BACKGROUND: Since 2000, there has been an increase in the number of randomised controlled trials of psychological interventions for common mental disorders in people of Chinese descent, which could provide important evidence regarding the cross-cultural effectiveness of psychological interventions. Systematic reviews of randomised controlled trials of psychological interventions, predominantly carried out in North America and Europe, have consistently identified methodological shortcomings; the quality of the evidence for people of Chinese descent has not been comprehensively evaluated. This systematic review aims to characterise the methodology and credibility of randomised controlled trials of psychological interventions for common mental disorders in people of Chinese descent (ie, ethnic Chinese populations). METHODS: In this systematic review, we searched MEDLINE, Embase, PsycINFO, CNKI, and WANFANG to identify eligible randomised controlled trials published in English or Chinese from database inception to Sept 1, 2025. We included trials of psychological interventions in adults of Chinese descent (with at least 80% of Han Chinese descent) aged 18 years and older with a diagnosis of a common mental disorder. 12 reviewers independently and in duplicate judged selection against inclusion criteria and extracted data on study characteristics, aggregated outcome data, and journal characteristics. Trial design, conduct, reporting, and outcomes of included studies were evaluated using a structured quality framework. We calculated post-intervention standardised mean differences between groups to characterise the distribution of reported effects. We involved people with related lived experience in the research and writing process. This study is registered with PROSPERO, CRD42023394956. FINDINGS: We identified 37 787 studies through database search, of which 857 randomised controlled trials, encompassing 75 143 participants, were included in the review. We found that 34 (4%) studies reported a registered trial protocol, 398 (46%) had adequate methods of randomisation, 21 (2%) used valid allocation concealment, 78 (9%) used outcome assessor blinding, 32 (4%) had an intention-to-treat analysis, and 78 (9%) referenced a treatment manual for the interventions delivered. 417 (49%) studies raised concerns over data authenticity, with a median effect size (g=2·06) more than double that of the 440 (51%) studies with no identified concerns (g=0·96). The reporting of adequate randomisation methods improved from none of 18 studies published before 2006 to 179 (70%) of 257 studies published in the last 5 years of the search range. Included studies were published across 278 journals, of which 188 (68%) journals provided no accessible guidance on trial reporting and only 41 (15%) referenced established reporting guidelines. INTERPRETATION: The large volume of randomised controlled trials with limitations in trial reporting, methodological rigour, and data authenticity raised concerns over the quality of the evidence. Systemic efforts including methodological training, regulatory infrastructure, and journal oversight are needed to improve the credibility and contribution of this growing body of evidence. FUNDING: None.
Li et al. (Wed,) studied this question.