Efficacy of inpatient psychotherapy for major depressive disorder: a meta‐analysis of controlled trials
Abstract
Objective This meta-analysis investigates the efficacy of inpatient psychotherapy in major depressive disorders compared to control conditions. Methods In total, 14 studies were entered into the meta-analysis with a total of 1.080 patients. Primary outcome was the standardized mean differences in self-rated depression outcomes. A priori planned subgroup analyses included the influence of different control conditions: (a) no psychiatric inpatient treatment (e.g., waitlist control), (b) treatment as usual (TAU; e.g., non-manualized clinical management), (c) TAU determined by study design (manualized/'placebo' control condition), as well as number of sessions and influence of self- vs. clinician ratings. Results The meta-analysis of 19 available comparisons resulted in a moderate pooled effect size showing a small and statistically significant benefit of the psychotherapeutic intervention over control conditions (g = 0.24, P 2 = 0%). This corresponds to a number needed to treat of 7.4. The effects of the interventions were stable over 12-month follow-up (g = 0.21, P 2 = 30%). Comparisons with waitlist or non-standardized control treatments tended to be associated with larger effect sizes than standardized control treatments. Conclusions Despite some limitations (small number of studies), this meta-analysis provides evidence for a small but sustained effect of inpatient psychotherapy in patients with major depressive disorders.
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Inpatient psychotherapy has significant effects compared to treatment as usual for depressive disorders.
“Concerning inpatient psychotherapeutic treatment, results of a recent metaanalysis by Schefft et al. (2019), suggest significant effects of inpatient psychotherapy compared to treatment as usual for depressive disorders.”
From A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders (2021) · cites this paper as Schefft et al., 2019
Effectiveness trials investigating treatments under routine clinical conditions are rare and only a very small number of studies investigated ACT for inpatients.
“Effectiveness trials, which investigate treatments under routine clinical conditions, are rare and only a very small number of studies investigated ACT for inpatients (Schefft et al., 2019).”
From A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders (2021) · cites this paper as Schefft et al., 2019
A total of 54 patients were lost to follow-up, a total rate of 31.76% (ACT: 38.75%, CBT: 25.56%), corresponding to the average of other inpatient studies (30%).
“A total of 54 patients were lost to follow-up, resulting in a total rate of 31.76% (ACT: 38.75%, CBT: 25.56%) and corresponds to the average of other inpatient studies (30%, Schefft et al., 2019).”
From A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders (2021) · cites this paper as Schefft et al., 2019
Compared to other inpatient studies (median=12%, Range=0%-30%), this dropout rate can be considered low.
“Compared to other inpatient studies (median = 12%, Range = 0% -30%) this dropout rate can be considered low (Schefft et al., 2019).”
From A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders (2021) · cites this paper as Schefft et al., 2019
The large and stable improvements in depressive symptoms across both therapy conditions are comparable to those of the effectiveness trial of ACT for inpatients by Benoy et al., 2019 and larger than those effect sizes reported in the most recently published meta-analysis of psychotherapy for inpatients.
“The large and stable improvements in depressive symptoms across both therapy conditions are comparable to those of the effectiveness trial of ACT for inpatients by Benoy et al., 2019 and larger than those effect sizes reported in the most recently published meta-analysis of psychotherapy for inpatients (Paterson et al., 2018; Schefft et al., 2019).”
From A clinical effectiveness trial comparing ACT and CBT for inpatients with depressive and mixed mental disorders (2021) · cites this paper as Schefft et al., 2019
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References 64 · Cited by 17
- Authors
- Schefft, C., Guhn, A., Brakemeier, E. ‐., Sterzer, P., & Köhler, S.
- Affiliations
- Charité – Universitätsmedizin Berlin (DE)
- Philipps University of Marburg (DE)
- Corresponding author
- Köhler, S.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2019-01-06
- Volume
- 139
- Issue
- 4
- Pages
- 322-335
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2904113915
- Cited by
- 17
- References
- 64
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 1 · 2019: 2
- FWCI
- 0.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (KO 5231/2‐1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- inpatient psychotherapy, major depressive disorder, psychotherapy efficacy, waitlist control, usual care, placebo comparison, number needed to treat, long-term follow-up
- MeSH terms
- Major Depressive Disorder, Hospitalization, Humans, Psychotherapy, Outcome Assessment, Health Care
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