Patient-centered group psychotherapy for depression and negative emotions: a systematic review and meta-analysis

TL;DR

This study finds that patient-centered group psychotherapy effectively reduces depression symptoms and improves functioning, especially in resource-limited settings.

Contribution

The study provides the first meta-analysis on patient-centered group psychotherapy for depression, highlighting its efficacy and functional benefits.

Findings

PCGP significantly reduces depressive symptoms and improves functional outcomes in adults with depression.

PCGP improves negative mood, though with high variability across studies.

PCGP shows a positive trend in medication adherence, though not statistically significant.

Abstract

Depressive disorders and negative emotions are a major global health challenge, affecting over 280 million people and worsened by the COVID-19 pandemic. Traditional treatments have limitations such as high relapse rates and accessibility issues. This study aimed to assess the efficacy of patient-centered group psychotherapy (PCGP) on depressive symptoms and functional outcomes, identify moderators, and provide recommendations.

Following PRISMA guidelines, we searched PubMed, CNKI, and other databases through October 2024, including 7 randomized controlled trials (RCTs) and one Clinical study (total N = 1,989). Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses via RevMan 5.4 calculated risk ratios (RRs) and standardized mean differences (SMDs), with heterogeneity evaluated via I² statistics.

Eligible participants comprised adults (≥18 years) with a principal diagnosis of major depressive disorder (DSM-5/ICD-10 criteria) or clinically significant negative emotional symptoms (e.g., PHQ-9≥15), excluding those with primary non-depressive psychiatric comorbidities. Studies involving mixed populations were included only if subgroup data for depressed participants were extractable. PCGP showed significant positive effects on overall effectiveness (RR = 1.10, 95% CI: 1.01-1.19, p = 0.03), symptom reduction (Positive and Negative Syndrome Scale (PANSS) scores, SMD = -1.96, 95% CI: -2.31 to -1.61, p < 0.001), and functional outcomes (Personal and Social Performance (PSP) scores, SMD = 1.96, 95% CI: 1.41-2.51, p < 0.001). It also improved negative mood (SMD = -4.28, 95% CI: -8.03 to -0.52, p = 0.03) but with high heterogeneity (I² = 99.0%). A positive trend was noted for medication adherence (RR = 1.11, 95% CI: 0.89-1.38, p = 0.35).

PCGP is an effective first-line adjunct therapy for depression, particularly in resource-limited settings. It addresses both symptom reduction and functional recovery by combining personalized goal-setting with group dynamics.

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