Psychoeducation as an adjunctive treatment for depression: a systematic review and meta-analysis

Abstract

Psychoeducation (PE) is a cost-effective psychosocial intervention recommended for many diseases; however, its application as an adjunctive treatment for patients with Major Depressive Disorder (MDD) remains unclear. This way, our study aims to gather information on how PE programs are organized and their efficacy in reducing MDD symptoms. Our search was conducted across databases (PubMed, EMBASE, and Web of Science), and sites (Clinical Trials, ProQuest, and Google Scholar) up to June 2024, including only studies with low/moderate risk of bias. From 5211 articles, 24 studies (23 RCTs and 1 cross-sectional study) were selected, resulting in data from 3311 participants; 1799 received some form of PE. Data obtained from RCT studies, comparing PE with waiting list (n = 3), Treatment as usual (n = 6), and other psychosocial treatment (n = 13), indicated that PE interventions were related to better symptom reduction only compared to TAU (SMD 0.24 [0.04–0.45]. By comparing pre and post-scores of PE interventions from each study, a large-size effect (Hedge’s g > 0.8) was found. In this sense, findings suggest PE as an important adjunctive treatment for MDD during depressive episodes, leading to significant symptom reduction regardless of the PE offered. However, the heterogeneity observed limits definitive conclusions about its optimal model. Future research should prioritize the development of standardized PE models, with clear theoretical foundations in order to enhance efficacy and generalizability of PE for MDD.