Effectiveness of a Humor-Integrated Cognitive-Behavioral Psychoeducation Program for Depression: A Randomized Controlled Trial

Purpose: To evaluate the effectiveness of a humor-integrated cognitive-behavioral therapy (CBT)–based psychoeducation program in reducing depressive symptoms and improving self-esteem, sense of humor, and adaptive coping in outpatients diagnosed with major depressive disorder (MDD). Method: Sixty outpatients with MDD were randomized to an experimental group ( n = 30) receiving an eight-session nurse-delivered program or a control group ( n = 30) receiving standard psychiatric care. Assessments were conducted at baseline, postintervention, and 1- and 3-month follow up. Results: The experimental group demonstrated significant improvements in all outcomes ( p < .05), with large effect sizes for humor measures (Multidimensional Sense of Humor Scale: η 2 = 0.572, d = 2.31; Coping Humor Scale: η 2 = 0.665, d = 2.82) and moderate-to-large effects for depression (Beck Depression Inventory: η 2 = 0.400, d = 1.63) and self-esteem (Rosenberg Self-Esteem Scale: η 2 = 0.119, d = 0.74), all maintained at follow up. Conclusion: A humor-integrated CBT–based psychoeducation program delivered by specialist psychiatric nurses effectively reduced depressive symptoms and improved adaptive coping among outpatients with MDD.