The effects of psychosocial interventions on geriatric depression in the mainland of China: A systematic review and meta-analysis

The effectiveness of psychosocial interventions for geriatric depression across different treatment settings, regions, and comorbidities in China remains unclear. Therefore, we systematically reviewed studies geared towards reducing geriatric depression in China. Nine databases in Chinese or English from database were searched from inception through January 2021. Randomized controlled trials investigating psychosocial interventions on older adults with depression in China were included. The primary outcome was post-intervention depression measured by self-report instruments. Random-effect model was used to pool the overall effect size Hedge's g. In 99 studies with a total of 9369 older adults with depression, psychosocial interventions were effective compared with control conditions (Hedges' g: −1·48 [95 % CI: −1·83 to −1·13]). Comorbidity with physical disease significantly affect the pooled effect size (without comorbidity: Hedges' g = −1.19, 95 % CI: −1.42 to −0.95; with comorbidity: Hedges' g = −2.06, 95 % CI: −2.97 to −1.14; p = 0.062), and heterogeneity was substantial (without comorbidity, I2 = 91·3 %, 95 % CI: 89·5 % to 92·7 %; with comorbidity, I2 = 94·3 %, 95 % CI: 93·1 % to 95·4 %). The quality of evidence according to the GRADE criteria was generally moderate. Significant heterogeneity among the studies reviewed was unavoidable, and the possible publication bias could lead to overestimation of the result. Psychosocial interventions are significantly effective for treating geriatric depression in China regardless of the setting, region, or therapeutic orientation. Policies should support the development and implementation of psychosocial interventions in China, especially in community settings, to reduce disease burden.