How many minutes of laughter does it take to treat depression?
STUDY: Liu CY et al, Journal of Psychiatric Research 2026
STUDY TYPE: Meta-analysis of randomized controlled trials
FUNDING: National Science and Technology Council, Taiwan; An-Nan Hospital, China Medical University
Background
Laughter therapy uses humor, laughter yoga, and clown techniques to lower stress hormones, boost endorphins, and improve mood. It has shown promise as a complement to standard psychiatric treatment, and this meta-analysis pulls those controlled trials together.
The Study
- 34 randomized controlled trials, 3,000+ participants across children, adults, and elderly
- Laughter therapy (various formats) versus control, across inpatient, outpatient, and nursing home settings
- Primary outcomes: depression and anxiety scores
Laughter therapy reduced depression scores with an effect size (SMD) of 0.9 and anxiety scores with an SMD of 0.83. Stress scores also fell (SMD = 0.68). Benefits held across all age groups and care settings. No effect on pain or quality of life overall.
The dose-response analysis found that depression benefits plateaued around 400 minutes of total treatment, anxiety around 600 minutes. That’s roughly 20-minute sessions twice a week for 3-4 months.
Limitations
Heterogeneity across studies was high. Most studies had “some concerns” or high risk of bias, mainly due to problems with blinding and randomization. Overall evidence certainty was rated very low by GRADE criteria.
The effect sizes look impressive on paper, but the very low evidence certainty and high heterogeneity across trials temper enthusiasm.
Practice Implications
- Depression stalls many pleasures, but if your patient is still able to laugh at a funny movie, try adding one in behavioral activation.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
