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A Systematic Review of the 
Effects of Aromatherapy with 
Lavender Essential Oil on 
Depression 
 
Azar Jafari-Koulaee1, Forouzan 
Elyasi2,3, Zohreh Taraghi3,4,5, 
Ehteram Sadat Ilali4,*, Mahmood 
Moosazadeh5 
 
1Student Research Committee, 
Mazandaran University of Medical 
Sciences, Sari, Iran; 2Department of 
Psychiatry, School of Medicine, 
Mazandaran University of Medical 
Sciences, Sari, Iran; 3Addiction Institute, 
Mazandaran University of Medical 
Sciences, Sari, Iran; 4Department of 
Geratric Nursing, School of Nursing and 
Midwifery, Mazandaran University of 
Medical Sciences, Sari, Iran; 5Health 
Science Research Center, Mazandaran 
University of Medical Sciences, Sari, Iran 
 
*Corresponding author 

 
Vol. 9, No. 1 (2020)   |   ISSN 2166-7403 (online)  
DOI 10.5195/cajgh.2020.442   |   http://cajgh.pitt.edu 



 
 
JAFARI-KOULAEE 
 

 
This work is licensed under a Creative Commons Attribution 4.0 United States License. 

 
This journal is published by the University Library System of the University of Pittsburgh as part  

of its D-Scribe Digital Publishing Program and is cosponsored by the University of Pittsburgh Press. 
 

Central Asian Journal of Global Health 
Volume 9, No. 1 (2020) | ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2020.442 | http://cajgh.pitt.edu 

 
 

Abstract 

Introduction: Depression is considered as one of the most serious health issues worldwide, and the search for the most effective 
and safe treatments for depression is essential. Aromatherapy with lavender have attracted the attention of many researchers due to 
their low cost and ease of use, so this study was conducted to review of the effects of aromatherapy with lavender essential oil on 
depression. 
Methods: This systematic review study was conducted by searching the databases (SID, Magiran, Google-Scholar, Medline via 
PubMed, Scopus, and Web of Science) by using the keywords such as depression, Lavandula, Lavender, and Aromatherapy, as 
well as applying OR and AND operators to the end of January 1, 2020 A.D. The inclusion criteria were: 1) Interventional studies 
that determined keywords were in the title or keywords of the article, 2) aromatherapy was conducted through inhalation or 
massage, 3) the full text of paper was accessible, and 4) published in English or Persian. Finally, the information obtained from 
articles was extracted using a checklist. 
Results: Out of 278 studies, 9 studies were included to the systematic review process after screening and eliminating duplicate 
papers according to the purpose of the study. Aromatherapy with lavender essential oil was conducted on the patients suffering 
from migraine, patients with the acute coronary syndrome, patients undergoing hemodialysis, community-dwelling older adult, and 
postpartum depression. The results obtained from some studies showed the positive effect of aromatherapy with lavender essential 
oil on depression whereas some studies did not report the effect of aromatherapy with lavender on depression significantly.  
Conclusion: It seems that aromatherapy with lavender probably can be used as a complementary, simple, and inexpensive method 
to improve mild and moderate depression. It is recommended to earmark using a collaborative approach and make use of 
interdisciplinary and psychology specialists as well as complementary medicine in applying aromatherapy with lavender essential 
oil. 

Keywords: Aromatherapy; Lavender; Depression; Complementary medicine  

A Systematic Review of the Effects 
of Aromatherapy with Lavender Essential Oil 
on Depression 
 
Azar Jafari-Koulaee1, Forouzan Elyasi2,3, 
Zohreh Taraghi3,4,5, Ehteram Sadat Ilali4,*, 
Mahmood Moosazadeh5 
 
1Student Research Committee, Mazandaran University 
of Medical Sciences, Sari, Iran; 2Department of 
Psychiatry, School of Medicine, Mazandaran University 
of Medical Sciences, Sari, Iran; 3Addiction Institute, 
Mazandaran University of Medical Sciences, Sari, Iran; 
4Department of Geratric Nursing, School of Nursing and 
Midwifery, Mazandaran University of Medical Sciences, 
Sari, Iran; 5Health Science Research Center, 
Mazandaran University of Medical Sciences, Sari, Iran 

Research 

Depression is considered as one of the most 
serious healthcare problems, and the statistics of 
individuals suffering from it is increasing. According to 
statistics, over 264 million suffer from depression 
throughout the world.1 In a review study, the prevalence 
of depression in Iran was reported 6% to 73%.2 The 
pathogenesis of depression is complicated, and numerous 
risk factors can impact depression affection. These 
factors include the medical chronic condition, stress, 
chronic pain, familial history, female gender, economic 
conditions, joblessness, drug abuse, low self-esteem, lack 
of social support, marital status, brain injury, and age.3-6 

Furthermore, obesity, malnutrition, physical inactivity, 
lack of sunlight, lack of sleep, and social problems in 
modern societies influence the rate of depression 



 
 

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This work is licensed under a Creative Commons Attribution 4.0 United States License. 
 

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of its D-Scribe Digital Publishing Program and is cosponsored by the University of Pittsburgh Press. 

 
Central Asian Journal of Global Health 

Volume 9, No. 1 (2020) | ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2020.442 | http://cajgh.pitt.edu 

 
 

affection.6 Unfortunately, suffering from depression is 
followed by unpleasant consequences; for example, a 
decrease in a patient's performance in personal, social, 
and familial dimensions and even suicide.7,8 Indeed, 
depression is the source of many somatic disorders,9,10 
insomnia,11 sexual disorders,12,13 and disorders in 
biologic rhythms.14 Hence, it seems necessary to seek the 
best, most effective, and least hazardous therapies and 
approaches to improve depression.  

In this respect, numerous pharmacological and 
non-pharmacological therapies are offered for depression 
improvement.15,16 Concerning the pharmacological 
therapies, it seems that many drugs play significant roles 
in treating psychological disorders; however, with 
respect to the presence of many complaints regarding the 
uselessness of these drugs for all patients, along with the 
emergence of diverse side effects and tolerance (if they 
are used in the long-run), numerous researchers have 
noticed using non-pharmacological therapies.17-19 
Several studies have addressed the positive effect of 
some non-pharmacological therapies, including art 
therapy,20 music,21,22 and aromatherapy,23,24 on the 
improvement in depression and anxiety. In the meantime, 
aromatherapy, as a non-pharmacological method, has 
been exploited in many studies owing to its hazardless 
and convenient usage.25 Aromatherapy employs the 
fragrant oils extracted from flowers and herbs to treat 
varying diseases. Essential oils can be used by inhaling, 
taking bath, or during massages.25,26 Lavender is of those 
herbs that are used in aromatherapy.27 This herb is from 
the lamiaceae family with the scientific name of 
lavandula angustifolia.28 Many studies have addressed 
the anti-pain,29,30 antianxiety and anti-depressant,27,31,32 
and sleep improvement33 effects. Also, some researchers 
have believed that lavender exerts its psychological 
effects through the effects on the limbic system, 
especially the amygdala and hippocampus. Mechanism 
of this plant on the cell surface is not completely known, 
but it has been reported that this plant probably had a 
similar function to benzodiazepines and increased GABA 
(gamma aminobutyric acid) in the amygdala.34 On the 

other hand, the review of the available databases showed 
that although some studies have reported the positive 
effects of aromatherapy with lavender on depression,27, 

35-40 but some others have reported reverse results.41,42 
Thus, considering the presence of contradictions in this 
field, lavender’s application to improving depression is 
still being argued. Hence, to access more precise and 
comprehensive evidence, this study reviewed the effect 
of aromatherapy with lavender on depression. 

 

Methods 

This systematic review study was conducted 
based on the Preferred Reporting Items for Systematic 
Reviews and Meta-Analysis (PRISMA)43 in 2020. To 
review the studies, we considered the components of the 
Population Intervention Comparison Outcome (PICO) 
structured review as a part of the research process.44 
PICO is one of the most suitable methods in discovering 
different literature for systematic review studies 
regarding diseases, therapeutic interventions, and 
consequences.45 At first, some factors, including the 
intervention type, kind of applied study, titles, and 
databases of concern are inserted in the standard PICO 
checklist for initial information estimation. To search 
more comprehensively, we searched the informational 
databases of SID, Magiran, Google-Scholar, Medline via 
PubMed, Scopus, and Web of Science by using the Mesh 
and non-Mesh keywords such as depression, Lavandula, 
Lavender, and Aromatherapy, as well as applying OR 
and AND operators, with no time limitation since 
establishment of databases to the end of January 1, 2020 
A.D. Also, the final references of searched articles, were 
evaluated as additional resources. The details of how 
keywords and operators were used to search the database 
are described below: 

• Scopus:(TITLE-ABS-KEY (lavender) 
OR TITLE-ABS 
KEY (lavandula) AND TITLE-ABS-



 
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Volume 9, No. 1 (2020) | ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2020.442 | http://cajgh.pitt.edu 

 
 

KEY (aromatherapy) AND TITLE-ABS-KEY 
(depression))  

• WOS:(TS=(aromatherapy AND (lavender OR 
lavandula) AND 
depression)) AND LANGUAGE: (English OR 
Persian) AND DOCUMENT TYPES: (Article) 

• PubMed:(((Lavender[Title/Abstract]) OR 
Lavandula[Title/Abstract]) AND 

Aromatherapy[Title/Abstract]) AND 
Depression[Title/Abstract] 

• Google Scholar:(Lavender OR Lavandula) 
AND Aromatherapy AND Depression  

• SID:(Lavender OR Lavandula) AND 
Aromatherapy AND Depression  

 

 
Figure 1. Flowchart of article selection using PRISMA

 

Records identified through database 
searching 
(n = 277 ) 

Sc
re

en
in

g
 

In
cl

ud
ed

 
El

ig
ib

ili
ty

 
Id

en
tif

ic
at

io
n

 

Additional records identified through 
other sources 

(n = 1 ) 

Total Records  
(n =278) 

Records screened 
(n = 254 ) 

Records excluded (n=239), with reasons such 

as:  

- No interventional study (n=87) 

- Not related to the depression (n=99) 

- Lavender was not used through 

aromatherapy (inhalation or massage) (n=15) 

- The full text of article was not accessible 

(n=28) 

- Published in other langugages (No English 

or Persian) (n=10) 

 

Full-text articles assessed for 
eligibility 
(n = 15 ) 

Records excluded (n=6), with reasons 

such as:  
- Poor quality (n=3) 

- insufficient and ambiguous information 

(n=3) 

Studies included in 
qualitative synthesis 

(n = 9  ) 

Records excluded                
(n=24): 

 
Duplicate cases (n=24) 

 



 
 
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Central Asian Journal of Global Health 
Volume 9, No. 1 (2020) | ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2020.442 | http://cajgh.pitt.edu 

 
 

Two researchers (A.J. & E.I.) reevaluated and 
reinvestigated the resources and databases to warrant the 
sufficiency and inclusiveness of information and article 
searching. After primary screening and removing 
duplicate cases, the articles were reviewed on the basis of 
inclusion and exclusion criteria, and finally eligible 
articles were included in the systematic review process.  

The inclusion criteria were: 1) Interventional 
studies that determined keywords were in the title or 
keywords of the them, 2) aromatherapy was conducted 
through inhalation or massage, 3) the full text of article 
was accessible, and 4) published in English or Persian. 
The studies with poor qualities, insufficient and 
ambiguous information were excluded from the process.  

The quality evaluation of the studies was 
conducted by the JADAD checklist. The JADAD 
checklist includes the three items of randomization, 
blinding, and withdrawals and dropouts that are in direct 
relationship with bias control in interventionist studies. 
The quality of studies was ranked as low-quality and 
high-quality studies if they were scored 1-2 and 3-5, 
respectively.46,47 In the present study, we eliminated the 
scores that were below 3 based on the checklist after the 
quality evaluation, and the scores above 3 were included 
in the review process.  

Finally, a checklist was used to extract the 
information of the papers imported to the review. This 
checklist consisted of items such as the author’s name, 
year of publication, type of study, sample size, type of 
variable, instrument, type of intervention, and results. 

 

Results 

Out of 278 studies, 9 studies were included to 
the systematic review process after screening and 
eliminating duplicate articles according to the purpose of 
the study. The details related to the stages of study 
selection are represented in Figure 1.  

The intervention in these studies was inhalation 
aromatherapy27,36-42 or aromatherapy massage35,40 with 
lavender. Aromatherapy with lavender essential oil was 
conducted on the patients suffering from migraine,41 
patients with the acute coronary syndrome,35 patients 
undergoing hemodialysis,27,39 community-dwelling older 
adults,36,40 and postpartum depression.37,38,40 Depression 
was measured by different scales, including Hospital 
Anxiety and Depression Scale (HADS), Geriatric 
Depression Scale (GDS), Beck Depression Inventory 
(BDI), Depression Anxiety Stress Scales-21, Center for 
Epidemiological Studies Depression (CES-D) Scale, and 
Edinburgh Anxiety Questionnaire and Stress Scale. The 
results obtained from studies showed the positive effect 
of aromatherapy with lavender essential oil on 
depression,27,35-40 whereas some studies did not report the 
positive effect of aromatherapy with lavender on 
depression significantly.41, 42 Other details are presented 
in Table 1. 

 

Discussion 

The present study aimed to review the effect of 
aromatherapy with lavender on depression. In this regard, 
the results of the review showed that the depression of 
patients undergoing hemodialysis significantly improved 
in the study of Tayebi et al.39 compared to the study of 
Bagheri Nesami et al.27 Perhaps, one of the possible 
reasons for the difference between the results of these two 
studies is the duration of every aromatherapy session; 
i.e., a session lasted one hour in the study of Tayebi et 
al.,39 while it was 15 minutes in the study of Bagheri 
Nesami et al.27 Longer aromatherapy periods may have 
better effects on depression reduction. Of course, the 
presence of other factors such as differences in the 
personal and cultural characteristics of individuals, the 
patients’ inclinations to use complementary medicine, 
and many other cases should be considered.  

Xiong et al.,40 in their study on older adults, 
reported that depression significantly decreased in the



 
 
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Author 
(year) 

Study 
design 

Sample size 
(n) / Type of 
sample of the 

study 

Type of 
intervention / 

Follow-up 
period 

Variable/ 
Instruments Results Conclusion Quality 

of study 

Bagheri-
Nesami1 et 
al. (2017) 

Randomized 
control trial 

ni=36; nc=36 / 
Hemodialysis 

patients 

Intervention 
group: 

aromatherapy 
with 3 drops of 

lavender 
essential oil 5% 
for 10 minutes 
every time they 

underwent 
hemodialysis for 
a period of one 

month 
Control group: 

routine care 
Follow-up 

period: 4 weeks 

Anxiety and 
depression/ Hospital 

Anxiety and 
Depression Scale 

(HADS) 

Before intervention (control 
group): Mean±SD= 4.05 

±4.48 
Two weeks after 

intervention (control group): 
Mean±SD= 5.00 ± 5.13 

Four weeks after 
intervention (control group): 

Mean±SD= 4.27 ± 5.04 
p = 0.221 

Before intervention 
(experimental group): 

Mean±SD= 4.54 ± 4.11 
Two weeks after 

intervention (experimental 
group): Mean±SD= 3.11 ± 

3.06 
Four weeks after 

intervention (experimental 
group): Mean±SD= 3.82 ± 

4.07 
p = 0.019 

Between the two groups: p 
= 0.005 

Significant 
differences 

existed 
between the 
two groups 
with respect 
to depression 
levels before, 
two and four 
weeks after 

the 
intervention. 

3 

Tayebi et al. 
(2015) 

Randomized 
control trial 

ni=30; nc=30 / 
Hemodialysis 

patients 

Interventional 
group: Inhale 
the lavender 
essential oil 

smeared on a 
piece of cloth 
(three drops of 

oil) for one hour 
during the 

hemodialysis 
Control group: 

routine care 
Follow-up 

period: 4 weeks 

Depression, anxiety, 
stress / Depression 

Anxiety Stress 
Scales-21 

Pre-test (interventional group): 
Mean±SD= 6.7±4.9 

Pre-test (control group): 
Mean±SD= 7.4 ± 6.9 

Post-test (interventional group): 
Mean±SD= 4.9±5.55 

Post-test (control group): 
Mean±SD= 7.4 ± 7.3 

Between the two groups: 
p<0.001 

Aromatherapy 
with lavender 
essential oil 
might reduce 
depression 
and stress 

among 
hemodialysis 

patients. 

3 



 
 

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Bahrami et 
al. (2016) 

Randomized 
control trial 

ni=45; nc=45 / 
Patients with 

acute coronary 
syndrome 

Intervention 
group received 

reflexology with 
lavender 

essential oil 
Control group: 

routine care 
Follow-up 

period: 4 weeks 

Depression / 
Hospital's Anxiety 

and Depression 
Scale 

Pre-test (experimental group): 
Mean±SD = 12.51 ± 5.40 
Pre-test (control group): 
Mean±SD = 8.04 ± 4.71 

p = 0.439 

Post-test (experimental group): 
Mean±SD = 8.04 ± 4.71 
Post-test (control group):  
Mean±SD = 11.11 ± 3.42 

p = 0.001 

Aromatherapy 
massage can 
be considered 

by clinical 
nurses an 
efficient 

therapy for 
alleviating 

psychological 
and 

physiological 
responses 

among older 
women 

suffering 
from acute 
coronary 

syndrome. 

3 

Xiong et al. 
(2017) 

Randomized 
control trial 

ni=20; ni=20; 
nc=20 / Chinese 

Community-
Dwelling Older 

Adults 

Aromatherapy 
massage group: 

30 min of 
aromatherapy 
massage with 

5ml oil lavender 
(diluted in sweet 
almond oil to a 
concentration of 

1%), twice 
weekly for 8 

weeks 
Aromatherapy 

inhalation 
group: 30 min of 
nasal inhalation 
of 50ml of the 

compound 
essential oils 

blended in 10ml 
of purified 

water, twice 
weekly for 8 

weeks 
Control group: 
no intervention 

Follow-up 
period: 10 

weeks 

Depression/ 
Geriatric 

Depression Scale 
Short Form (GDS-

SF) & Patient 
Health 

Questionnaire-9 
(PHQ-9) 

Pre-test (massage group): 
Mean±SD = 6.70 ± 1.92 

Pre-test (inhalation group): 
Mean±SD = 7.00 ± 1.34 
Pre-test (control group): 
Mean±SD = 6.80 ± 1.47 

Post-test (massage group): 
Mean±SD = 3.25 ± 2.15 

Post-test (inhalation group): 
Mean±SD = 3.75 ± 1.68 
Post-test (control group): 
Mean±SD = 6.65 ± 1.23 

6-week follow-up (massage 
group): Mean±SD = 3.95 ±2.07 
6-week follow-up (inhalation 

group): Mean±SD = 4.35 ±1.56 
6-week follow-up (control 

group): Mean±SD = 6.95 ±1.25 

10-week follow-up (massage 
group): Mean±SD = 3.63 ±2.00 
10-week follow-up (inhalation 
group): Mean±SD = 4.55 ±1.29 

10-week follow-up (control 
group): Mean±SD = 6.70 ±1.61 

After 
intervention, 

the 
aromatherapy 
massage and 

inhalation 
groups 

demonstrated 
significantly 
lower GDS-

SF than 
control 

participants. 

3 



 
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Central Asian Journal of Global Health 
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Janizadeh et 
al. (2016) 

Quasi 
experimental 

 

ni=20; ni=20; 
ni=20; nc=20 / 
Elderly Women 

Interventional 
group 1: yoga 

practice 
Interventional 
group 2: yoga 

practice 
combined with 
lavender use in 
the first month 

of training 
Interventional 
group 3: yoga 

practice 
combined with 
lavender use in 

the second 
month of 
training 
All three 

interventional 
groups practiced 

yoga for 2 
months. 

Control group: 
routine care 
Follow-up 

period: 8 weeks 

Depression/ Beck 
Depression 

Inventory (BDI) 

Pre-test (interventional group 
1): Mean±SD= 24.40 ±12.72 

Post-test (interventional group 
1): Mean±SD= 21.20 ± 12.12 

p= 0.001 

Pre-test (interventional group 
2): Mean±SD=23.10±11.77  

Post-test (interventional group 
2): Mean±SD= 14 ±7.65 

p= 0.001 

Pre-test (interventional group 
3): Mean±SD=19.50±8.42 

Post-test (interventional group 
3): Mean±SD= 13.40 ± 7.73 

p= 0.001 

Pre-test (control group): 
Mean±SD= 21.30±8.55 

Post-test (control group): 
Mean±SD= 20.80± 8.63 

Greater 
reduction in 
depression in 
the combined 

groups 
compared to 

the yoga 
practice 
group. 

However, 
there was no 
significant 
difference 

between the 
two combined 

groups 

3 

Jafari-
Koulaee et 
al. (2018) 

Randomized 
control trial 

ni=30; nc=30 / 
Migraine 
patients 

Interventional 
group: Inhaled 
2-3 drops of 

lavender essence 
for 15 min, three 
times a week for 

4 consecutive 
weeks 

Control group: 
routine care 
Follow-up 

period: 4 weeks 

Depression / Beck 
Depression 

Inventory (BDI-13) 

Pre-test (interventional group): 
Mean±SD= 10.93±0.56 
Pre-test (control group): 
Mean±SD= 9.70±2.33 

Post-test (interventional group): 
Mean±SD= 5.23±0.57 

Post-test (control group): 
Mean±SD= 5.10 ± 0.53 

p=0.13 

Lavender 
essential oil 

can be useful 
for reducing 
depression 

and headache 
disability in 

migraine 
patients. 

3 

Kianpour et 
al. (2016) 

Randomized 
control trial 

ni=25; nc=34; 
np=31 / Women 

in the 
postpartum 

period 

Interventional 
group: 7 drops 
of lavender oil 
and 1cc rose 
water at the 

concentration of 
100%, 

Postpartum 
Depression / 
Edinburgh 

questionnaire 

Before intervention 
(interventional group): 

Mean±SD= 10.37 ±3.21 
Before intervention (control 

group): Mean±SD= 10.61±4.21 
Before intervention (placebo 

group): Mean±SD= 9.71 ±4.20 

The use of 
aromatherapy 

can be 
recommended 

in high-risk 
women. 

4 



 
 

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Volume 9, No. 1 (2020) | ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2020.442 | http://cajgh.pitt.edu 

 
 

Placebo group: 7 
drops of 

odorless sesame 
seed oil, with 1 

cc of musk 
willow sweat at 

the 
concentration of 

100% 
Control group: 

routine care 
Follow-up 

period: 6 weeks 

p>0.05 

2 weeks after delivery 
(interventional group): 
Mean±SD= 7.80 ±3.90 

2 weeks after delivery (control 
group): Mean±SD= 8.51 ±3.61 
2 weeks after delivery (placebo 
group): Mean±SD= 11.70±4.10 

p>0.001 

6 weeks after delivery 
(interventional group): 
Mean±SD= 6.80 ±3.61 

6 weeks after delivery (control 
group): Mean±SD= 9.50 ±3.03 
6 weeks after delivery (placebo 
group): Mean±SD= 7.90 ±3.30 

p=0.01 

Kianpour et 
al. (2016) 

Randomized 
control trial 

ni=70; nc=70 / 
Women in the 

postpartum 
period 

Interventional 
group: 

Aromatherapy 
consisted of 

inhaling three 
drops of 
lavender 

essential oil 
every 8h with 
for 4 weeks 

Control group: 
no aromatherapy 

Follow-up 
period: 12 

weeks 

Postpartum 
Depression / 

21-item Depression, 
Anxiety, and Stress 

Scale and the 
Edinburgh stress, 

anxiety, and 
depression scale 

2 weeks after intervention 
(interventional group): 
Mean±SD=5.31±4.42 

2 weeks after intervention 
(control group): Mean±SD= 

7.34 ±5.16 
p=0.003 

1 month after intervention 
(interventional group): 
Mean±SD= 4.10 ±3.92 

1 month after intervention 
(control group): Mean±SD= 

7.59 ±5.14 
p < 0.0001 

3 months after intervention 
(interventional group): 
Mean±SD= 3.81 ±3.48  

3 months after intervention 
(control group): Mean±SD= 

7.27 ±5.11 
p < 0.0001 

Inhaling the 
scent of 

lavender for 4 
weeks can 

prevent stress, 
anxiety, and 
depression 

after 
childbirth. 

3 

Sehhatie et 
al. (2015) 

Controlled 
double-
blinded 
random 

clinical trial 

ni=158; nc=162/ 
Women in the 

postpartum 
period 

Interventional 
group: 

showering, 
being in upright 

posture, 
aromatherapy 
with lavender 

(1ml solution of 

Mothers’ 
Postpartum 
Depression / 
Edinburgh 

questionnaire 

Pre-test (experimental group):  
Mean±SD= 6.1±3.2 

Post-test (experimental group): 
Mean±SD= 7.8±4.6 

Pre-test (Control group): 
Mean±SD= 6.3±3.2 

Post-test (Control group): 

The results 
show the 

decrease of 
depression in 

the 
intervening 

group as 
compared to 

4 



 
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20% lavender 
essence), and 

soft music 
without words 
Control group: 

the interventions 
were customary 

according to 
delivery 

interventions. 
Follow-up 

period: 8 weeks 

Mean±SD= 8.8±5.4 

Mean difference (95% CI) =   
(-0.2-1.8)-0.8 

p=0.124 

the control 
group which 
could be due 
to the effect 

of non-
pharmacologi
cal methods 
of pain relief 

in labor. 

Table 1. Summary of data extracted from the reviewed articles (N=9) 

inhalation and massage aromatherapy group compared to 
the control group. Furthermore, it was observed that the 
long-term effects of aromatherapy with lavender on 
depression reduction lasted for 10 weeks after the 
intervention.38 In line with the mentioned study, 
Kianpour et al.37,38 conducted a study on postpartum 
depression that the long-tern effect of aromatherapy with 
lavender on depression reduction was found 6 weeks, one 
month, and even three months after delivery. On the other 
hand, in another study,49 although the positive effects of 
aromatherapy lasted up to six weeks after the 
intervention, there was not a significant difference 
between the experimental and control groups in their 
depression scores after 10 weeks. Perhaps, one of the 
possible reasons for the difference in results is that the 
patients of this study49 were suffering from cancer, and 
the kind of aroma applied to aromatherapy was not 
specified, whereas the participants in the study of Xiong 
et al.40 and Kianpour et al.37,38 were the community 
dwelling older adult and women in postpartum period, 
respectively, and they utilized lavender essential oil.  

In a study conducted on postpartum depression, 
Kianpour et al.37,38 found that women’s depression 
significantly decreased after aromatherapy with lavender. 
However, Sehatti et al.42 reported that aromatherapy with 
lavender essential oil did not significantly decrease the 
depression of women after their delivery. One of the 

reasons for the difference between results may be the 
kind of utilized lavender essential oil. Kianpour et al.37 
and another study38 employed a pure lavender essential 
oil and the one diluted by rose essential oil, respectively, 
while Sehatti et al.42 employed lavender essential oil 20% 
diluted by distilled water. Moreover, the difference in the 
time of depression measurement may be another reason. 
It is because Kianpour et al.37 and another study38 
measured depression 2, 4, and 12 weeks and 2 and 6 
weeks after delivery, respectively. However, in another 
study, depression was assessed 8 weeks after delivery.  

Janizadeh et al.36 showed that if the lavender 
essential oil were applied along with yoga, it would have 
positive effects on the depression reduction of depressed 
women. Therefore, we can state that aromatherapy with 
Lavender essential oil combined with other non-
pharmacological interventions that impact depression, 
including yoga, may be more effective in improving 
depression. Of course, it is worth to mention that some 
factors such as the type and severity of depression, as 
well as individuals’ personal and physical conditions and 
inclinations, should be taken into account. Hence, the 
conduction of more large-scale studies is necessary for 
acquiring more comprehensive and precise evidence in 
this regard.  

Overall, the possible reasons for the differences 
in the results of the studies in terms of severity of 



 
 

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decreasing depression may be related to the differences 
in definition of cases, randomization, blinding and 
sample size determination. In the reviewed studies, 
participations were not homogeneous (migraine 
patients,41 acute coronary syndrome patients,35 
hemodialysis patients,27,39 community-dwelling older 
adults,36,40 and postpartum depression).37,38,40 Also, 
randomization was done in almost all studies,27,35-42 
whereas blinding was performed in only two studies.38,42 
On the other hand, although according to the review of 
the studies, sample size calculation in most of the studies 
was done based on the sample size formula or an 
acceptable method for estimating the sample size, but 
sample size in some of the studies was small or moderate 
thus, it seems that further large clinical trials with larger 
sample size are needed to provide more accurate 
evidence. 

The results of the most studies revealed that 
probably, lavender aromatherapy can improve the 
depression of patients undergoing hemodialysis, patients 
suffering from acute coronary syndrome, community 
dwelling older adults, and postpartum depression. 
Furthermore, the results showed that probably, 
aromatherapy can improve depression if it is mixed with 
other non-pharmacological interventions, including 
physical exercises and yoga, but available studies are not 
sufficient. Although, it seems that lavender aromatherapy 
as a complementary, simple, and inexpensive method can 
be used by clinical nurses to improve depression (mild to 
moderate), along with other measures, in patients with 
chronic diseases or undergoing diagnostic and 
therapeutic measures and postpartum depression, but 
further high-quality RCTs studies are needed to confirm 
these findings and to achieve the best level of evidence in 
this field. High-quality RCTs studies can provide more 
reliable findings so that we can use their findings in 
evidence-based practice. Also, a collaborative and 
interdisciplinary approach is recommended for applying 
lavender aromatherapy.  

Despite the strengths of this study, one of the 
limitations of this study is inaccessibility to some of the 
studies because of publishing in non-English or non-
Persian language. A relatively low sample size in some 
of the studies and lack of high-quality RCTs are other 
limitations. Meanwhile, the impossibility of meta-
analysis due to the heterogeneity of the design of studies 
and research population is another limitation of the study.  

Depression is a major contributor to the overall 
global burden of disease, and it is essential to support 
those who are suffering from this mental disorder by 
applying easy and safe methods. In this regard, it is 
recommended that future research be conducted focusing 
on the evaluation of the effect of complementary 
medicine interventions (e.g. aromatherapy) and the 
importance of applying them in combination with other 
interventions to reduce depression and its psychological 
and social burden of this debilitating disease in the world.  

 

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