Objective To systematically analyze the research status, highlights, and advancements of five-element music therapy (FEMT) in intervening depression with bibliometric methods.

Methods Relevant research literature on FEMT for depression intervention was retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Science and Technology Journal Database (VIP), and Web of Science (WOS), spanning from January 1, 2000 to August 6, 2025. Bibliometric analysis was performed using Excel, VOSviewer, and CiteSpace, with a focus on dimensions like publication trends, journal distribution, institutional and author collaboration, keyword co-occurrence, clustering, and burst detection, and highly cited publications.

Results A total of 382 articles were included, comprising 304 Chinese articles and 78 English articles. Annual publication volume in this field exhibited a steady upward trend, with Chinese literature initiating earlier and maintaining dominance, while English literature demonstrated marked growth from 2019 onward. Network analysis of institutional and author collaborations revealed collaborative networks centered on research teams led by Facai LIN (Nanjing University of Chinese Medicine) and Li LI (Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine), with Chinese authors and institutions remaining dominant contributors to English literature. Keyword analysis indicated that Chinese literature emphasizes clinical applications such as “depression” “five-elements music” “five-tone therapy” and “acupuncture”, whereas English literature prioritize “music therapy” “depression” “randomized controlled trial” and “anxiety” with a focus on mechanisms and standardization. Cluster analysis revealed a paradigm shift from traditional Chinese medicine (TCM) theoretical explanations to research integrating neurobiological mechanisms and modern technologies. Analysis of highly cited literature further corroborated this trend, indicating that FEMT research is transitioning from empirical clinical exploration to evidence-based mechanistic inquiry.

Conclusion FEMT research on depression shows distinct thematic emphase, with Chinese literature focusing on TCM theory and clinical applications, while English literature emphasize evidence-based mechanisms. Future research should integrate systematic reviews and high-quality clinical trials and strengthen cross-institutional collaboration to enhance mechanistic evidence and broaden the scope of FEMT.