Knowledge mapping of biofeedback for depression from 1999 to 2023: A bibliometric analysis

• Biofeedback has been increasingly applied in the clinical treatment of depression. • Biofeedback studies for depression grew rapidly after 2014, peaking at 71 publications in 2022. • The U.S. dominated in publications and impact, while Germany and China showed significant contributions. • EEG and fMRI-based neurofeedback are promising for depression treatment, targeting brain regions linked to emotional regulation. • Limited global collaboration highlights the need for standardized protocols and multicenter studies to advance the field. Depression is a leading neuropsychiatric disorder causing disability worldwide. In recent years, biofeedback has been increasingly applied in the clinical treatment of depression. This study aims to explore the emerging trends and knowledge structure in biofeedback for depression. The retrieval was conducted in the Science Citation Index-Expanded database from 1999 to 2023. The CiteSpace, Microsoft Excel 365, and a bibliometric online platform were used to visualize bibliometric networks and conduct statistical analyses, exploring the relationships and contributions among countries/regions, institutions, funding agencies, journals, authors, and keywords. A total of 540 publications related to biofeedback for depression were included in this analysis, revealing a two-phase growth trend. From 1999 to 2013, there was steady but slow growth, with a compound annual growth rate of 7.49%. This was followed by an explosive growth phase from 2014 onwards, with a 23.02% annual growth rate, peaking at 71 publications in 2022. The United States ranked top in the number of publications, citations, and h-index, while Bodurka, J was the most prolific author. The University of London produced the highest number of publications. The most frequent keywords were "depression" and "biofeedback," with "anxiety," "chronic pain," and "therapy" also prominent, underscoring the potential of HRV biofeedback in treating depression and its comorbidities. Since 2010 and 2016, scientific interest in biofeedback for depression has experienced two significant growths. The United States leads in this field, with Germany and China following. However, the scope of biofeedback applications for depression treatment is still limited, and there is a lack of inter-institutional collaboration. Biofeedback is an important direction of non-invasive adjuvant options for depression treatment in clinical practice.