The symptom‐specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta‐analysis
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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” .
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Psychotherapies, when combined with pharmacological treatments, are conceptually supported insofar as they facilitate learning, coping and resilience mechanisms that synergize with the hypothesized biological mechanisms of action of antidepressants.
“Psychotherapies, when combined with pharmacological treatments, are conceptually supported insofar as they facilitate learning, coping and resilience mechanisms that synergize with the hypothesized biological mechanisms of action of antidepressants 262 .”
From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [262]
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Allard, C. B., Norman, S. B., Straus, E., Kim, H. M., Stein, M. B., Simon, N. M., & Rauch, S. A. M. (2021) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2021.101666 · Cited by 13 · see citing works
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Symptoms that remain after depression treatment in patients with coronary heart disease
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Prediction of electroconvulsive therapy outcome: A network analysis approach
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Helpful Treatment of Depression—Delivering the Right Messages
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Using deep learning and pretreatment EEG to predict response to sertraline, bupropion, and placebo
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Psychophysiological responses to group cognitive-behavioral therapy in depressive patients
Varela, Y. M., de Almeida, R. N., Galvão, A. C. D. M., de Sousa, G. M., de Lima, A. C. L., da Silva, N. G., Leocádio-Miguel, M. A., Soares, B. L., Hallak, J. E. C., Maia‐de‐Oliveira, J. P., et al. (2021) · Current Psychology · doi:10.1007/s12144-020-01324-9 · Cited by 9 · see citing works
Whiston, A., Igou, E. R., Fortune, D. G., Analog Devices Team, & Semkovska, M. (2022) · IEEE Journal of Translational Engineering in Health and Medicine · doi:10.1109/jtehm.2022.3228483 · Cited by 12 · see citing works
Schumacher, L., Burger, J., Echterhoff, J., & Kriston, L. (2022) · doi:10.31234/osf.io/ea7fu · Cited by 9 · see citing works
Bauer‐Staeb, C., Griffith, E., Faraway, J. J., & Button, K. S. (2022) · Psychological Medicine · doi:10.1017/s0033291722001556 · Cited by 8 · see citing works
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Digital measures of activity and motivation impact depression and anxiety in the real world
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Potential Benefits of Remote Continuous Care for Depression
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Possible Futures for the Psychological Network Approach: Agenda for Clinical Scientists
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Høstmælingen, A., Ulvenes, P., Nissen‐Lie, H. A., Eielsen, M., & Wampold, B. E. (2021) · Journal of Counseling Psychology · doi:10.1037/cou0000572 · Cited by 5 · see citing works
Differential impact of affective and cognitive symptoms on remission of major depression
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The profile of symptom change with transcranial magnetic stimulation for major depressive disorder
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Huong, C., & Brown, D. M. Y. (2024) · Mental health and physical activity · doi:10.1016/j.mhpa.2024.100586 · Cited by 4 · see citing works
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Changes in depression domains as predictors of return to work in common mental disorders
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Behandlingsmetoders rolle i evidensbasert psykologisk praksis
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Intervening on psychopathology networks: Evaluating intervention targets through simulationsPreprint
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Symptom specificity of ayahuasca's effect on depressive symptoms
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Cognitive distortions are associated with increasing political polarization
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Self-citation心理ネットワークアプローチがもたらす「臨床革命」—認知行動療法の文脈に基づく展望—
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Randomized Controlled Trials and the Efficacy of Psychotropic Medications
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The Role of Treatment Methods in Evidence-based Psychological Practice
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- Authors
- 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, D. C., 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.
- Affiliations
- University Medical Center Groningen (NL)
- Amsterdam Public Health (NL)
- University of Pennsylvania (US)
- University of Colorado Boulder (US)
- Center for Anxiety and Depression, Mercer Island Washington WA USA
- Emory University (US)
- Leipzig University (DE)
- Vanderbilt University (US)
- The University of Texas Southwestern Medical Center (US)
- University of Toronto (CA)
- University of California, Los Angeles (US)
- Northwestern University (US)
- University of Notre Dame (US)
- UNSW Sydney (AU)
- LWL-Universitätsklinikum Bochum (DE)
- Centre for Addiction and Mental Health (CA)
- Duke‐National University of Singapore Graduate Medical School Singapore
- Truman State University (US)
- ORCID
- Boschloo, Lynn
- Bekhuis, Ella
- Weitz, Erica S.
- Reijnders, Mirjam
- DeRubeis, Robert J.
- Dimidjian, Sona
- Dunlop, Boadie W.
- Hegerl, Ulrich
- Hollon, Steven D.
- Jarrett, Robin B.
- Kennedy, Sidney H.
- Miranda, Jeanne
- Mohr, David C.
- Parker, Gordon
- Petrak, Frank
- Herpertz, Stephan
- Quilty, Lena C.
- Segal, Zindel V.
- Vittengl, Jeffrey R.
- Schoevers, Robert A.
- Cuijpers, Pim
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2019-05-06
- Volume
- 18
- Issue
- 2
- Pages
- 183-191
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC6502416
- OpenAlex
- W2944427364
- Cited by
- 137
- References
- 46
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 18 · 2023: 14 · 2022: 23 · 2021: 23 · 2020: 22 · 2019: 7 · 2012: 1
- FWCI
- 11.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- VU Research Portal (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- antidepressants, cognitive behavioral therapy, depression, depressive symptoms, suicidal ideation, guilt, psychic anxiety, somatic symptoms, depressive mood, precision psychiatry
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