SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. Mood Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1657615
Effect of nonpharmacologic therapies on depressive symptoms in patients with chronic fatigue syndrome: a network meta-analysis
Provisionally accepted
- 1Heilongjiang University of Chinese Medicine, Harbin, China
- 2The Tumour Hospital of Harbin Medical University, Harbin, China
- 3First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, China
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Background: Depression or depressive symptoms exacerbate the burden in patients with chronic fatigue syndrome (CFS). The therapeutic effects of various non-pharmacological interventions remain unclear. Objective: This paper aims to evaluate the effectiveness of different non-pharmacological measures in alleviating depression or depressive symptoms in patients with CFS through network meta-analysis. Methods: PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang, CBM, VIP, and Sinomed databases were searched for randomized controlled trials (RCTs) until March 26, 2025. The Cochrane Risk of Bias Assessment Tool 2.0 was utilized to appraise the risk of bias. A network meta-analysis was conducted using the GeMTC package in R (4.4.2). This protocol has been registered in PROSPERO (CRD420251020737). Results: 47 RCTs involving 4,028 participants were included. Compared with control measures, diet therapy was most effective in improving depression or depressive symptoms in patients with CFS (SMD = -5.64, 95% CI: -8.98 to -2.29), followed by moxibustion (Mox) (SMD = -2.91, 95% CI: -4.61 to -1.22), acupuncture (Ap) + Mox + acupoint embedding (SMD = -3.16, 95% CI: -0.39 to -5.98), and Ap + Mox (SMD = -2.53, 95% CI: -1.17 to -3.91). Conclusion: Diet therapy is the most effective in improving depression or depressive symptoms in patients with CFS, followed by Mox. Further carefully designed RCTs are warranted to substantiate these findings.
Keywords: Depression, non-pharmacological therapy, Network meta-analysis, Systematic review, chronic fatigue syndrome
Received: 01 Jul 2025; Accepted: 31 Jul 2025.
Copyright: © 2025 Jiang, Cao, Xia and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Long Wang, First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, China
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