Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A Network Meta-Analysis

Research output: Journal contributionsJournal articlesResearchpeer-review

Authors

  • J. Barth
  • T. Munder
  • H. Gerger
  • Eveline Nüesch
  • S. Trelle
  • H. Znoj
  • Peter Jüni
  • Pim Cuijpers

Background:Previous meta-analyses comparing the efficacy of psychotherapeutic interventions for depression were clouded by a limited number of within-study treatment comparisons. This study used network meta-analysis, a novel methodological approach that integrates direct and indirect evidence from randomised controlled studies, to re-examine the comparative efficacy of seven psychotherapeutic interventions for adult depression.Methods and Findings:We conducted systematic literature searches in PubMed, PsycINFO, and Embase up to November 2012, and identified additional studies through earlier meta-analyses and the references of included studies. We identified 198 studies, including 15,118 adult patients with depression, and coded moderator variables. Each of the seven psychotherapeutic interventions was superior to a waitlist control condition with moderate to large effects (range d = -0.62 to d = -0.92). Relative effects of different psychotherapeutic interventions on depressive symptoms were absent to small (range d = 0.01 to d = -0.30). Interpersonal therapy was significantly more effective than supportive therapy (d = -0.30, 95% credibility interval [CrI] [-0.54 to -0.05]). Moderator analysis showed that patient characteristics had no influence on treatment effects, but identified aspects of study quality and sample size as effect modifiers. Smaller effects were found in studies of at least moderate (Δd = 0.29 [-0.01 to 0.58]; p = 0.063) and large size (Δd = 0.33 [0.08 to 0.61]; p = 0.012) and those that had adequate outcome assessment (Δd = 0.38 [-0.06 to 0.87]; p = 0.100). Stepwise restriction of analyses by sample size showed robust effects for cognitive-behavioural therapy, interpersonal therapy, and problem-solving therapy (all d>0.46) compared to waitlist. Empirical evidence from large studies was unavailable or limited for other psychotherapeutic interventions.Conclusions:Overall our results are consistent with the notion that different psychotherapeutic interventions for depression have comparable benefits. However, the robustness of the evidence varies considerably between different psychotherapeutic treatments.Please see later in the article for the Editors' Summary.

Original languageEnglish
Article numbere1001454
JournalPLoS ONE
Volume10
Issue number5
Number of pages17
ISSN1932-6203
DOIs
Publication statusPublished - 28.05.2013

    Research areas

  • Health sciences - Mental health therapies, Depression, meta-analyses, Psychotherapie, Behavior, Cognitive psychology, Problem solving, Cognition
  • Psychology

Documents

DOI

Recently viewed

Publications

  1. Relative inequality and poverty in Germany and the United States using alternative equivalence scales
  2. Verzug beim Napf-Rückwärts-Fließpressen
  3. Koordination verbessern
  4. Die Welt steht Kopf
  5. Firm size, firm age and job duration
  6. Zusammenhang zwischen Burnout und Persönlichkeit
  7. Global economic implications of alternative climate policy strategies
  8. Local perceptions as a guide for the sustainable management of natural resources
  9. The transaction costs of eProcurement
  10. Wege zur Neuorientierung des Wissensmanagements
  11. Similar performance in central and range-edge populations of a Eurasian steppe grass under different climate and soil pH regimes
  12. Didaktik privater Rechtsgestaltung
  13. Buche oder Eiche
  14. Change-Beneficial Process Architectures and the Human as a Change Enabler
  15. Visual Accounting
  16. Die große Flut und die Arche
  17. Krieg in der Zivilgesellschaft
  18. Reflexive Responsibilisierung
  19. Effects of global climate change on geographic distributions of vertebrates in North Queensland
  20. Restoration mechanisms at moderate temperatures for As-Cast ZK40 magnesium alloys modified with individual Ca and Gd additions
  21. Das Echo des Propheten Jesaja
  22. DRM... TRIPS... WIPO...
  23. Validität des NEPS-Mathematiktests für die neunte Klasse
  24. Biodegradability of the Anti-Tumour Agent Ifosfamide and its Occurrence in Hospital Effluents and Communal Sewage
  25. Prüfung von Nachhaltigkeitsberichten
  26. Tourism and Love
  27. Wissen und Governance
  28. The cost of depression
  29. Context of social action
  30. § 349
  31. Error management or error prevention
  32. Die Drittintervention in Beschwerdeverfahren vor dem EGMR
  33. High temperature strength and hot working technology for As-cast Mg-1Zn-1Ca (ZX11) alloy
  34. Automotive applications of magnesium and its alloys
  35. Theorielose Empirie?