Cited by 137Treatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

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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Boschloo, Lynn, Bekhuis, Ella, Weitz, Erica S., Reijnders, Mirjam, DeRubeis, Robert J., Dimidjian, Sona, Dunner, David L., Dunlop, Boadie W. +16 more·2019·World Psychiatry

Abstract

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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Crossref · 10.1002/wps.20630

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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 .”

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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)
Venue
World Psychiatry
Publisher
Wiley
Published
2019-05-06
Volume
18
Issue
2
Pages
183-191
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
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
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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