Care-as-usual control groups across different settings in randomized trials on psychotherapy for adult depression: a meta-analysis
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https://doi.org/10.1017/S0033291719003581 |
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Título
Care-as-usual control groups across different settings in randomized trials on psychotherapy for adult depression: a meta-analysisFecha de publicación
2019Editor
Cambridge University PressISSN
0033-2917; 1469-8978Cita bibliográfica
Cuijpers P, Quero S, Papola D, Cristea IA, Karyotaki E (2019). Care-as-usual control groups across different settings in randomized trials on psychotherapy for adult depression: a meta-analysis. Psychological Medicine 1–11. https://doi.org/10.1017/ S0033291719003581Tipo de documento
info:eu-repo/semantics/articleVersión de la editorial
https://www.cambridge.org/core/journals/psychological-medicine/article/careasusu ...Versión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
Background. Care-as-usual (CAU) is often used as a control condition in psychotherapy
research, but it may vary considerably what that entails, ranging from no treatment, to routine
treatment in primary care, general ... [+]
Background. Care-as-usual (CAU) is often used as a control condition in psychotherapy
research, but it may vary considerably what that entails, ranging from no treatment, to routine
treatment in primary care, general medical care, perinatal care, and specialized mental health
care.
Methods. We conducted a meta-analysis of trials comparing psychotherapy for depression to
CAU, with a focus on the different categories of CAU and countries where the studies were
conducted. We used an existing database of randomized trials on psychotherapy for depression that is updated every year.
Results. A total of 140 studies with 15 419 patients were included. We found no significant
differences in effects between categories of CAU (effect sizes ranging from g = 0.43 for
CAU in primary care to g = 0.73 for no treatment), but heterogeneity was high in all CAU
categories. After stratifying effects across specific countries (within CAU categories) we
found that heterogeneity was considerably lower and there were several significant differences
between countries. Overall, effects were larger in non-Western countries (g = 0.84 to 1.28)
compared to those in Western countries (g = 0.52; p for difference = 0.002). Effects were
smaller in studies with risk of bias (p = 0.01).
Conclusions. There are no significant differences between major categories of CAU when
compared to psychotherapy conditions in randomized trials. However, effects of psychotherapy differ considerably across CAU conditions in specific countries. CAU therefore is a
heterogeneous control condition in psychotherapy research. [-]
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Psychological Medicine 1–11.Derechos de acceso
© Cambridge University Press 2019
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