The Efficacy of Bibliotherapy in Depression Management: A Systematic Review of Randomized Clinical Trials

Abstract

Aim: This systematic review critically evaluates the efficacy of bibliotherapy in addressing mental health concerns across various populations and intervention modalities. Methods: A comprehensive bibliographic search was conducted, identifying 20 articles from databases PubMed, Scopus, and Google Scholar, representing studies published in English between 1990 and 2022. The selected randomized clinical trials were subjected to rigorous evaluation using Cochrane's Risk of Bias tool to assess methodological quality. Inclusion criteria focused on RCTs examining bibliotherapy programs for depression treatment. The selected studies were analyzed based on their comparison of bibliotherapy outcomes with standard treatments or no intervention. Follow-up periods ranging from 2 weeks to 3 years were considered. Results: Out of 413 retrieved results, 20 articles were included, reporting 3354 subjects. The methodological quality of the studies, assessed using Cochrane's Risk of Bias tool, was found to be sound. Bibliotherapy demonstrated significant improvements in depressive symptoms in older patients as studied in 3 long-term bibliotherapy RCTs and 7 shortterm bibliotherapy RCTs. In young patients, 3 long-term bibliotherapy RCTs have shown significant improvement in depressive symptoms over 6 months to 2 years, whereas 7 short-term bibliotherapy RCTs also showed significant improvement within a brief timeframe. The review explores bibliotherapy's efficacy in managing occupational stress and its potential as a therapy for depression in populations with chronic physical illnesses. Conclusion: The findings imply that bibliotherapy could serve as an affordable and prompt intervention, potentially reducing the need for additional medications. However, the study emphasizes the importance of further research to strengthen the evidence base, particularly in diverse populations and settings.