TY - JOUR

T1 - The effects of psychotherapies for major depression in adults on remission, recovery and improvement

T2 - A meta-analysis

AU - Cuijpers, Pim

AU - Karyotaki, Eirini

AU - Weitz, Erica

AU - Andersson, Gerhard

AU - Hollon, Steven D.

AU - Van Straten, Annemieke

PY - 2014/4/20

Y1 - 2014/4/20

N2 - Background Standardised effect sizes have been criticized because they are difficult to interpret and offer little clinical information. This meta-analysis examines the extent of actual improvement, the absolute numbers of patients no longer meeting criteria for major depression, and absolute rates of response and remission. Methods We conducted a meta-analysis of 92 studies with 181 conditions (134 psychotherapy and 47 control conditions) with 6937 patients meeting criteria for major depressive disorder. Within these conditions, we calculated the absolute number of patients no longer meeting criteria for major depression, rates of response and remission, and the absolute reduction on the BDI, BDI-II, and HAM-D. Results After treatment, 62% of patients no longer met criteria for MDD in the psychotherapy conditions. However, 43% of participants in the control conditions and 48% of people in the care-as-usual conditions no longer met criteria for MDD, suggesting that the additional value of psychotherapy compared to care-as-usual would be 14%. For response and remission, comparable results were found, with less than half of the patients meeting criteria for response and remission after psychotherapy. Additionally, a considerable proportion of response and remission was also found in control conditions. In the psychotherapy conditions, scores on the BDI were reduced by 13.42 points, 15.12 points on the BDI-II, and 10.28 points on the HAM-D. In the control conditions, these reductions were 4.56, 4.68, and 5.29. Discussion Psychotherapy contributes to improvement in depressed patients, but improvement in control conditions is also considerable.

AB - Background Standardised effect sizes have been criticized because they are difficult to interpret and offer little clinical information. This meta-analysis examines the extent of actual improvement, the absolute numbers of patients no longer meeting criteria for major depression, and absolute rates of response and remission. Methods We conducted a meta-analysis of 92 studies with 181 conditions (134 psychotherapy and 47 control conditions) with 6937 patients meeting criteria for major depressive disorder. Within these conditions, we calculated the absolute number of patients no longer meeting criteria for major depression, rates of response and remission, and the absolute reduction on the BDI, BDI-II, and HAM-D. Results After treatment, 62% of patients no longer met criteria for MDD in the psychotherapy conditions. However, 43% of participants in the control conditions and 48% of people in the care-as-usual conditions no longer met criteria for MDD, suggesting that the additional value of psychotherapy compared to care-as-usual would be 14%. For response and remission, comparable results were found, with less than half of the patients meeting criteria for response and remission after psychotherapy. Additionally, a considerable proportion of response and remission was also found in control conditions. In the psychotherapy conditions, scores on the BDI were reduced by 13.42 points, 15.12 points on the BDI-II, and 10.28 points on the HAM-D. In the control conditions, these reductions were 4.56, 4.68, and 5.29. Discussion Psychotherapy contributes to improvement in depressed patients, but improvement in control conditions is also considerable.

KW - Cognitive-behavior therapy

KW - Interpersonal psychotherapy

KW - Meta-analysis

KW - Psychotherapy

KW - Remission

KW - Response

KW - Health sciences

KW - Psychology

UR - http://www.scopus.com/inward/record.url?scp=84896531779&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2014.02.026

DO - 10.1016/j.jad.2014.02.026

M3 - Scientific review articles

C2 - 24679399

AN - SCOPUS:84896531779

VL - 159

SP - 118

EP - 126

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -