Cited by 572Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and ApplicationsPsychological Treatments and Assessments

The DOI matches its Crossref record; 212 of the 212 references it cites were found in a registry or an index; 8 of the 18 sources its claims cite were checked for support.

How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence

Open access

Cuijpers, Pim, Cristea, Ioana A., Karyotaki, Eirini, Reijnders, Mirjam, Huibers, Marcus J.H.·2016·World Psychiatry

DOI 10.1002/wps.20346PMC PMC5032489

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Abstract

We report the current best estimate of the effects of cognitive behavior therapy (CBT) in the treatment of major depression (MDD), generalized anxiety disorder (GAD), panic disorder (PAD) and social anxiety disorder (SAD).

Integrity signals

Registry

Crossref · 10.1002/wps.20346

Cites

212 of 212 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

8 of 18 cited sources checked · 6 supported · 0 flagged · accuracy not yet measured

The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“After adding the effect sizes of these unpublished trials to those of the published ones, the mean effect size for psychotherapy dropped by more than 25%.”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > (World Psychiatry 2016;15:245-258)
What the sources say
- Partly supported
  The Results (Adjusting for study publication bias; page unavailable) report that adding unpublished trials reduced the pooled psychotherapy effect-size estimate from g = 0.52 to g = 0.39. The paper describes this overall reduction as 25%, not more than 25%. (LLM, conf=0.90)
  cites [15] 15. Driessen E, Hollon SD, Bockting CLH et al. Does publication bias inflate the apparent efficacy of psychological treatment for major depressive disorder? A systematic review and meta-analysis of US National Institutes of Health-funded trials. PLoS One 2015;10:e0137864. sourceExperimental — accuracy not yet measured
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Every source the paper cites for this claim was checked and supports it.
In the paper
“a recent study found that almost one quarter of trials of psychotherapy for adult depression funded by the US National Institutes of Health were not published 15 .”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > (World Psychiatry 2016;15:245-258)
What the sources say
- Supported
  The Abstract (Methods and Findings) reports that 13 of 55 NIH-funded grants that began psychotherapy trials for major depressive disorder did not result in publications—23.6%, or almost one quarter. The Introduction specifies that the trials concerned adult or geriatric patients. (LLM, conf=0.95)
  cites [15] 15. Driessen E, Hollon SD, Bockting CLH et al. Does publication bias inflate the apparent efficacy of psychological treatment for major depressive disorder? A systematic review and meta-analysis of US National Institutes of Health-funded trials. PLoS One 2015;10:e0137864. source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Every source the paper cites for this claim was checked and supports it.
In the paper
“There is considerable indirect evidence of publication bias in psychotherapy research, based on excess publication of small studies with large effect sizes 16 .”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > (World Psychiatry 2016;15:245-258)
What the sources say
- Supported
  In “Indicators of publication bias in the full sample,” the funnel plot shows smaller studies with lower effect sizes missing, and statistical tests give highly significant indicators of publication bias. The Discussion describes these as strong indications in controlled studies of psychotherapy for adult depression, supporting the claim’s characterization of indirect evidence. (LLM, conf=0.90)
  cites [16] 16. Cuijpers P, Smit F, Bohlmeijer E et al. Efficacy of cognitive-behavioural therapy and other psychological treatments for adult depression: meta- analytic study of publication bias. Br J Psychiatry 2010;196:173-8. source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“However, this was a relatively small drop compared to that reported in other studies on publication bias in psychotherapies for MDD 15,18,184 .”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > DISCUSSION
What the sources say
- Supported
  The Results table reports a 25% reduction in the effect-size estimate for psychological treatment versus controls after unpublished studies were included. The Introduction reports a 37% reduction in an earlier study of psychological treatments for depression, supporting the characterization of this paper’s drop as relatively small by comparison. (LLM, conf=0.90)
  cites [15] 15. Driessen E, Hollon SD, Bockting CLH et al. Does publication bias inflate the apparent efficacy of psychological treatment for major depressive disorder? A systematic review and meta-analysis of US National Institutes of Health-funded trials. PLoS One 2015;10:e0137864. source
- Not checked — no full text of the sourcecites [18] 18. Cuijpers P, van Straten A, Bohlmeijer E et al. The effects of psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size. Psychol Med 2010;40:211-23. source
- Supported
  The cited study reports a publication-bias-adjusted effect-size drop for CBT in adult depression, providing one of the comparison results invoked by the citing sentence. In “CBT, Compared With Control Condition” (p. 6), the effect size falls from g = 0.71 to g = 0.53. Describing the citing study’s own drop as relatively small is the citing authors’ comparison, not a finding attributed to this source. (LLM, conf=0.88)
  cites [184] 184. Cuijpers P, Berking M, Andersson G et al. A meta-analysis of cognitive- behavioural therapy for adult depression, alone and in comparison with other treatments. Can J Psychiatry 2013;58:376-85. source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Psychological treatments are equally effective in the treatment of depression 8 and anxiety disorders [9][10][11] .”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > (World Psychiatry 2016;15:245-258)
What the sources say
- Partly supported
  The paper reports no significant overall difference between psychotherapy and pharmacotherapy across the depressive and anxiety disorders studied (p. 2). But the Discussion (pp. 10–11) identifies differences for particular disorders, notably psychotherapy’s greater efficacy in OCD. The unqualified claim of equal effectiveness across depression and anxiety disorders therefore overstates the findings. (LLM, conf=0.86)
  cites [8] 8. Cuijpers P, Sijbrandij M, Koole SL et al. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta- analysis of direct comparisons. World Psychiatry 2013;12:137-48. sourceExperimental — accuracy not yet measured
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites [9][10][11]
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes

Show all 40 claims

It may state two separate claims as one. 37
Probably not a substantial claim. 5
The quote only partly states this claim. 1

The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Dozens of trials and several meta-analyses have shown that CBT is effective in treating depression 8,14 and anxiety disorders [9][10][11] .”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > (World Psychiatry 2016;15:245-258)
What the sources say
- Supported
  The introduction (p. 2) describes psychotherapy as an efficacious treatment for depressive and anxiety disorders and cites earlier meta-analyses. The Characteristics of included studies (p. 8) reports dozens of studies across both disorder groups, with CBT accounting for 49 of 78 psychotherapy comparisons. The paper assesses CBT largely through comparisons with medication rather than against no treatment, but its discussion (p. 10) reports small to nonexistent differences for major depression, panic disorder, and social anxiety disorder. (LLM, conf=0.88)
  cites [8] 8. Cuijpers P, Sijbrandij M, Koole SL et al. The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta- analysis of direct comparisons. World Psychiatry 2013;12:137-48. source
- Supported
  The citation to this source is attached to the depression portion of the sentence, not the anxiety-disorders portion. The Results report that CBT was investigated in 139 studies, and the Discussion’s Conclusions report robust effects for CBT in larger trials. The Introduction also describes prior meta-analyses of CBT for depression. (LLM, conf=0.92)
  cites [14] 14. Barth J, Munder T, Gerger H et al. Comparative efficacy of seven psycho- therapeutic interventions for patients with depression: a network meta- analysis. PLoS Med 2013;10:e1001454. source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites [9][10][11]
Load-bearingStrength:boosted· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“In a meta-analysis of 115 trials of psychotherapy for depression, only 11 met all basic indicators of quality, and the effect sizes of these trials were considerably smaller than those of lower quality ones 18 .”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > (World Psychiatry 2016;15:245-258)
What the sources say
- Not checked — no full text of the sourcecites [18] 18. Cuijpers P, van Straten A, Bohlmeijer E et al. The effects of psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size. Psychol Med 2010;40:211-23. source
Load-bearingStrength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Psychological placebo conditions were not included, because they have considerable effects on depression 24 and probably also on anxiety disorders 19 .”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > Identification and selection of studies
What the sources say
- Not checked — no full text of the sourcecites [24] 24. Cuijpers P, Driessen E, Hollon SD et al. The efficacy of non-directive sup- portive therapy for adult depression: a meta-analysis. Clin Psychol Rev 2012;32:280-91. source
- Not checked — no full text of the sourcecites [19] 19. Mohr DC, Spring B, Freedland KE et al. The selection and design of con- trol conditions for randomized controlled trials of psychological inter- ventions. Psychother Psychosom 2009;78:275-84. source
Load-bearingStrength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Waiting list is probably a”
§ How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [21] 21. Furukawa TA, Noma H, Caldwell DM et al. Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta- analysis. Acta Psychiatr Scand 2014;130:181-92. source
Load-bearingStrength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.

39 of 39

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

The GAD placebo result reverses the claimed control-group pattern
Minor
The discussion says waiting-list comparisons produced significantly larger effects than pill-placebo comparisons for every disorder. For GAD, the results report the opposite: the pill-placebo effect was significantly larger than the waiting-list effect.

1 of 1

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Authors: Cuijpers, P., Cristea, I. A., Karyotaki, E., Reijnders, M., & Huibers, M. J. H.
Affiliations: Amsterdam Public Health (NL)
Babeș-Bolyai University (RO)
ORCID: Cuijpers, Pim
Cristea, Ioana A.
Karyotaki, Eirini
Reijnders, Mirjam
Huibers, Marcus J.H.
Venue: World Psychiatry
Publisher: Wiley
Published: 2016-09-22
Volume: 15
Issue: 3
Pages: 245-258
ISSN: 1723-8617 (ISSN-L)
2051-5545
DOI: 10.1002/wps.20346
PMC: PMC5032489
OpenAlex: W2522867222
Semantic Scholar: c3394bb499422118f0a59876c9a5e69800873bd2
Cited by: 572
References: 208
Citations by year: 2026: 58 · 2025: 52 · 2024: 60 · 2023: 61 · 2022: 64 · 2021: 70 · 2020: 58 · 2019: 63 · 2018: 50 · 2017: 34 · 2016: 2
FWCI: 70.45
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: World Psychiatry (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
VU Research Portal (publishedVersion, other-oa)
Research Publications (Maastricht University) (submittedVersion, other-oa)
Padua Research Archive (University of Padova) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords: cognitive behavioral therapy, major depressive disorder, generalized anxiety disorder, panic disorder, social anxiety disorder, anxiety disorders, treatment efficacy, waiting list control group, publication bias, trial quality, placebo comparison

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How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence

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