Comparison of the therapeutic effects of open psychiatric wards for patients with depression: a meta-analysis

To systematically evaluate and compare the differences in treatment outcomes between open and closed psychiatric wards for hospitalized patients with depression, and to provide evidence-based support for optimizing psychiatric ward management models.

PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database were searched for relevant literature published from inception to December 20, 2025. Randomized controlled trials (RCTs) comparing the therapeutic effects of open versus closed psychiatric wards in hospitalized patients with depression were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias tool. Meta-analysis was performed using RevMan 5.4.

A total of 9 RCTs were included. The meta-analysis showed that the open psychiatric ward group achieved better outcomes than the closed psychiatric ward group in depression symptom scores, with statistically significant differences in both the Self-Rating Depression Scale (SDS) score [MD = -3.81, 95% CI (-4.22, -3.40)] and the Hamilton Depression Rating Scale (HAMD) score [MD = -0.99, 95% CI (-1.18, -0.81)] (both P < 0.01). In terms of treatment adherence, the open ward group was higher than the closed psychiatric ward group [RR = 1.23, 95% CI (1.04, 1.47), P = 0.02]. There was no statistically significant difference between the two groups in clinical response rate [RR = 1.09, 95% CI (0.92, 1.29), P = 0.32]. Neither Egger's regression test nor Begg's rank correlation test indicated significant publication bias.

Compared with closed psychiatric wards, open psychiatric wards may help improve depressive symptoms and increase treatment adherence among hospitalized patients with depression; however, their effect on clinical response rate remains unclear. Future high-quality, multicenter studies are needed to further verify the efficacy and safety of open psychiatric wards.