Effects of group psychotherapy compared to waiting list or other active intervention on depression and other clinical outcomes in adults with autism spectrum disorder: A systematic review

Objective

This systematic review evaluates the efficacy of group psychotherapy for adults with autism spectrum disorder (ASD). Symptoms of depression, mortality, drop out due to lack of effect or side effects, complications, anxiety, global functioning, and quality of life were considered as outcomes.

Methods

Following PRISMA guidelines and pre-registration in PROSPERO, the databases MEDLINE, Cochrane Library, EMBASE, CINAHL, and APA PsycINFO were searched in December 2022 for studies involving adults with ASD that compared group psychotherapy with other individual psychotherapy, pharmacological treatment, other active interventions, or waiting list. The risk of bias of included studies was assessed, and data were extracted and summarized. Meta-analyses were planned if appropriate. The certainty of the evidence was assessed using GRADE.

Results

Five studies (n = 261) were included. Four studies (3 randomized controlled trials [RCTs], 1 non-RCT) compared group psychotherapy to waiting list. Given the studies’ heterogeneity no meta-analyses were performed. The studies reported inconsistent findings regarding depressive symptoms and anxiety. None of the studies reported data regarding quality of life, global functioning, mortality or suicide, drop out, or complications. One RCT comparing group psychotherapy to recreational activity found no significant difference in depressive symptoms, global functioning, or quality of life. No study comparing group psychotherapy with other individual psychotherapy or pharmacological treatment was found.

Conclusion

Based on five controlled studies it is uncertain whether group psychotherapy compared to waiting list or recreational activity results in differences in depressive symptoms, anxiety, global functioning, or quality of life in adults with ASD.