Psychologic Treatment of Depression Compared With Pharmacotherapy and Combined Treatment in Primary Care: A Network Meta-Analysis
Impact
![Google Scholar](/xmlui/themes/Mirage2/images/uji/logo_google.png)
![Microsoft Academico](/xmlui/themes/Mirage2/images/uji/logo_microsoft.png)
Metadata
Show full item recordcomunitat-uji-handle:10234/9
comunitat-uji-handle2:10234/8033
comunitat-uji-handle3:10234/8636
comunitat-uji-handle4:
INVESTIGACIONMetadata
Title
Psychologic Treatment of Depression Compared With Pharmacotherapy and Combined Treatment in Primary Care: A Network Meta-AnalysisAuthor (s)
Date
2021-05Publisher
Annals of Family MedicineDOI
10.1370/afm.2676ISSN
1544-1709Bibliographic citation
Cuijpers, P., Oud, M., Karyotaki, E., Noma, H., Quero, S., Cipriani, A., ... & Furukawa, T. A. (2021). Psychologic Treatment of Depression Compared With Pharmacotherapy and Combined Treatment in Primary Care: A Network Meta-Analysis. The Annals of Family Medicine, 19(3), 262-270.Type
info:eu-repo/semantics/articlePublisher version
https://www.annfammed.org/content/19/3/262Version
info:eu-repo/semantics/publishedVersionSubject
Abstract
PURPOSE Most patients with depression are treated by general practitioners, and most of those patients prefer psychotherapy over pharmacotherapy. No network meta-analyses have examined the effects of psychotherapy ... [+]
PURPOSE Most patients with depression are treated by general practitioners, and most of those patients prefer psychotherapy over pharmacotherapy. No network meta-analyses have examined the effects of psychotherapy compared with pharmacotherapy, combined treatment, care as usual, and other control conditions among patients in primary care.
METHODS We conducted systematic searches of bibliographic databases to identify randomized trials comparing psychotherapy with pharmacotherapy, combined treatment, care as usual, waitlist, and pill placebo. The main outcome was treatment response (50% improvement of depressive symptoms from baseline to end point).
RESULTS A total of 58 studies with 9,301 patients were included. Both psychotherapy and pharmacotherapy were significantly more effective than care as usual (relative risk [RR] for response = 1.60; 95% CI, 1.40-1.83 and RR = 1.65; 95% CI, 1.35-2.03, respectively) and waitlist (RR = 2.35; 95% CI, 1.57-3.51 and RR = 2.43; 95% CI, 1.57-3.74, respectively) control groups. We found no significant differences between psychotherapy and pharmacotherapy (RR = 1.03; 95% CI, 0.88-1.22). The effects were significantly greater for combined treatment compared with psychotherapy alone (RR = 1.35; 95% CI, 1.00-1.81). The difference between combined treatment and pharmacotherapy became significant when limited to studies with low risk of bias and studies limited to cognitive behavior therapy.
CONCLUSIONS Psychotherapy is likely effective for the treatment of depression when compared with care as usual or waitlist, with effects comparable to those of pharmacotherapy. Combined treatment might be better than either psychotherapy or pharmacotherapy alone. [-]
Funder Name
National Institute for Health Research (NIHR) Oxford Cognitive Health Clinical Research Facility; an NIHR Research Professorship | NIHR Oxford and Thames Valley Applied Research Collaboration; and the NIHR Oxford Health Biomedical Research Centre | CIBERObn, an initiative of the ISCIII
Project code
RP-2017-08-ST2-006 | BRC-1215-20005 | ISCIII CB06 03/0052
Rights
info:eu-repo/semantics/openAccess
This item appears in the folowing collection(s)
- PSB_Articles [1321]