American Journal of Nursing Research
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American Journal of Nursing Research. 2017, 5(5), 158-164
DOI: 10.12691/ajnr-5-5-1
Open AccessArticle

Effect of Psychodrama on the Severity of Symptoms in Depressed Patients

Nagwa Mohamed Souilm1 and Safaa Abdelazem Osman Ali2,

1Psychiatric and Mental Health Nursing, Faculty of Nursing, South Valley University, Egypt

2Psychiatric and Mental Health Nursing, Faculty of Nursing, Fayoum University, Egypt

Pub. Date: September 21, 2017

Cite this paper:
Nagwa Mohamed Souilm and Safaa Abdelazem Osman Ali. Effect of Psychodrama on the Severity of Symptoms in Depressed Patients. American Journal of Nursing Research. 2017; 5(5):158-164. doi: 10.12691/ajnr-5-5-1


Psychodrama has been successfully used in the management of certain psychosomatic ailments. However, no controlled studies examining its effectiveness in depression have been conducted. The aim of this study was to evaluate the effect of a program for psychodrama on the severity of symptoms of depressed patients. This quasi-experimental study was conducted in El-Abassia Hospital for mental health. It included a sample of 30 patients having depression, randomly divided into a study group to attend a psychodrama intervention, and a control group having routine hospital protocol. Data were collected using an interview form with Beck Depression Inventory (BDI). The study was carried out in assessment, implementation, and evaluation phases. The study group was exposed to 12 one-hour sessions of psychodrama. The study lasted from September to December 2016. The patients in the two groups had similar demographic characteristics. At the pretest, the depression score was higher in the study group (p=0.003), but its duration had no statistically significant difference. After the intervention, all study group patients had no depression, except one, compared to 9 (60.0%) In the control group (p=0.08). The median score of depression was lower in the study group (1.0) compared with the control group (10.0), p=0.001. In multivariate analysis, the intervention was identified as a significant independent negative predictor of the depression score, while married status was a positive predictor. The results point to the effectiveness of a psychodrama intervention in alleviating the severity of depression. Hence, it is recommended to utilize this technique on a larger scale in patients with major depression.

psychodrama major depression symptoms patients Beck Depression Inventory (BDI)

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[1]  Chen Y., Bennett D., Clarke R., Guo Y., Yu C., Bian Z., Ma L., Huang Y., Sun Q., Zhang N., Zheng X., Chen J., Peto R., Kendler K.S., Li L., and Chen Z. (2017). Patterns and correlates of major depression in Chinese adults: a cross sectional study of 0.5 million men and women. Psychol Med.; 47(5): 958-970.
[2]  Patten S.B., Williams J.V., Lavorato D.H., Fiest K.M., Bulloch A.G., and Wang J. (2015). The prevalence of major depression is not changing. Can J Psychiatry.; 60(1): 31-4.
[3]  Fawzy M., and Hamed S.A. (2017). Prevalence of psychological stress, depression and anxiety among medical students in Egypt. Psychiatry Res.; 255: 186-194.
[4]  El Kady H.M., and Ibrahim H.K. (2013). Depression among a group of elders in Alexandria, Egypt. East Mediterr Health J.; 19(2): 167-74.
[5]  Patten S.B., Williams J.V., Lavorato D.H., Bulloch A.G., Wiens K., and Wang J. (2016). Why is major depression prevalence not changing? J Affect Disord.; 190: 93-7.
[6]  Drakulic A.M. (2014). Critical reflections for understanding the complexity of psychodramatic theory. Psychiatr Danub.; 26(1): 12-9.
[7]  Carnabucci and Karen, (2014). Show and Tell Psychodrama, Nusanto Publishing, United States.
[8]  Konopik D.A., and Cheung M. (2013). Psychodrama as a social work modality. Soc Work.; 58(1): 9-20.
[9]  American Society of Group Therapy and Psychodrama, (2014): Retrieved from
[10]  Giannone F., Giordano C., and Di Blasi M. (2015). Group Psychotherapy in Italy. Int J Group Psychother.; 65(4): 501-11.
[11]  Pénzes I., Bánki A., and Túry F. (2014). "Theater of the body" -- the possibilities of psychodrama in the treatment of irritable bowel syndrome. Psychiatr Hung.; 29(3): 273-94. Review. Hungarian.
[12]  Michael L. (2016). 'Welcoming the other': psychodrama in an acute inpatient unit. Australas Psychiatry.; 24(1): 46-8.
[13]  Oflaz F., Meriç M., Yuksel Ç., and Ozcan C.T. (2011). Psychodrama: an innovative way of improving self-awareness of nurses. J Psychiatr Ment Health Nurs.; 18(7): 569-75.
[14]  Özbas A.A., and Tel H. (2016). The effect of a psychological empowerment program based on psychodrama on empowerment perception and burnout levels in oncology nurses: Psychological empowerment in oncology nurses. Palliat Support Care.; 14(4): 393-401.
[15]  Ackerman M., and Ackerman S.J. (1962). The use of psychodrama in a postpartum depression. Am Coll Neuropsychiatr.; 1:67-70.
[16]  Drakulic A.M. (2011). Clinical and no-clinical setting specificities in first session short-term psychotherapy psychodrama group. Coll Antropol.; 35(1): 173-9.
[17]  Destoop M., Schrijvers D., De Grave C., Sabbe B., and De Bruijn E.R. (2012). Better to give than to take? Interactive social decision-making in severe major depressive disorder. J Affect Disord.; 137(1-3): 98-105.
[18]  Celano C.M., Beale E.E., Mastromauro C.A., Stewart J.G., Millstein R.A., Auerbach R.P., Bedoya C.A., and Huffman J.C. (2017). Psychological interventions to reduce suicidality in high-risk patients with major depression: a randomized controlled trial. Psychol Med.; 47(5): 810-821.
[19]  Beck, A. T., Steer, R.A., & Garbin, M.G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77-100.
[20]  GareebA.G. (2007). Depressive Disorders: Diagnosis, risk factors, theories and measurements Egyptian Journal of Psychological Studies, 56 (17), 39-97.
[21]  Almuneef M., ElChoueiry N., Saleheen H.N., and Al-Eissa M. (2017). Gender based disparities in the impact of adverse childhood experiences on adult health: findings from a national study in the Kingdom of Saudi Arabia. Int J Equity Health.; 16(1): 90.
[22]  Brown C.R., Hambleton I.R., Sobers-Grannum N., Hercules S.M., Unwin N., Nigel Harris E., Wilks R., MacLeish M., Sullivan L., Murphy M.M., U.S. Caribbean Alliance for Health Disparities Research Group (USCAHDR). (2017). Social determinants of depression and suicidal behaviour in the Caribbean: a systematic review. BMC Public Health.; 17(1): 577.
[23]  Han K.M., Chang J., Won E., Lee M.S., and Ham B.J. (2017). Precarious employment associated with depressive symptoms and suicidal ideation in adult wage workers. J Affect Disord.; 218: 201-209.
[24]  Magaard J.L., Seeralan T., Schulz H., and Brütt A.L. (2017). Factors associated with help-seeking behaviour among individuals with major depression: A systematic review. PLoS One.; 12(5): e0176730.
[25]  Burns J.K., Tomita A., and Lund C. (2017). Income inequality widens the existing income-related disparity in depression risk in post-apartheid South Africa: Evidence from a nationally representative panel study. Health Place.; 45: 10-16.
[26]  Conde-Sala J.L., Portellano-Ortiz C., Calvó-Perxas L., and Garre-Olmo J. (2017). Quality of life in people aged 65+ in Europe: associated factors and models of social welfare-analysis of data from the SHARE project (Wave 5). Qual Life Res.; 26(4): 1059-1070.
[27]  Ell K., Aranda M.P., Wu S., Oh H., Lee P.J., and Guterman J. (2016). Promotora assisted depression care among predominately Hispanic patients with concurrent chronic illness: Public care system clinical trial design. Contemp Clin Trials.; 46: 39-47.
[28]  Freidl M., Benda N., and Friedrich F. (2015). Psychiatric illness and length of stay in general hospitals: do case finding methods matter? Neuropsychiatr.; 29(2): 77-83.
[29]  Costa E.M., Antonio R., Soares M.B., and Moreno R.A. (2006): Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study. Rev Bras Psiquiatr.; 28(1):40-3. Epub 2006 Mar 24.
[30]  Camacho D., Estrada E., Lagomasino I.T., Aranda M.P., and Green J. (2017). Descriptions of depression and depression treatment in older Hispanic immigrants in a geriatric collaborative care program. Aging Ment Health.: 1-7.
[31]  Oguzhanoglu N.K., Sözeri-Varma G., Karadag F., Tümkaya S., Efe M., and Kıroglu Y. (2014): [Prefrontal cortex neurochemical metabolite levels in major depression and the effects of treatment: an HMRS study]. [Article in Turkish] Turk Psikiyatri Derg.; 25(2): 75-83.
[32]  Cano-Prous A., Moyá-Querejeta J., Alonso A., Martín-Lanas R., and Cervera- Enguix S. (2013): Personality: a determinant in marital dissatisfaction in individuals with major depression and their couples. Actas Esp Psiquiatr.; 41(6): 340-8. Epub 2013 Nov 1.
[33]  Taylor R.J., Chae D.H., Chatters L.M., Lincoln K.D., and Brown E. (2012): DSM-IV 12-month and lifetime major depressive disorder and romantic relationships among African Americans. J Affect Disord.; 142(1-3): 339-42.
[34]  Shaik S., Rajkumar R.P., Menon V., and Sarkar S. (2017): Gender, Life Events, and Depression: An Exploratory Study. Indian J Psychol Med.; 39(3): 330-335.