Conflicts of interest and spin in reviews of psychological therapies: a systematic review
Open accessAbstract
Objective: To explore conflicts of interest (COI) and their reporting in systematic reviews of psychological therapies, and to evaluate spin in the conclusions of the reviews. Methods: MEDLINE and PsycINFO databases were searched for systematic reviews published between 2010 and 2013 that assessed effects of psychological therapies for anxiety, depressive or personality disorders, and included at least one randomised controlled trial. Required COI disclosure by journal, disclosed COI by review authors, and the inclusion of own primary studies by review authors were extracted. Researcher allegiance, that is, that researchers concluded favourably about the interventions they have studied, as well as spin, that is, differences between results and conclusions of the reviews, were rated by 2 independent raters. Results: 936 references were retrieved, 95 reviews fulfilled eligibility criteria. 59 compared psychological therapies with other forms of psychological therapies, and 36 psychological therapies with pharmacological interventions. Financial, non-financial, and personal COI were disclosed in 22, 4 and 1 review, respectively. 2 of 86 own primary studies of review authors included in 34 reviews were disclosed by review authors. In 15 of the reviews, authors showed an allegiance effect to the evaluated psychological therapy that was never disclosed. Spin in review conclusions was found in 27 of 95 reviews. Reviews with a conclusion in favour of psychological therapies (vs pharmacological interventions) were at high risk for a spin in conclusions (OR=8.31 (1.41 to 49.05)). Spin was related in trend to the inclusion of own primary studies in the systematic review (OR=2.08 (CI 0.83 to 5.18) p=0.11) and researcher allegiance (OR=2.63 (0.84 to 8.16) p=0.16). Conclusions: Non-financial COI, especially the inclusion of own primary studies into reviews and researcher allegiance, are frequently seen in systematic reviews of psychological therapies and need more transparency and better management.
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In psychotherapy, allegiance to a particular approach due to personal training or prior research involvement may significantly influence reported outcomes.
“In psychotherapy, for instance, an allegiance to a particular ap proach, due to personal training or involvement in previous research efforts, may significantly influence reported outcomes of results [293][294][295][296] .”
From Ethical challenges in contemporary psychiatry: an overview and an appraisal of possible strategies and research needs (2024) · cites this paper as [293]
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- Authors
- Lieb, K., Osten-Sacken, J. V. D., Stoffers-Winterling, J., Reiss, N., & Barth, J.
- Affiliations
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Goethe University Frankfurt (DE)
- University of Zurich (CH)
- Corresponding author
- Lieb, Klaus
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2016-04
- Volume
- 6
- Issue
- 4
- Pages
- e010606
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4853969
- OpenAlex
- W2343875755
- Cited by
- 69
- References
- 24
- Citations by year
- 2026: 1 · 2025: 17 · 2024: 7 · 2023: 3 · 2022: 1 · 2021: 12 · 2020: 8 · 2019: 3 · 2018: 5 · 2017: 7 · 2016: 5
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmaceutical industry and healthcare
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Psychology Research and Bibliometrics
- Keywords
- conflicts of interest, conflict of interest disclosure, psychotherapy, anxiety disorders, depressive disorders, personality disorders, pharmacological interventions
- MeSH terms
- Anxiety Disorders, Depressive Disorder, Humans, Personality Disorders, Psychotherapy, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Conflict of Interest, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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