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INTRODUCTION: Laughter Yoga is claimed to promote mental health and is increasingly popular worldwide. Despite its popularity, there has been no systematic review of Laughter Yoga intervention studies and thus evidence of its effects on mental health is unclear. AIM: This review aimed to critically evaluate the effects of group-based Laughter Yoga on improving mental health in adults. METHOD: We conducted a systematic review of experimental studies (published from 1995 to 2017). Study quality was assessed, the effect sizes for individual mental health outcomes were calculated and all reviewed studies were narratively synthesized. RESULTS: Six experimental studies with inconsistent results were included in this review. The most promising effect of Laughter Yoga is the improvement of depressive symptoms, indicating significant medium-large effect sizes in two studies over the short term. The overall level of evidence was weak due to poor study quality and risks of bias. DISCUSSION: Laughter Yoga shows potential, but currently there is insufficient evidence to support its effectiveness in improving mental health when compared to other group-based interventions. IMPLICATIONS FOR PRACTICE: This review highlights the need to conduct rigorous trials of laughter yoga before the intervention can be considered as an evidence-based intervention to improve mental health. This article is protected by copyright. All rights reserved.

Caring for people with dementia (PWD) poses a lot of challenges to family caregivers. Mindfulness-based intervention (MBI) is a newly adopted psychosocial intervention through an integration of the mind and body to reduce stress of the participants (caregivers). This study aims to determine whether and to what extent MBI for family caregivers of PWD can reduce their stress. Electronic databases including MEDLINE, CINAHL, Cochrane Library, PsycINFO, EMBASE, and the Web of Science were searched for relevant studies published between 1990 and 2016. All randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effects of MBI on reducing stress in family caregivers of PWD were eligible for inclusion in this review. Five studies were included. Of these, three trials involving 144 participants were eligible for the meta-analysis. The analysis showed that stress levels dropped significantly after the MBI. The findings showed a significantly more favorable effect of MBI with the standardized mean difference with a moderate aggregated effect size of 0.57 (95% CI [0.23, 0.92], overall effect Z = 3.25 at p = 0.001). This effect was only found immediately after the MBI but not in the follow-up sessions. In conclusion, the available evidence suggests that MBI seems to be effective at reducing stress among family caregivers of PWD. However, it should be noted that the number of studies involved was small (n = 5), as were the sample sizes, and no sustained effect was found. Multi-center RCTs of the effects of MBI involving larger and more diverse samples of family caregivers of PWD are recommended before any clear conclusion can be reached.