• Heidi Ka-Ying Lo, Fiona Yan-Yee Ho, Jerry Wing-Fai Yeung, Stephy Tim-Wai Ng, Eva Yuen-Ting Wong, and Ka-Fai Chung.
• Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong.
• Fam Pract. 2024 Oct 8; 41 (5): 662679662-679.

IntroductionSelf-help interventions may offer a scalable adjunct to traditional care, but their effectiveness in relapse prevention is not well-established. Objectives: This review aimed to assess their effectiveness in preventing relapses among individuals with mood disorders.MethodsWe systematically reviewed the pertinent trial literature in Web of Science, EMBASE, PubMed, PsycINFO, and Cochrane databases until May 2024. Randomized controlled trials that examined the self-help interventions among individuals diagnosed with major depressive disorder (MDD) or bipolar disorder (BD) were included. The random-effects model computed the pooled risk ratios of relapse, with subgroup analyses and meta-regression analyses to explore heterogeneity sources.ResultsFifteen papers and 16 comparisons of randomized trials involving 2735 patients with mood disorders were eligible for this meta-analysis. Adjunct self-help interventions had a small but significant effect on reducing the relapse rates of major depressive disorder (pooled risk ratio: 0.78, 95% confidence interval (CI): 0.66-0.92, P = 0.0032, NNT = 11), and were marginally better in bipolar disorder (pooled risk ratio: 0.62, 95% CI: 0.40-0.97, P = .0344, NNT = 12), as compared to treatment as usual (TAU). No subgroup difference was found based on intervention components, settings, delivery method, or guidance levels. The average dropout rate for self-help interventions (18.9%) did not significantly differ from TAU dropout rates. The examination of treatment adherence was highly variable, precluding definitive conclusions.ConclusionsSelf-help interventions demonstrate a modest preventative effect on relapse in mood disorders, despite low to very low certainty. Future research is essential to identify which elements of self-help interventions are most effective.© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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