Effect of Laughter Therapy on Depression among Middle-Aged Women: A Systematic Review and Meta-Analysis

Background: Laughter therapy, known for its health benefits, has become a popular treatment for psychological conditions such as depression over the last ten years. The effectiveness of laughter therapy may differ with the cause of depression and the age of patients. No systematic reviews or meta-analyses have focused on the impact of laughter therapy on middle-aged women's depression. This study aimed to evaluate the effect of laughter therapy on depression in middle-aged women. Methods: Randomized controlled trials (RCTs) or quasi-experimental studies on laughter therapy were included in this systematic review and meta-analysis which compared to the control group. The systematic review included English and non-English articles that were searched in CINAHL, MEDLINE, Cochrane Library, and EMBASE electronic databases. Search terms included laugh, qigong, laughter therapy, humor, yoga, intervention, depression, middle age, menopause, and women. The article screening process was conducted by four authors independently and finally agreed upon by all. This systematic review and meta-analysis were reported according to the PRISMA guidelines. JBI critical appraisal tools were used to assess the quality of inclusion studies. The risk of bias was assessed using the risk of bias in non-randomized studies – of Interventions (ROBINS-I) assessment tool. Results: A total of 3102 studies were examined, and two publications (two quasi-experimental studies) were included. Studies were included and evaluated by the inclusion and exclusion criteria. The results indicated a significant decrease in depression among middle-aged women. Conclusion: Laughter therapy demonstrated cost-effectiveness and exhibited no adverse effects in middle-aged women, making it a viable option for promoting health and reducing depression among middle-aged women.