large Indianapolis hospital . SUBJECTS 28 women , 0 - 18 months postpartum . INTERVENTIONS The treatment groups were r and omized to either the inhalation group or the aromatherapy h and m'technique . Treatment consisted of 15 min sessions , twice a week for four consecutive weeks . An essential oil blend of rose otto and lav and ula angustifolia @ 2 % dilution was used in all treatments . The non-r and omized control group , comprised of volunteers , was instructed to avoid aromatherapy use during the 4 week study period . Allopathic medical treatment continued for all participants . OUTCOME MEASUREMENTS All subjects completed the Edinburgh Postnatal Depression Scale ( EPDS ) and Generalized Anxiety Disorder Scale ( GAD-7 ) at the beginning of the study . The scales were then repeated at the midway point ( two weeks ) , and at the end of all treatments ( four weeks ) . RESULTS Analysis of Variance ( ANOVA ) was utilized to determine differences in EPDS and /or GAD-7 scores between the aromatherapy and control groups at baseline , midpoint and end of study . No significant differences were found between aromatherapy and control groups at baseline . The midpoint and final scores indicated that aromatherapy had significant improvements greater than the control group on both EPDS and GAD-7 scores . There were no adverse effects reported . CONCLUSION The pilot study indicates positive findings with minimal risk for the use of aromatherapy as a complementary therapy in both anxiety and depression scales with the postpartum woman . Future large scale research in aromatherapy with this population is recommended UNLABELLED Distress associated with cancer often presents with symptoms of depression and /or anxiety .  Cognitive Behaviour Therapy ( CBT ) is one of the most effective psychological treatments . Complementary therapies , especially aromatherapy massage ( AM ) , are also popular and alleviate anxiety . No studies have directly compared these two treatments . AIMS The aim of this study is to ( 1 ) test the feasibility of recruitment into a r and omised controlled trial of AM versus CBT in patients with cancer ; ( 2 ) test and modify the intervention ; ( 3 ) determine whether changes in outcomes were consistent with published data . METHODS Patients at all stages of cancer , recruited from oncology outpatient clinics and screening eight or more for anxiety and /or depression on the HADS , were r and omised to Treatment as Usual ( TAU ) plus up to eight sessions weekly of either AM or CBT , offered within 3 months . The POMS was collected at baseline and 3 and 6 months post baseline . RESULTS Of those suitable , over 60 % ( 39/63 ) participated ( AM , n = 20 ; CBT , n = 19 ) and over 90 % ( 36/39 ) were followed up . Both packages were well received . The preference was for AM , with more sessions were taken up ; ( Mean number sessions AM = 7.2 ( SD 2.0 ) and CBT = 5.4 ( SD 3.1 ) ; P<0.05 ) . Significant improvements in POMS ( Total Mood , depression and anxiety scores ) occurred with both interventions . Between-group comparison showed a non-significant trend towards greater improvement in depression with CBT . CONCLUSIONS Recruitment was feasible ; the interventions acceptable and engagement with treatment was high . Improvements with both interventions were observed . The beneficial effects on depression with CBT appeared to be sustained OBJECTIVES Stress reduction care is important for pregnant women to decrease obstetric complications and children 's health problems after birth . The aim of this study is to clarify the physical and psychologic effects of inhalation aromatherapy on pregnant women . Essential oils with high linalool and linalyl acetate content that may be used during pregnancy were selected and among these , and the one preferred by the participant was used . DESIGN This was a prospect i ve , r and omized , controlled trial . SETTING S/LOCATION This trial was performed at a gynecology outpatient department in a hospital in Kyoto , Japan . PARTICIPANTS The study included pre 
    Output:
    
Aromatherapy showed potential to be used as an effective therapeutic option for the relief of depressive symptoms in a wide variety of subjects .
Particularly , aromatherapy massage showed to have more beneficial effects than inhalation aromatherapy