Family Psychoeducation for Major Depressive Disorder: A Systematic Review

Previous reviews have indicated that family psychoeducation (FPE) improves depressive symptoms in patients with major depressive disorder (MDD) and enhances the wellbeing of family members. With recent research advances and new pharmacotherapy options for MDD, current evidence on the effectiveness of FPE on key patient outcomes was needed. This systematic review aimed to evaluate the evidence on the impact of FPE on antidepressant adherence (primary outcome), as well as on depressive symptoms, personal recovery, medication beliefs and concerns, and components of FPE for MDD (secondary outcomes). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, five electronic databases were searched for experimental studies, including randomised controlled trials (RCTs) and non-randomised trials with pre-post designs. Only articles in English, published up to December 13th, 2024, that met the inclusion criteria were included. The risk of bias in each study was assessed using the Joanna Briggs Institute checklist for RCTs or quasi-experimental studies, depending on the study type. Out of the 2154 records identified, four (three RCTs and one quasi-experimental study) met the inclusion criteria and were included in the review. None of the studies assessed antidepressant adherence. Three studies reported improvements in patients' depressive symptoms. Due to limited and heterogeneous studies, a descriptive synthesis of results was used rather than a meta-analysis. This review highlights a significant gap in research on FPE for MDD and the limited evidence currently available. Further research is needed to evaluate its effectiveness on both clinical (e.g., adherence and severity of depressive symptoms) and non-clinical outcomes (e.g., personal recovery and beliefs and concerns about antidepressants) in individuals with MDD. Systematic Review Registration: PROSPERO CRD42024587967.