Cited by 159Psychotherapy Techniques and ApplicationsMental Health Treatment and AccessDigital Mental Health Interventions

The DOI matches its Crossref record; 67 of the 69 references it cites were found in a registry or an index; none of the 2 sources its claims cite is checked for support yet.

Psychotherapies for depression in low- and middle-income countries: a meta-analysis

Open access

Abstract

Most psychotherapies for depression have been developed in high‐income Western countries of North America, Europe and Australia. A growing number of randomized trials have examined the effects of these treatments in non‐Western countries. We conducted a meta‐analysis of these studies to examine whether these psychotherapies are effective and to compare their effects between studies from Western and non‐Western countries. We conducted systematic searches in bibliographical databases and included 253 randomized controlled trials, of which 32 were conducted in non‐Western countries. The effects of psychotherapies in non‐Western countries were large (g=1.10; 95% CI: 0.91‐1.30), with high heterogeneity (I 2=90; 95% CI: 87‐92). After adjustment for publication bias, the effect size dropped to g=0.73 (95% CI: 0.51‐0.96). Subgroup analyses did not indicate that adaptation to the local situation was associated with the effect size. Comparisons with the studies in Western countries showed that the effects of the therapies were significantly larger in non‐Western countries, also after adjusting for characteristics of the participants, the treatments and the studies. These larger effect sizes in non‐Western countries may reflect true differences indicating that therapies are indeed more effective; or may be explained by the care‐as‐usual control conditions in non‐Western countries, often indicating that no care was available; or may be the result of the relative low quality of many trials in the field. This study suggests that psychotherapies that were developed in Western countries may or may not be more effective in non‐Western countries, but they are probably no less effective and can therefore also be used in these latter countries.

Overview

Integrity signals

Registry

Crossref · 10.1002/wps.20493

Cites

67 of 67 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 2 cited sources checked · 0 supported · 0 flagged

Show all 36 claims

  • It may state two separate claims as one. 21
  • Probably not a substantial claim. 8
25 of 25
  • The paper relies on this without support.

    Most psychotherapies for depression were developed in high-income Western countries.

    “Most psychotherapies have been developed in high-income Western countries in North America, Europe and Australia, and the vast majority of the more than 450 randomized trials which have examined their effects 20 have been conducted in those countries.”
  • The paper relies on this without support.

    The 32 included non-Western trials are representative of psychotherapies for depression in non-Western countries generally.

    “This study suggests that psychotherapies that were developed in Western countries may or may not be more effective in non-Western countries, but they are probably no less effective and can therefore also be used in these latter countries.”
  • The paper relies on this without support.

    Low-intensity interventions are simpler and less costly to deliver than high-intensity ones.

    “because these are easier and cheaper to implement than high intensity ones.”
3 of 3

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.

  • Conflicting upper confidence limits for the same pooled effect

    Minor

    The text and Table 3 report the same effect size and heterogeneity after excluding the three extreme outliers, but give different upper limits for its 95% confidence interval: 1.06 versus 1.02.

1 of 1

Citations

Cites

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Show all 69 references

2 of the 69 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Beck AT, 1996, BDI‐II, Beck depression Inventory: manual
  2. Orsini N, 2005, Heterogi: Stata module to quantify heterogeneity in a meta‐analysis

Cited by

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Metadata

Authors
Cuijpers, P., Karyotaki, E., Reijnders, M., Purgato, M., & Barbui, C.
Affiliations
  • Vrije Universiteit Amsterdam (NL)
  • University of Verona (IT)
Venue
World Psychiatry
Publisher
Wiley
Published
2018-01-19
Volume
17
Issue
1
Pages
90-101
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
OpenAlex
W2724934802
Cited by
159
References
69
Citations by year
2026: 6 · 2025: 12 · 2024: 27 · 2023: 28 · 2022: 19 · 2021: 26 · 2020: 18 · 2019: 14 · 2018: 8
FWCI
19.35
Type
journal article
Language
en
Open access
Locations
  • World Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
depression, psychotherapy, low- and middle-income countries, cross-cultural generalizability, treatment effectiveness, publication bias, trial quality

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