Effects of Guided Imagery–Supported Psychoeducation on Self-Esteem, Perceived Stress, and Depressive Symptoms in Patients with Depression: A Randomized Controlled Trial

Depression is a common mental disorder associated with elevated perceived stress and low self-esteem, adversely affecting functioning and quality of life. Although guided imagery is a promising intervention for reducing depressive symptoms, evidence regarding its use with psychoeducation remains limited. This randomized controlled study examined the effects of guided imagery–supported psychoeducation on depressive symptoms, self-esteem, and perceived stress in individuals with depression. Sixty psychiatric outpatients were randomly assigned to an experimental group (n = 30) or a control group (n = 30). The experimental group received guided imagery–supported psychoeducation, while the control group received routine treatment. Data were collected using the Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES), and Perceived Stress Scale (PSS). Following the intervention, PSS scores decreased from 39.6 ± 6.74 to 22.0 ± 6.35 and BDI scores from 29.3 ± 8.5 to 12.63 ± 7.48 in the experimental group. Two-way mixed ANOVA revealed significant group × time interactions for perceived stress (F = 33.69, p < 0.01, ηp2=0.367) and depressive symptoms (F = 2.03, p < 0.01, ηp2=0.342). No significant interaction was found for self-esteem (F = 1.237, p > 0.05, ηp2=0.021). Findings suggest that guided imagery–supported psychoeducation may reduce depressive symptoms and perceived stress. This study adds evidence on combining guided imagery and psychoeducation in depression and highlights its potential value in psychiatric nursing practice.