Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects

Journal of Affective Disorders
E KaryotakiPim Cuijpers

Abstract

The present meta-analysis aimed to examine to what extent combined pharmacotherapy with psychotherapy results in a different response to treatment compared to psychotherapy or pharmacotherapy alone in adults with major depression at six months or longer postrandomization. A systematic literature search resulted in 23 randomized controlled trials with 2184 participants. Combined treatment was compared to either psychotherapy or anti-depressant medication alone in both the acute phase and the maintenance phase. Odds ratios of a positive outcome were calculated for all comparisons. In acute phase treatment, combined psychotherapy with antidepressants outperformed antidepressants alone at six months or longer postrandomization in patients with major depressive disorder (OR=2.93, 95%CI 2.15-3.99, p<0.001). Heterogeneity was zero (95%CI 0-57%, p>0.05). However, combined therapy resulted in equal response to treatment compared to psychotherapy alone at six months or longer postrandomization. As for the maintenance treatment, combined maintenance psychotherapy with antidepressants resulted in better-sustained treatment response compared to antidepressants at six months or longer postrandomization (OR=1.61, 95%CI 1.14-2.27, p<0.05). Het...Continue Reading

References

Oct 1, 1992·Archives of General Psychiatry·S D HollonV B Tuason
Dec 1, 1990·Archives of General Psychiatry·E FrankV J Grochocinski
Oct 1, 1989·The American Journal of Psychiatry·I W MillerG I Keitner
Jan 1, 1986·Archives of General Psychiatry·A D SimonsR D Wetzel
Dec 1, 1994·Psychiatry Research·J ReichM Keller
Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Apr 29, 2000·Annals of Internal Medicine·J W WilliamsJ Cornell
Apr 21, 2001·Journal of Affective Disorders·F de JongheJ Peen
Aug 3, 2002·The American Journal of Psychiatry·Nicola CasacalendaKarl Looper
Jul 30, 2003·Archives of General Psychiatry·E S PaykelM Pope
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
May 4, 2004·General Hospital Psychiatry·Digna J F van SchaikRichard van Dyck
Jul 3, 2004·The British Journal of Psychiatry : the Journal of Mental Science·Frans de JongheJack Dekker
Jul 9, 2004·Archives of General Psychiatry·Sandro PampallonaCarmine Munizza
Dec 31, 2004·The American Journal of Psychiatry·Jo Anne SireyGeorge S Alexopoulos
Mar 17, 2006·The New England Journal of Medicine·Charles F ReynoldsDavid J Kupfer
Nov 3, 2007·BMJ : British Medical Journal·John P A IoannidisEvangelos Evangelou
May 20, 2008·BMC Psychiatry·Pim CuijpersGerhard Andersson
Oct 13, 2009·The Journal of Clinical Psychiatry·Pim CuijpersGerhard Andersson
Jul 2, 2010·The British Journal of Psychiatry : the Journal of Mental Science·Matthijs W BeltmanAnne E Speckens
Jan 25, 2011·The American Journal of Cardiology·Carmine PizziLamberto Manzoli
Jul 21, 2011·Nordic Journal of Psychiatry·Pim CuijpersAnnemieke van Straten
Jan 1, 2010·Indian Journal of Psychological Medicine·M S Reddy
Mar 19, 2013·Clinical Psychology Review·Thomas MunderJürgen Barth
Jun 6, 2013·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Pim CuijpersCharles F Reynolds
Oct 22, 2013·Patient Preference and Adherence·Sophia E Winter, Jacques P Barber
Apr 1, 2014·Journal of Affective Disorders·Pim CuijpersAnnemieke van Straten

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Citations

Jan 11, 2020·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Pim CuijpersToshi A Furukawa
Nov 23, 2019·American Journal of Psychotherapy·Marie CroweRichard Porter
Mar 14, 2019·The Journal of Nervous and Mental Disease·Hui-Li HeHui-Feng Duan
Sep 27, 2019·BMJ Evidence-based Medicine·Janus Christian JakobsenIrving Kirsch
Oct 28, 2019·Journal of Mental Health·Erin F Ward-Ciesielski, Shireen L Rizvi
Oct 8, 2016·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Gavin Andrews, Megan J Hobbs
Jul 12, 2019·Frontiers in Psychiatry·Paul Enck, Stephan Zipfel
Nov 25, 2019·Current Psychiatry Reports·Pim CuijpersBruce Arroll
Jun 14, 2019·Frontiers in Psychology·Cátia BragaMiguel M Gonçalves
Aug 13, 2020·International Journal of Environmental Research and Public Health·Adilson MarquesMargarida Gaspar de Matos
Feb 12, 2020·International Journal of Environmental Research and Public Health·Adilson MarquesDiego Gomez-Baya
Apr 25, 2020·Journal of Clinical Psychology in Medical Settings·Emily McTateAhna L H Pai
Jun 11, 2020·Current Psychiatry Reports·Ueli KramerAntonio Pascual-Leone
Mar 31, 2020·Clinics in Geriatric Medicine·Ryan D GreeneSophia Wang
Jan 24, 2020·Journal of Affective Disorders·Hyun Woong RohSang Joon Son
Apr 6, 2021·Curēus·Yahia Albobali, Mahmoud Y Madi
Dec 24, 2020·The Australian and New Zealand Journal of Psychiatry·Gin S MalhiGreg Murray

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