PEP Topic 

Aromatherapy is the use of fragrant essential oils distilled from plants to alter mood or improve health. Aromatherapy was studied in patients with cancer in the management of lymphedema and depression.

Effectiveness Not Established

Systematic Review/Meta-Analysis

Yim, V., Ng, A., Tsang, H., & Leung, A.Y. (2009). A review on the effects of aromatherapy for patients with depressive symptoms. Journal of Alternative & Complementary Medicine, 15(2), 187–195.



To complete a systematic review of the effects of aromatherapy on patients with symptoms of depression

Search Strategy:

  • Databases searched were CINAHL, PubMed, MEDLINE, PsyInfo, and Cochrane Library.
  • Search keywords were aromatherapy, scent, fragrance, essential oil, depression, depressive disorder, and depressive symptoms. All retrieved reports were of peer-reviewed studies, in English, published 2000–2008.
  • A study was included if it referred to the clinical application of aromatherapy as the treatment of patients with some kind of clinical condition or patients suffering from symptoms of depression.
  • A study was excluded if it referred to the chemistry of essential oils or if it was published as a dissertation.

Literature Evaluated:

  • The total number of studies retrieved was 48.
  • Two studies were of patients with depression; one, of postnatal mothers; three, of patients with cancer.
  • Two studies were randomized controlled trials (RCTs), three were not RCTs, and one was quasiexperimental.
  • The evaluation method consisted of a systematic review by two graduate students in a master’s degree program in occupational therapy. The graduate students extracted the data.

Sample Characteristics:

  • The final number of studies included was six.
  • The total sample size was 387. The sample range across studies was 5–288.
  • Two studies evaluated the effectiveness of aromatherapy on patients with depression, three studied secondary depressive symptoms in patients with cancer, and one focused on postnatal depression. All studies discussed the effectiveness of aromatherapy massage on depressive symptoms.

Phase of Care and Clinical Applications:

Authors did not mention the phase of care.


Aromatherapy has an alleviation effect on the mood of patients with depressive symptoms; however, there is a notable lack of studies on the use of aromatherapy by people with depression. Almost all the studies use aromatherapy massage and not aromatherapy alone, so whether the effects are from the aroma intervention, the massage intervention, or a combination of the two remains unclear.


Of the six studies, the sample size of three included eight participants or fewer. The size of the others was 36, 42 and 288, respectively. In addition to being small, the samples did not necessarily include cancer patients. These studies were inconsistent and used various oils for the aromatherapy.

Nursing Implications:

The evidence is insufficient to support recommendations for the use of aromatherapy for the treatment of depression. Aromatherapy may, however, be used as complementary and alternative therapy for depression and be considered as a treatment for depression in patients with secondary depression arising from chronic medical conditions.