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Open psychiatric wards improve depression scores and treatment adherence in hospitalized patients with depressionOpen psychiatric wards may improve depression outcomes

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Key Takeaway
Note that open psychiatric wards significantly improve depression scores and treatment adherence in hospitalized patients.

This meta-analysis synthesized data from 9 RCTs involving hospitalized patients with depression to compare outcomes between open and closed psychiatric wards. The analysis focused on depression symptom scores, treatment adherence, and clinical response rates.

Key findings indicate that patients in open psychiatric wards achieved significantly better outcomes on the Self-Rating Depression Scale (SDS) with a mean difference of -3.81 (95% CI -4.22, -3.40; P < 0.01) and on the Hamilton Depression Rating Scale (HAMD) with a mean difference of -0.99 (95% CI -1.18, -0.81; P < 0.01). Additionally, treatment adherence was higher in the open ward group (RR = 1.23; 95% CI 1.04, 1.47; P = 0.02).

However, the meta-analysis found no statistically significant difference in clinical response rates between the two settings (RR = 1.09; 95% CI 0.92, 1.29; P = 0.32). The authors note that the specific impact on clinical response remains unclear.

These findings suggest that open ward management may be a useful strategy for improving depressive symptoms and enhancing treatment adherence in inpatient settings. However, because the effect on clinical response rate was not statistically significant, clinicians should weigh these benefits carefully when designing ward protocols.

How this fits prior evidence

This meta-analysis addresses a gap in non-pharmacological management of depression by evaluating environmental factors. While prior coverage highlighted the efficacy of structured exercise (SMD -0.67 for depression) and specific modalities like dance or Tai Chi, this finding adds evidence regarding the impact of ward environment on symptom scores (MD -3.81 for SDS) and treatment adherence (RR = 1.23). It complements existing non-pharmacological interventions by suggesting that open ward settings may improve symptoms and adherence in hospitalized populations.

If you or someone you love is hospitalized for depression, the type of ward they're in could make a difference. A new analysis of 9 clinical trials suggests that open psychiatric wards (where patients can move freely) may lead to better outcomes than closed wards.

The study found that patients in open wards scored lower on depression rating scales like the Self-Rating Depression Scale and the Hamilton Depression Rating Scale. They also had higher treatment adherence. However, there was no clear difference in the overall clinical response rate between the two ward types.

The analysis included data from 9 randomized controlled trials involving hospitalized patients with depression. The researchers compared open wards to closed wards, where movement is restricted. The results showed a small but meaningful improvement in symptoms and adherence for open wards.

It's important to note that the effect on clinical response rate was not statistically significant, meaning we can't be sure open wards lead to more patients getting better overall. The study didn't report on safety or side effects. More research is needed to confirm these findings and understand who benefits most.

What this means for you:
Open psychiatric wards may help reduce depression symptoms and improve treatment adherence in hospitalized patients.

Common questions

What is an open psychiatric ward?

An open psychiatric ward is a hospital unit where patients can move freely within the ward and sometimes outside. It's different from a closed ward, where doors are locked and movement is restricted. This study compared open and closed wards for people hospitalized with depression.

Does an open ward help with depression?

The analysis found that patients in open wards had better scores on depression rating scales, like the Self-Rating Depression Scale and the Hamilton Depression Rating Scale. They also had higher treatment adherence. However, the overall clinical response rate was not significantly different between open and closed wards.

What were the side effects of open wards?

The study did not report on adverse events, serious adverse events, or discontinuations. So we don't have information about potential risks or side effects of open wards compared to closed wards. More research is needed to understand safety.

Who was included in this study?

The analysis included data from 9 randomized controlled trials involving hospitalized patients with depression. The patients were in psychiatric wards, and the studies compared open wards to closed wards. The exact number of patients was not reported.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
ObjectiveTo systematically evaluate and compare the differences in treatment outcomes between open and closed psychiatric wards for hospitalized patients with depression, and to provide evidence-based support for optimizing psychiatric ward management models.MethodsPubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database were searched for relevant literature published from inception to December 20, 2025. Randomized controlled trials (RCTs) comparing the therapeutic effects of open versus closed psychiatric wards in hospitalized patients with depression were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias tool. Meta-analysis was performed using RevMan 5.4.ResultsA total of 9 RCTs were included. The meta-analysis showed that the open psychiatric ward group achieved better outcomes than the closed psychiatric ward group in depression symptom scores, with statistically significant differences in both the Self-Rating Depression Scale (SDS) score [MD = −3.81, 95% CI (−4.22, −3.40)] and the Hamilton Depression Rating Scale (HAMD) score [MD = −0.99, 95% CI (−1.18, −0.81)] (both P < 0.01). In terms of treatment adherence, the open ward group was higher than the closed psychiatric ward group [RR = 1.23, 95% CI (1.04, 1.47), P = 0.02]. There was no statistically significant difference between the two groups in clinical response rate [RR = 1.09, 95% CI (0.92, 1.29), P = 0.32]. Neither Egger’s regression test nor Begg’s rank correlation test indicated significant publication bias.ConclusionCompared with closed psychiatric wards, open psychiatric wards may help improve depressive symptoms and increase treatment adherence among hospitalized patients with depression; however, their effect on clinical response rate remains unclear. Future high-quality, multicenter studies are needed to further verify the efficacy and safety of open psychiatric wards.
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