Negative effects of psychotherapies for adult depression: A meta-analysis of deterioration rates

Journal of Affective Disorders
Pim CuijpersDavid D Ebert

Abstract

The risk for deterioration in patients receiving psychotherapy for adult depression has not been examined extensively and it is not clear whether psychotherapy reduces this risk or may even increase it in some patients. We conducted a meta-analysis of trials comparing these psychotherapies with control conditions that report deterioration rates. We used an existing database of randomized trials on psychotherapies for adult depression which was updated up to 1/1/2017, through systematic searches in bibliographic databases. We included trials that reported clinically significant deterioration rates. We included 18 studies with 23 comparisons between therapy and control groups. The pooled risk ratio of deterioration was 0.39 (95% CI: 0.27∼0.57), indicating that patients in the psychotherapy groups have a 61% lower chance to deteriorate than patients in the control groups. We found that 20 patients need to be treated with psychotherapy in order to avoid one case of deterioration, compared to the control conditions. The median deterioration rate in the therapy groups was 4%, and in some studies more than 10%, indicating that clinicians should always be aware of the risk of deterioration. The results should be considered with caution...Continue Reading

Citations

Sep 10, 2019·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Pim Cuijpers
Jul 25, 2019·Frontiers in Psychology·Sarah Bloch-ElkoubyJ Christopher Muran
Nov 21, 2020·Archives of Suicide Research : Official Journal of the International Academy for Suicide Research·Philip J BatterhamDominique Kazan
Jan 18, 2022·European Child & Adolescent Psychiatry·Andrew A McAleavey

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