Jorm, A.F., Morgan A.J. and Hetrick, S.E. (2008) Relaxation for Depression (Review), The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

Background: Many members of the public have negative attitudes towards antidepressants. Psychological interventions are more acceptable but require considerable therapist training. Acceptable psychological interventions that require less training and skill are needed to ensure increased uptake of intervention. A potential intervention of this sort is relaxation techniques.

Objectives: To determine whether relaxation techniques reduce depressive symptoms and improve response/remission.

Method: The register of trials kept by the Cochrane Collaboration Depression, Anxiety and Neurosis Group was searched up to February 2008.  The reference lists of included studies were also searched.  Studies were included if they were randomised or quasi-randomised controlled trials of relaxation techniques (progressive muscle relaxation, relaxation imagery, autogenic training) in participants diagnosed with depression or having a high level of depression symptoms. Self-rated and clinician-rated depression scores and response/remission were the primary outcomes.  In total, there were 15 trials with 11 included in the meta-analysis.

Author’s Conclusions: This review shows that relaxation is better than wait-list, no treatment or minimal treatment at relieving self-rated depression, but not as effective as psychological therapies like cognitive-behaviour therapy. If relaxation and psychological therapies were equal in cost and availability, then relaxation would have no clinical role. However, relaxation is a very simple intervention which could be implemented at minimal cost. Relaxation can be readily manualised and requires brief training. By contrast, psychological therapies require a highly skilled clinician and are a scarce resource. Relaxation and psychological treatment could be used together in stepped care, with relaxation offered as a first-line treatment and psychological therapy as a second-line for those who do not respond.