Short psychodynamic supportive psychotherapy, antidepressants, and their combination in the treatment of major depression: a mega-analysis based on three randomized clinical trials
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The efficacy of Short Psychodynamic Supportive Psychotherapy (SPSP) has not yet been compared with pharmacotherapy. A mega-analysis based on three original Randomized Clinical Trials (RCTs) was performed. Patients with (mild to moderate) major depressive disorder were randomized in (24 weeks) SPSP (n = 97), pharmacotherapy (n = 45), or their combination (n = 171). Efficacy was assessed by the Hamilton Depression Rating Scale (HDRS), Clinical Global Impression of Severity and of Improvement (CGI-S), the Symptom Checklist (SCL; depression subscale) and the Quality of Life Depression Scale (QLDS). Pearson chi(2) calculations were used to compare success rates. Analyses of covariance (ANCOVAs) were used to test inter-group differences. Success rates indicated that independent observers (HDRS) found no differences in symptom reduction between SPSP and pharmacotherapy (P = 0.214), but therapists (CGI-S, P = 0.026), and patients (SCL, P = 0.036) favored SPSP. Combined therapy was found superior to pharmacotherapy by all three (patients (P = 0.000), therapists (P = 0.024), independent observers (P = 0.024)). Independent observers (P = 0.062) and therapists (P = 0.430) found no differences between combined therapy and SPSP, but patients (P = 0.016) found combined therapy to be superior. As far as quality of life is concerned, success rates indicated that patients (QLDS) found no differences between SPSP and pharmacotherapy (P = 0.073) or between SPSP and combined therapy (P = 0.217). However, they found combined therapy superior to pharmacotherapy (P = 0.015). The results of the mega-analysis suggest that combined therapy is more efficacious than pharmacotherapy. SPSP and pharmacotherapy seem equally efficacious, except for some indications that patients and therapists favor SPSP for symptom reduction. Combined therapy and SPSP also seem equally efficacious, except that patients think that the first is better in symptom reduction.
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Meta-analyses showed that the combination of medication and psychological therapy was more effective than monotherapy in both current MDD and prevention of relapse/recurrence.
“Meta-analyses indeed showed that the combination of medication and psychological therapy was more effective than monotherapy in both current MDD (Cuijpers et al., 2014;de Maat et al., 2008;Pampallona et al., 2004) and prevention of relapse/ recurrence (Guidi et al., 2011).”
From Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled trial (2015) · cites this paper as de Maat et al., 2008
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“SPSP is a specific form of psychodynamic psychotherapy that has been tested in several RCTs in the Netherlands [18] and was found to be non-inferior to Cognitive Behavioural Therapy (CBT) for patients with major depressive disorder [19].”
BackgroundInfluentialSelf-citation
- Authors
- de Maat, S., Dekker, J., Schoevers, R., van Aalst, G., Gijsbers-van Wijk, C., Hendriksen, M., Kool, S., Peen, J., Van, R., & de Jonghe, F.
- Affiliations
- Mentrum (NL)
- Corresponding author
- Dekker, Jack
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2008-07
- Volume
- 25
- Issue
- 7
- Pages
- 565-574
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W2133658031
- Cited by
- 93
- References
- 34
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 6 · 2018: 1 · 2017: 3 · 2016: 5 · 2015: 8 · 2014: 3 · 2013: 8 · 2012: 8
- FWCI
- 9.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- antidepressants, major depressive disorder, combined psychotherapy and pharmacotherapy, treatment efficacy, quality of life, symptom relief
- MeSH terms
- Adult, Antidepressive Agents, Combined Modality Therapy, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Male, Middle Aged, Personality Inventory, Psychoanalytic Therapy, Psychotherapy, Brief, Quality of Life, Social Support, Randomized Controlled Trials as Topic, Patient Satisfaction
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