Psychological treatments are as effective as pharmacotherapies in the treatment of adult depression: a summary from Randomized Clinical Trials and neuroscience evidence

Cuijpers, Pim; Gentili, Claudio

doi:10.4081/ripppo.2017.273

Cited by 15 publications

(16 citation statements)

References 57 publications

(66 reference statements)

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“…The effects of psychological interventions for treatment of adult depression have been shown to be comparable to those achieved with pharmacological intervention, and are probably longer-lasting (Cuijpers and Gentili, 2017). In particular, cognitive-behavioural therapy (CBT) is a common and effective psychological intervention for the treatment of depression (Churchill et al ., 2002; Butler et al ., 2006; National Institute for Clinical Excellence, 2009; Shafran et al ., 2009; Lepping et al ., 2017).…”

Section: Introductionmentioning

confidence: 99%

The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis

et al. 2019

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Cognitive-behavioural therapy (CBT) is an effective treatment for depressed adults. CBT interventions are complex, as they include multiple content components and can be delivered in different ways. We compared the effectiveness of different types of therapy, different components and combinations of components and aspects of delivery used in CBT interventions for adult depression. We conducted a systematic review of randomised controlled trials in adults with a primary diagnosis of depression, which included a CBT intervention. Outcomes were pooled using a component-level network meta-analysis. Our primary analysis classified interventions according to the type of therapy and delivery mode. We also fitted more advanced models to examine the effectiveness of each content component or combination of components. We included 91 studies and found strong evidence that CBT interventions yielded a larger short-term decrease in depression scores compared to treatment-as-usual, with a standardised difference in mean change of −1.11 (95% credible interval −1.62 to −0.60) for face-to-face CBT, −1.06 (−2.05 to −0.08) for hybrid CBT, and −0.59 (−1.20 to 0.02) for multimedia CBT, whereas wait list control showed a detrimental effect of 0.72 (0.09 to 1.35). We found no evidence of specific effects of any content components or combinations of components. Technology is increasingly used in the context of CBT interventions for depression. Multimedia and hybrid CBT might be as effective as face-to-face CBT, although results need to be interpreted cautiously. The effectiveness of specific combinations of content components and delivery formats remain unclear. Wait list controls should be avoided if possible.

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Section: Introductionmentioning

confidence: 99%

The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis

et al. 2019

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“…many patients remain resistant to treatment 5,6 . In response, current advances in neuroscience have identified additional mechanisms of the disorder's underlying pathophysiology, leading to alternative or additional pathogenic hypotheses and therapeutic interventions 5,7 .…”

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confidence: 99%

Variation in chemokines plasma concentrations in primary care depressed patients associated with Internet-based cognitive-behavioral therapy

Romero-Sanchiz

Nogueira-Arjona

Araos

et al. 2020

Sci Rep

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How the presence of inflammation has repercussions for brain function is a topic of active research into depression. Signals released from immune system-related cells, including chemokines, might be indicative of active depression and can, hypothetically, serve as biomarkers of response to interventions, both pharmacological and psychological. The objective of this study is to analyze the peripheral plasma concentrations of CXCL12, CCL11, CX3CL1 and CCL2 in a cohort of depressed primary-care patients, as well as their evolution after an internet-based cognitive-behavioral intervention. The concentrations of those chemokines were measured in 66 primary-care patients with mild and moderate depression, before and after the intervention, as well as 60 controls, using multiplex immunoassays. Concentrations of CXCL12 and CCL2 were significantly higher in the clinical sample in comparison with controls. A stable multivariate discriminative model between both groups was found. Concentrations of all chemokines decreased after the internet-based psychological intervention. These findings support the implication of chemokines in depression, even in a sample of patients with mild and moderate severity. Furthermore, they demonstrate the need for further multidisciplinary research that confirms how biomarkers such as plasma chemokines can serve as a marker for depression and are sensitive to non-pharmacological interventions. Depression is one of the most prevalent mental health problems throughout the world. In the last decade, it has been identified by the World Health Organization as one of the leading causes of disability worldwide 1,2. Despite extensive empirical support for the effectiveness of both psychological and pharmacological interventions 3,4 ,

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“…Several evidence-based treatments are available for adults with depression. Meta-analyses and reviews have shown that different treatments are effective (e.g., [ 3 , 4 ]). Cognitive Behavioral Therapy (CBT) has been researched the most.…”

Section: Introductionmentioning

confidence: 99%

One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression

A-Tjak¹,

Morina

Topper

et al. 2021

BMC Psychiatry

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Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change. Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering, and experiential avoidance. Results Patients in both conditions reported significant and large reductions of depressive symptoms (d = − 1.26 to − 1.60) and improvement in quality of life (d = 0.91 to − 1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression. Trial registration clinicaltrials.gov; NCT01517503. Registered 25 January 2012 - Retrospectively registered.

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Psychological treatments are as effective as pharmacotherapies in the treatment of adult depression: a summary from Randomized Clinical Trials and neuroscience evidence

Abstract: Not available.

Cited by 15 publications

References 57 publications

The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis

The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis

Variation in chemokines plasma concentrations in primary care depressed patients associated with Internet-based cognitive-behavioral therapy

One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression

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