Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment type
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Title
Psychotherapies for depression: a network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment typeAuthor (s)
Date
2021-06Publisher
John Wiley & SonsISSN
1723-8617Bibliographic citation
Pim Cuijpers, Eirini Karyotaki, Marketa Ciharova, Clara Miguel, Hisashi Noma, Toshi A. Furukawa, The effects of psychotherapies for depression on response, remission, reliable change, and deterioration: A meta‐analysis, Acta Psychiatrica Scandinavica, 10.1111/acps.13335, 0, 0, (2021). Wiley Online LibraryType
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https://onlinelibrary.wiley.com/doi/10.1002/wps.20860Version
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Abstract
The efects of psychotherapies for depression have been examined in several hundreds of randomized trials, but no recent network meta-analysis (NMA) has integrated the results of these studies. We conducted an NMA of ... [+]
The efects of psychotherapies for depression have been examined in several hundreds of randomized trials, but no recent network meta-analysis (NMA) has integrated the results of these studies. We conducted an NMA of trials comparing cognitive behavioural, interpersonal, psychodynamic, problem-solving, behavioural activation, life-review and “third wave” therapies and non-directive supportive counseling with each other and with care-as-usual, waiting list and pill placebo control conditions. Response (50% reduction in symptoms) was the primary outcome, but we also assessed remission, standardized mean dierence, and acceptability (all-cause dropout rate). Random-eects pairwise and network meta-analyses were conducted on 331 randomized trials with 34,285 patients. All therapies were more ecacious than care-as-usual and waiting list control conditions, and all therapies – except non-directive supportive counseling and psychodynamic therapy – were more ecacious than pill placebo. Standardized mean dierences compared with care-as-usual ranged from –0.81 for life-review therapy to –0.32 for non-directive sup-portive counseling. Individual psychotherapies did not dier signicantly from each other, with the only exception of non-directive supportive counseling, which was less ecacious than all other therapies. e results were similar when only studies with low risk of bias were included. Most therapies still had signicant eects at 12-month follow-up compared to care-as-usual, and problem-solving therapy was found to have a somewhat higher long-term ecacy than some other therapies. No consistent dierences in acceptability were found. Our conclusion is that the most important types of psychotherapy are ecacious and acceptable in the acute treatment of adult depression, with few signicant dierences between them. Patient preference and availability of each treatment type may play a larger role in the choice between types of psychotherapy, although it is possible that a more detailed characterization of patients with a diagnosis of depression may lead to a more precise matching between individual patients and individual psychotherapies [-]
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World Psychiatry 2021;20:283–293Rights
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