The symptom‐specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta‐analysis

Autor: Robert J. DeRubeis, Ulrich Hegerl, Jeffrey R. Vittengl, Frank Petrak, Boadie W. Dunlop, Erica Weitz, Sona Dimidjian, Anne D. Simons, Robert A. Schoevers, David L. Dunner, Lynn Boschloo, Robin B. Jarrett, Ella Bekhuis, David C. Mohr, Gordon Parker, Mirjam Reijnders, Zindel V. Segal, Pim Cuijpers, Steven D. Hollon, Sidney H. Kennedy, Stephan Herpertz, Jeanne Miranda, A. John Rush, Lena C. Quilty
Přispěvatelé: Clinical, Neuro- & Developmental Psychology, APH - Mental Health, APH - Global Health, Perceptual and Cognitive Neuroscience (PCN), Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Clinical Cognitive Neuropsychiatry Research Program (CCNP)
Rok vydání: 2019
Předmět:
DISORDER
medicine.medical_treatment
psychic anxiety
law.invention
depressive symptoms
0302 clinical medicine
Randomized controlled trial
law
RATING-SCALE
Depression (differential diagnoses)
media_common
OUTCOMES
Depression
general somatic symptoms
Cognitive behavioral therapy
Psychiatry and Mental health
Feeling
suicidal thoughts
Meta-analysis
RELIABILITY
Anxiety
Pshychiatric Mental Health
medicine.symptom
NETWORK STRUCTURE
medicine.medical_specialty
media_common.quotation_subject
behavioral disciplines and activities
feelings of guilt
03 medical and health sciences
SDG 3 - Good Health and Well-being
Rating scale
PSYCHOTHERAPY
mental disorders
precision psychiatry
medicine
DIFFERENTIAL CHANGE
Psychiatry
business.industry
Hamilton Rating Scale for Depression
PHARMACOTHERAPY
Research Reports
antidepressant medication
RANDOMIZED-TRIAL
cognitive behavioral therapy
030227 psychiatry
TREATING DEPRESSION
depressed mood
business
030217 neurology & neurosurgery
Zdroj: Boschloo, L, Bekhuis, E, Weitz, E S, Reijnders, M, DeRubeis, R J, Dimidjian, S, Dunner, D L, Dunlop, B W, Hegerl, U, Hollon, S D, Jarrett, R B, Kennedy, S H, Miranda, J, Mohr, DC, Simons, A D, Parker, G, Petrak, F, Herpertz, S, Quilty, L C, John Rush, A, Segal, Z V, Vittengl, J R, Schoevers, R A & Cuijpers, P 2019, ' The symptom-specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression : results from an individual patient data meta-analysis ', World Psychiatry, vol. 18, no. 2, pp. 183-191 . https://doi.org/10.1002/wps.20630
World Psychiatry, 18(2), 183-191. Masson SpA
World psychiatry, 18(2), 183-191. Wiley
ISSN: 2051-5545
1723-8617
Popis: A recent individual patient data meta-analysis showed that antidepressant medication is slightly more efficacious than cognitive behavioral therapy (CBT) in reducing overall depression severity in patients with a DSM-defined depressive disorder. We used an update of that dataset, based on seventeen randomized clinical trials, to examine the comparative efficacy of antidepressant medication vs. CBT in more detail by focusing on individual depressive symptoms as assessed with the 17-item Hamilton Rating Scale for Depression. Five symptoms (i.e., "depressed mood" , "feelings of guilt" , "suicidal thoughts" , "psychic anxiety" and "general somatic symptoms") showed larger improvements in the medication compared to the CBT condition (effect sizes ranging from .13 to .16), whereas no differences were found for the twelve other symptoms. In addition, network estimation techniques revealed that all effects, except that on "depressed mood" , were direct and could not be explained by any of the other direct or indirect treatment effects. Exploratory analyses showed that information about the symptom-specific efficacy could help in identifying those patients who, based on their pre-treatment symptomatology, are likely to benefit more from antidepressant medication than from CBT (effect size of .30) versus those for whom both treatments are likely to be equally efficacious. Overall, our symptom-oriented approach results in a more thorough evaluation of the efficacy of antidepressant medication over CBT and shows potential in "precision psychiatry" .
Databáze: OpenAIRE
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