Effects of psychosocial interventions on cancer-related fatigue in patients with colorectal cancer: a systematic review and meta-analysis of randomised controlled trials

Purpose This review aimed to scrutinise and critically appraise the evidence on the effects of psychosocial interventions in alleviating CRF for colorectal cancer patients. Methods MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Ultimate, APA PsycInfo, CNKI, and WANFANG Database were electronically searched from inception to 31st August 2025 for randomised controlled trials examining psychosocial interventions for CRF in colorectal cancer patients. Meta-analyses were performed for short-term (immediately post-intervention to 1 month), medium-term (> 1 to 3 months), and long-term (> 3 months) follow-up periods. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The Review Manager Software (Version 5.4.1) was used for data analysis. Results Nine studies with 1426 participants were included. Interventions were categorised as psychotherapies, psycho-behavioural interventions, and yoga. Meta-analyses indicated that compared to controls, psychosocial interventions significantly reduced CRF at short-term (standardised mean difference (SMD) = −0.53, 95% confidence interval (CI) = −0.82 to −0.23), medium-term (SMD = −0.51, 95%CI = −0.73 to −0.29), and long-term (SMD = −0.24, 95%CI = −0.46 to −0.01) follow-up. Subgroup analyses indicated that psycho-behavioural interventions were effective (SMD = −0.39, 95% CI = −0.76 to −0.01), while psychotherapy and yoga showed no significant effects. The certainty of evidence ranged from very low to moderate. Conclusions Psychosocial interventions, particularly psycho-behavioural approaches, appear effective in reducing CRF among patients with colorectal cancer; however, effects were consistent at medium-term and long-term follow-up, while short-term findings showed substantial heterogeneity. More rigorous, adequately powered trials are needed to strengthen and extend the current evidence base.