A meta‐analysis of randomized controlled trials of laughter and humour interventions on depression, anxiety and sleep quality in adults

AIM: To quantify the effect of laughter and humour interventions on depression, anxiety, and sleep quality in adults. DESIGN: A meta-analysis of randomized controlled trials. DATA SOURCES: PubMed, Embase, PsycINFO, Web of Science, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Weipu, and Wanfang Data were searched from their inception up to December 2018. REVIEW METHODS: The reporting of this meta-analytical review was conducted according to the guidelines of the Cochrane Collaboration. Two reviewers selected the studies, extracted the data, and evaluated the risk of bias (Cochrane Collaboration bias assessment tool) of the included papers independently. RESULTS: Ten studies comprising 814 participants were included. Meta-analysis showed that these interventions significantly decreased adults' depression, anxiety, and improved their sleep quality. The results of subgroup analysis showed that depression benefits more from long-term laughter intervention. CONCLUSIONS: This meta-analysis revealed that laughter and humour interventions are effective in relieving depression, anxiety, and improve sleep quality in adults. More studies with high quality and follow-up assessment should be conducted for future research. IMPACT: This review synthesized current evidence using laughter and humour interventions to reduce negative emotion and promote better results in adults, especially with respect to target the applicability between different populations or intervention methods. In addition, humour and laughter interventions are safe, convenient, interesting and can promote interpersonal relationship in both patients and medical workers, which have great feasibility and potential to be used as an aspect of psychotherapy for clinical and nursing to improve well-beings in adults.