Acute depression: cognitive therapy effective regardless of format

  • Cuijpers P & al.
  • JAMA Psychiatry
  • 17 Apr 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Cognitive behavior therapy (CBT) delivered in a group setting, over the telephone, or in a guided self-help format is as effective as individual therapy for the treatment of acute depression.
  • Guided self-help CBT was less acceptable than individual and group CBT, and unguided self-help therapy was less effective overall.

Why this matters

  • An accompanying editorial notes that the findings suggest other psychotherapy formats are a viable alternative for people with depression for whom individual psychotherapy is not an option, as long as a trained clinician is involved.

Study design

  • Network meta-analysis of 155 trials including 15,191 participants with acute depression.
  • Patients received either CBT (individual, group, telephone, guided, and unguided self-help) or control care (waiting list/usual care/pill placebo).
  • Funding: None disclosed.

Key results

  • No significant difference was observed with CBT delivered in a group, telephone, or in a guided self-help (P=.56, P=.13, and P=.06, respectively) vs individual therapy.
  • Guided self-help was less acceptable vs individual (relative risk [RR], 1.44; 95% CI, 1.09-1.89) and group (RR, 1.38; 95% CI, 1.06-1.80) therapies.
  • Unguided self-help CBT was less effective vs individual (standardized mean difference [SMD], 0.50), group (SMD, 0.59), telephone (SMD, 0.50), and guided (SMD, 0.34) CBT.

Limitations

  • Heterogeneity between studies.

Coauthored with Antara Ghosh, PhD

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit