Psychologic treatment of depression compared with pharmacotherapy and combined treatment in primary care:A network meta-analysis
Autor: | Soledad Quero, Hisashi Noma, Matthijs Oud, Eirini Karyotaki, Pim Cuijpers, Toshi A. Furukawa, Andrea Cipriani, Bruce Arroll |
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Přispěvatelé: | Clinical Psychology, World Health Organization (WHO) Collaborating Center, APH - Global Health, APH - Mental Health |
Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
cognitive behavior therapy Network Meta-Analysis Primary care Placebo law.invention primary care 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Randomized controlled trial SDG 3 - Good Health and Well-being law Internal medicine medicine Humans 030212 general & internal medicine network meta-analysis Depression (differential diagnoses) Cognitive Behavioral Therapy Primary Health Care Depression business.industry Psychotherapy psychotherapy Pill Meta-analysis Relative risk Systematic Review major depression Family Practice business |
Zdroj: | Cuijpers, P, Oud, M, Karyotaki, E, Noma, H, Quero, S, Cipriani, A, Arroll, B & Furukawa, T A 2021, ' Psychologic treatment of depression compared with pharmacotherapy and combined treatment in primary care : A network meta-analysis ', Annals of Family Medicine, vol. 19, no. 3, pp. 262-270 . https://doi.org/10.1370/afm.2676 Annals of Family Medicine, 19(3), 262-270. Annals of Family Medicine, Inc Ann Fam Med The Annals of Family Medicine Vol. 19, Issue 3 1 May 2021 Repositori Universitat Jaume I Universitat Jaume I |
ISSN: | 1544-1709 |
Popis: | © 2021, Annals of Family Medicine, Inc. All rights reserved.PURPOSE Most patients with depression are treated by general practitioners, and most of those patients prefer psychotherapy over pharmacotherapy. No network meta-analyses have examined the effects of psychotherapy compared with pharmacotherapy, combined treatment, care as usual, and other control conditions among patients in primary care. METHODS We conducted systematic searches of bibliographic databases to identify randomized trials comparing psychotherapy with pharmacotherapy, combined treatment, care as usual, waitlist, and pill placebo. The main outcome was treatment response (50% improvement of depressive symptoms from baseline to end point). RESULTS A total of 58 studies with 9,301 patients were included. Both psychotherapy and pharmacotherapy were significantly more effective than care as usual (relative risk [RR] for response = 1.60; 95% CI, 1.40-1.83 and RR = 1.65; 95% CI, 1.35-2.03, respectively) and waitlist (RR = 2.35; 95% CI, 1.57-3.51 and RR = 2.43; 95% CI, 1.57-3.74, respectively) control groups. We found no significant differences between psychotherapy and pharmacotherapy (RR = 1.03; 95% CI, 0.88-1.22). The effects were significantly greater for combined treatment compared with psychotherapy alone (RR = 1.35; 95% CI, 1.00-1.81). The difference between combined treatment and pharmacotherapy became significant when limited to studies with low risk of bias and studies limited to cognitive behavior therapy. CONCLUSIONS Psychotherapy is likely effective for the treatment of depression when compared with care as usual or waitlist, with effects comparable to those of pharmacotherapy. Combined treatment might be better than either psychotherapy or pharmacotherapy alone. |
Databáze: | OpenAIRE |
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