Comparative efficacy of group versus individual reminiscence therapy for depression in older adults: A network meta-analysis stratified by severity.

OBJECTIVES

To directly compare the efficacy of individual reminiscence therapy (IRT) and group reminiscence therapy (GRT) for alleviating depressive symptoms in older adults, and to evaluate their effects on secondary outcomes, including anxiety, cognitive function, life satisfaction, and quality of life.

METHODS

A systematic review and network meta-analysis (NMA) was conducted. Eleven Chinese and English databases were searched from inception to December 1, 2025. Randomized controlled trials (RCTs) comparing IRT or GRT against a medication control group (MCG), a non-medication control group (NCG), or each other were included. Risk of bias (RoB) was assessed using the RoB 2 tool, and evidence certainty was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Pairwise and network meta-analyses were performed, with comparisons further stratified by baseline depression severity (mild, moderate, severe). Treatment rankings were based on the surface under the cumulative ranking (SUCRA) statistic. Subgroup analyses were conducted to examine potential effect modifiers, including intervention format, baseline depression severity, control type, intervention duration, session frequency, total sessions, cumulative intervention time, geographical region, setting, and provider qualification.

RESULTS

Twenty RCTs with 1,633 participants were included. For depression, both IRT and GRT were significantly superior to MCG and NCG, with no statistically significant difference between the two modalities overall (SMD = -0.03; 95 %CI: -0.49, 0.42). Severity-stratified analysis revealed that GRT had the highest probability of being optimal for mild depression (SUCRA = 92.5 %), while IRT ranked highest for moderate (SUCRA = 80.6 %) and severe depression (SUCRA = 84.5 %). For secondary outcomes, IRT was superior to GRT for reducing anxiety and improving cognitive function, whereas GRT was more effective for enhancing life satisfaction. Subgroup analyses showed no significant moderating effects for any of the examined variables (all P > 0.05).

CONCLUSIONS

Both IRT and GRT are effective for depression in older adults, with no statistically significant difference between them. GRT may be preferred for mild depression, while IRT may be more suitable for moderate-to-severe depression. IRT shows additional benefits for anxiety and cognition, whereas GRT excels in improving life satisfaction. These findings support a personalized, severity-informed approach to selecting RT delivery formats in clinical practice.