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Cited by 317Psychotherapy Techniques and ApplicationsSchizophrenia research and treatmentAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials

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Lynch, D., Laws, K. R., McKenna, P. J.·2010·Psychological Medicine
DOI 10.1017/s003329170900590x
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Abstract

Background: Although cognitive behavioural therapy (CBT) is claimed to be effective in schizophrenia, major depression and bipolar disorder, there have been negative findings in well-conducted studies and meta-analyses have not fully considered the potential influence of blindness or the use of control interventions. Method: We pooled data from published trials of CBT in schizophrenia, major depression and bipolar disorder that used controls for non-specific effects of intervention. Trials of effectiveness against relapse were also pooled, including those that compared CBT to treatment as usual (TAU). Blinding was examined as a moderating factor. Results: CBT was not effective in reducing symptoms in schizophrenia or in preventing relapse. CBT was effective in reducing symptoms in major depression, although the effect size was small, and in reducing relapse. CBT was ineffective in reducing relapse in bipolar disorder. Conclusions: CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates. It is effective in major depression but the size of the effect is small in treatment studies. On present evidence CBT is not an effective treatment strategy for prevention of relapse in bipolar disorder.

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  • From meta-analyses, effects of CBT on either depressive symptoms or relapse remain uncertain due to important methodological problems and study selection factors.

    “From meta‐analyses, effects on either depressive symptoms or on relapse remain uncertain due to important methodological problems and study selection factors.87, 88, 89”

    From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [87]

    The Discussion (page unavailable) explicitly concludes that CBT is effective for both acute symptoms of major depression and relapse prevention, rather than saying both effects remain uncertain. It qualifies the acute-symptom benefit as modest and notes limitations in trial quality; the relapse analysis excludes four studies for systematic bias but still reports a significant pooled benefit (Effectiveness against relapse, page unavailable). (LLM, conf=0.86)

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Authors
Lynch, D., Laws, K. R., & McKenna, P. J.
Affiliations
  • Stobhill Hospital (GB)
  • University of Hertfordshire (GB)
  • Centro de Investigación Biomédica en Red de Salud Mental (ES)
Corresponding author
McKenna, P. J.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2009-05-29
Volume
40
Issue
1
Pages
9-24
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s003329170900590x
OpenAlex
W2128163029
Cited by
317
References
74
Citations by year
2025: 2 · 2024: 9 · 2023: 8 · 2022: 13 · 2021: 8 · 2020: 6 · 2019: 28 · 2018: 23 · 2017: 14 · 2016: 16 · 2015: 17 · 2014: 24 · 2013: 43 · 2012: 42
FWCI
36.72
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (submittedVersion)
Funders
  • Centro de Investigación Biomédica en Red de Salud Mental
  • Instituto de Salud Carlos III
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
cognitive behavioral therapy, schizophrenia, major depressive disorder, bipolar disorder, relapse prevention, usual care, blinding, symptom relief, treatment effectiveness
MeSH terms
Adult, Bipolar Disorder, Major Depressive Disorder, Humans, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Cognitive Behavioral Therapy, Treatment Outcome, Controlled Clinical Trials as Topic, Secondary Prevention

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