The DOI matches its Crossref record; 272 of the 272 references it cites were found in a registry or an index; 67 of the 178 sources its claims cite were checked for support.
Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder
Open accessAbstract
Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) has revised its 2009 guidelines for the management of major depressive disorder (MDD) in adults by updating the evidence and recommendations. The target audiences for these 2016 guidelines are psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. "Psychological Treatments" is the second of six sections of the 2016 guidelines. Results: Evidence-informed responses were developed for 25 questions under 5 broad categories: 1) patient characteristics relevant to using psychological interventions; 2) therapist and health system characteristics associated with optimizing outcomes; 3) descriptions of major psychotherapies and their efficacy; 4) additional psychological interventions, such as peer interventions and computer- and technology-delivered interventions; and 5) combining and/or sequencing psychological and pharmacological interventions. Conclusions: First-line psychological treatment recommendations for acute MDD include cognitive-behavioural therapy (CBT), interpersonal therapy (IPT), and behavioural activation (BA). Second-line recommendations include computer-based and telephone-delivered psychotherapy. Where feasible, combining psychological treatment (CBT or IPT) with antidepressant treatment is recommended because combined treatment is superior to either treatment alone. First-line psychological treatments for maintenance include CBT and mindfulness-based cognitive therapy (MBCT). Patient preference, in combination with evidence-based treatments and clinician/system capacity, will yield the optimal treatment strategies for improving individual outcomes in MDD. © The Author(s) 2016.
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64 No full text of the sources · 32 Partly supported · 22 No basis given · 12 Own interpretation · 9 Supported · 7 Not checked yet · 6 Supported so far · 3 Couldn’t confirm · 2 Sources not found · 1 Mixed support · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“there is Level 2 Evidence for treatment of depression with co-occurring cardiovascular disease for CBT, interpersonal therapy (IPT), and problem-solving therapy (PST).25,[27][28][29]”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > Medical comorbidities.
What the sources say
- Not checked — no full text of the sourcecites [25] 25. Ramasubbu R, Taylor VH, Samaan Z, et al. The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and select comorbid medical conditions. Ann Clin Psychiatry. 2012;24:91-109. source
- Not checked — no full text of the sourcecites [27] 27. Dickens C, Cherrington A, Adeyemi I, et al. Characteristics of psychological interventions that improve depression in people with coronary heart disease: a systematic review and meta- regression. Psychosom Med. 2013;75:211-221. source
- Partly supportedcites [28] 28. Mavrides N, Nemeroff C. Treatment of depression in cardio- vascular disease. Depress Anxiety. 2013;30:328-341. sourceExperimental — accuracy not yet measured
The Psychotherapeutic Interventions section reports improved depression scores for a problem-solving-therapy intervention that could also include medication, and the Discussion reports a positive CBT trial. But the Discussion says psychotherapy trial results were mixed and IPT showed no additional benefit over usual care. The paper does not assign these therapies a “Level 2 Evidence” rating. Page numbers are unavailable in our copy. (LLM, conf=0.87)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“the magnitude of benefit for psychological treatment appears to increase with increasing severity, 17”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.2. Which Individuals with Depression Are Most Likely to Benefit from Psychological Treatment?
What the sources say
- Partly supportedcites [17] 17. Bower P, Kontopantelis E, Sutton A, et al. Influence of initial severity of depression on effectiveness of low intensity inter- ventions: meta-analysis of individual patient data. BMJ. 2013;346:f540. sourceExperimental — accuracy not yet measured
The section on whether baseline severity moderates effectiveness reports that more severely depressed patients had larger treatment effects. But the analysis concerns low-intensity interventions for depression, not psychological treatment generally; the increase was small and might not be clinically significant. (LLM, conf=0.85)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“there is evidence that psychological treatments are beneficial even for subthreshold depressive symptoms.18”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.2. Which Individuals with Depression Are Most Likely to Benefit from Psychological Treatment?
What the sources say
- Supportedcites [18] 18. Cuijpers P, Koole SL, van Dijke A, et al. Psychotherapy for subclinical depression: meta-analysis. Br J Psychiatry. 2014; 205:268-274. source
The Discussion reports a small-to-moderate, statistically significant effect of psychological treatments on subclinical depression. It cautions that the positive results were based on self-report measures and that study quality was often suboptimal, but this supports the citing sentence’s qualified statement that there is evidence of benefit. (LLM, conf=0.92)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In persistent depressive disorder (PDD), medication treatment or combination of medication with psychological treatment provides more benefit than psychological treatment alone.12,13”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.2. Which Individuals with Depression Are Most Likely to Benefit from Psychological Treatment?
What the sources say
- Not checked — no full text of the sourcecites [12] 12. Cuijpers P, Huibers M, Ebert DD, et al. How much psy- chotherapy is needed to treat depression? A metaregression analysis. J Affect Disord. 2013;149:1-13. source
- Partly supportedcites [13] 13. Kriston L, von Wolff A, Westphal A, et al. Efficacy and acceptability of acute treatments for persistent depressive dis- order: a network meta-analysis. Depress Anxiety. 2014;31: 621-630. sourceExperimental — accuracy not yet measured
The Efficacy and Acceptability of Psychotherapeutic and Combined Treatments section (page not provided) reports that medication was more effective than interpersonal psychotherapy (IPT) alone, and that IPT plus medication was more effective than medication alone at borderline significance. But it found no significant efficacy difference between medication and CBASP, with or without medication. The claim overgeneralizes these treatment-specific findings to psychological treatment alone across PDD. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Psychological treatments in general and cognitive-behavioural therapy (CBT) in particular appear to be equally effective for different subtypes of depression, including atypical depression, melancholic depression, and anxious depression.9,10”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.2. Which Individuals with Depression Are Most Likely to Benefit from Psychological Treatment?
What the sources say
- Could not verifycites [9] 9. Simon GE, Perlis RH. Personalized medicine for depression: can we match patients with treatments? Am J Psychiatry. 2010;167:1445-1455. sourceExperimental — accuracy not yet measured
The Selection of a Specific Psychotherapy section discusses whether clinical characteristics predict different responses to cognitive therapy and other psychotherapies, but does not compare effectiveness across atypical, melancholic, and anxious depression. The section on specific antidepressants discusses atypical symptoms and anxiety only in relation to medication response. Searches for these subtypes alongside psychotherapy and CBT found no passage supporting the cited claim; page numbers were not available in our copy. (LLM, conf=0.74)
- Partly supportedcites [10] 10. Driessen E, Hollon SD. Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators. Psy- chiatr Clin North Am. 2010;33:537-555. sourceExperimental — accuracy not yet measured
In “CBT for severe depression” (page unavailable), the paper reports that cognitive therapy was as efficacious as phenelzine for atypical depression. In “Illness characteristics” (page unavailable), it says there is little evidence that melancholic depression responds less well to CBT than to medication. It does not establish equal effectiveness across the named subtypes, address anxious depression, or make that subtype-wide claim for psychological treatments generally. (LLM, conf=0.86)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
Every source the paper cites for this claim was checked and supports it.
In the paper
“More women than men prefer psychological treatment over medication treatment.36”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.4. How Do Gender and Age Influence the Decision to Use Psychological Treatment?
What the sources say
- Supportedcites [36] 36. McHugh RK, Whitton SW, Peckham AD, et al. Patient pre- ference for psychological vs pharmacologic treatment of psy- chiatric disorders: a meta-analytic review. J Clin Psychiatry. 2013;74:595-602. source
The Discussion states that preference for psychotherapy was stronger among women. The Results (Subgroup Analysis) also report that samples with a greater proportion of women preferred psychological treatment at higher rates. (LLM, conf=0.91)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The collecting of patient feedback helps to track symptoms, experience of treatment, and functioning using validated scales (e.g., the Patient Health Questionnaire-9 [PHQ-9] 51 ) such that changes can be made if patients are not improving.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.5. What Are the Key Therapist Factors That Improve Clinical Outcomes?
What the sources say
- Supportedcites [51] 51. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16:606-613. source
The citation identifies the PHQ-9 as an example of a validated scale. The Discussion states that the study establishes its construct and criterion validity, while the Results link PHQ-9 depression-severity scores with functioning. The citation need not establish every aspect of the surrounding statement about patient feedback. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Meta-analyses that evaluated efficacy of group psychological therapy for depression concluded that it is more effective than treatment as usual.77,78”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.8. Does Group or Individual Format for Psychological Treatment Influence Outcome?
What the sources say
- Supportedcites [77] 77. Huntley AL, Araya R, Salisbury C. Group psychological therapies for depression in the community: systematic review and meta-analysis. Br J Psychiatry. 2012;200:184-190. source
The Results report a significant effect favouring group CBT over usual care immediately after treatment. The Main findings likewise conclude that group CBT provides an immediate benefit over usual care, while cautioning that the evidence is limited and often at risk of bias. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [78] 78. Okumura Y, Ichikura K. Efficacy and acceptability of group cognitive behavioral therapy for depression: a sys- tematic review and meta-analysis. J Affect Disord. 2014; 164:155-164. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“there is limited evidence of efficacy for acute MDD treatment.74”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Partly supportedcites [74] 74. Fonagy P, Rost F, Carlyle J, et al. Pragmatic randomized con- trolled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry. 2015;14:312-321. sourceExperimental — accuracy not yet measured
The paper's introductory discussion (indexed under Abstract; page not supplied) says evidence-gathering on longer-term psychoanalytic treatments is in its early stages, supporting the claim that evidence is limited. But the trial studies treatment-resistant depression and does not establish that evidence is limited specifically for acute MDD treatment. (LLM, conf=0.83)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“a single additional faceto-face study together with a new meta-analysis including many older, small studies elevate behavioural activation (BA) to first-line treatment.70,71”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Not checked — no full text of the sourcecites [70] 70. Carlbring P, Ha ¨gglund M, Luthstro ¨m A, et al. Internet-based behavioral activation and acceptance-based treatment for depression: a randomized controlled trial. J Affect Disord. 2013;148:331-337. source
- Supportedcites [71] 71. Moradveisi L, Huibers MJH, Renner F, et al. Behavioural acti- vation v. antidepressant medication for treating depression in Iran: randomised trial. Br J Psychiatry. 2013;202:204-211. source
This source is the face-to-face trial in the two-citation sentence: the Behavioural activation section describes 16 sessions over 12 weeks. The Discussion reports that behavioural activation was more effective than antidepressant medication in this trial and says it could be considered a first-choice treatment. The separate claim about a new meta-analysis is not attributed to this trial. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 7
- It may state two separate claims as one. 39
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“peer interventions are recommended as a second-line adjunctive treatment for MDD (Level 2 Evidence).”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.18. What Are Peer Interventions and Their Efficacy for Depression?
What the sources say
- Partly supportedcites [134] sourceExperimental — accuracy not yet measured
The Discussion and Conclusion report that peer support improves depressive symptoms compared with usual care and may be an effective component of depression care. They do not recommend it specifically as a second-line adjunctive treatment or assign it a “Level 2 Evidence” grade. The Results section also says trials studying peer support only as an add-on to depression care management were excluded. (LLM, conf=0.88)
- Disputedcites [135] 135. Fuhr DC, Salisbury TT, De Silva MJ, et al. Effectiveness of peer-delivered interventions for severe mental illness and depression on clinical and psychosocial outcomes: a systematic review and meta-analysis. Soc Psychiatry Psy- chiatr Epidemiol. 2014;49:1691-1702. sourceExperimental — accuracy not yet measured
The Results section, ‘Effect of peer-delivered interventions on depression’ (page unavailable), reports no effect on clinical outcomes or loneliness compared with usual care. The paper does not assign a Level 2 evidence grade or recommend peer interventions as a second-line adjunctive treatment for MDD; its reported depression findings run contrary to that recommendation. (LLM, conf=0.86)
Checked by a reasoning model — may be wrong.
- Partly supportedcites [136] 136. Valenstein M, Pfeiffer PN, Brandfon S, et al. Augmenting ongoing depression care with a mutual peer support interven- tion versus self-help materials alone: a randomized trial. Psy- chiatr Serv. 2016;67:236-239. sourceExperimental — accuracy not yet measured
The Methods describe testing peer support alongside ongoing depression treatment, so the paper supports its use as an adjunct in the trial. But the Results and Conclusions report no benefit over enhanced usual care; they do not recommend peer interventions as second-line treatment or assign a Level 2 evidence rating. The authors say other peer-support models might be more effective. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Rests on an assumption: Peer support can be beneficial either alone or as a complement to clinical care.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Psychological treatments benefit men and women to the same extent; psychological treatments are equally suitable for individuals of all ages, levels of education, and cultural and ethnic backgrounds.9”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.2. Which Individuals with Depression Are Most Likely to Benefit from Psychological Treatment?
What the sources say
- Partly supportedcites [9] 9. Simon GE, Perlis RH. Personalized medicine for depression: can we match patients with treatments? Am J Psychiatry. 2010;167:1445-1455. sourceExperimental — accuracy not yet measured
The Introduction says specific psychotherapies have success comparable to antidepressant medication as first-line treatment for moderate depression, supporting a general claim of benefit. It does not establish equal benefit for men and women or equal suitability across ages, education levels, and cultural or ethnic backgrounds; the sections on treatment selection instead discuss other patient characteristics. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“importantly, improved adherence to medical interventions as well as improvement in depression.32”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > Medical comorbidities.
What the sources say
- Supportedcites [32] 32. Sin NL, DiMatteo MR. Depression treatment enhances adher- ence to antiretroviral therapy: a meta-analysis. Ann Behav Med. 2014;47:259-269. source
The Discussion reports that depression treatments and mental health interventions improved adherence to antiretroviral therapy among people living with HIV/AIDS. It also states that these interventions improved depressive symptoms. The medical treatment assessed was specifically antiretroviral therapy. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Therapist experience, adherence, and ability to be responsive to individual patient differences are associated with better outcomes.54,55”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.5. What Are the Key Therapist Factors That Improve Clinical Outcomes?
What the sources say
- Could not verifycites [54] 54. Fournier JC, DeRubeis RJ, Amsterdam J, et al. Gains in employ- ment status following antidepressant medication or cognitive therapy for depression. Br J Psychiatry. 2015;206:332-338. sourceExperimental — accuracy not yet measured
The Methods (Acute Treatment; page unavailable) say therapist qualifications and adherence were characterized elsewhere, but do not link either to outcomes. The Discussion (page unavailable) raises differences in therapists’ techniques only as an untested explanation for site differences. Searches for therapist experience, adherence, and responsiveness to individual patients found no passage establishing the claimed association. (LLM, conf=0.77)
- Not checked — no full text of the sourcecites [55] 55. Johnsen TJ, Friborg O. The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: a meta- analysis. Psychol Bull. 2015;141:747-768. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
Every source the paper cites for this claim was checked and supports it.
In the paper
“although even less-trained therapists can have efficacy in treating depression and indeed may be the only source of treatment.56”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.5. What Are the Key Therapist Factors That Improve Clinical Outcomes?
What the sources say
- Supportedcites [56] 56. van Ginneken N, Tharyan P, Lewin S, et al. Non-specialist health worker interventions for the care of mental, neurologi- cal and substance-abuse disorders in low-and middle-income countries. Cochrane Database Syst Rev. 2013;11:CD009149. source
The Authors’ Conclusions (page unavailable) report that lay health worker–led psychological interventions may improve recovery from depression or anxiety. The Background and ‘How the intervention might work’ sections (pages unavailable) describe a shortage of specialists in low- and middle-income countries and say non-specialist workers may have little or no specialist support or referral options, supporting the qualified point that they may be the only available source of treatment in some settings. (LLM, conf=0.86)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Some meta-analytic comparisons between specific models of psychological treatment have shown no significant differences in efficacy, 57 with others showing modest differences.58”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Supportedcites [57] 57. Cuijpers P, Berking M, Andersson G, et al. A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Can J Psychiatry. 2013; 58:376-385. source
The citation is attached to the claim that some comparisons found no significant efficacy differences, not to the separate claim about modest differences. The Discussion (p. 10) says this meta-analysis found CBT no more or less effective than other psychotherapies, while noting that some comparisons included few studies. (LLM, conf=0.93)
- Supportedcites [58] 58. Linde K, Ru ¨cker G, Sigterman K, et al. Comparative effec- tiveness of psychological treatments for depressive disorders in primary care: network meta-analysis. BMC Fam Pract. 2015;16:103. source
The Results report no differences between nine treatment categories except for one comparison. The Discussion likewise says there were no differences between individual treatments with one exception, while noting that wide credible intervals could not rule out clinically relevant differences. Citation 57 supports the no-significant-differences clause; the modest-differences clause is attached to citation 58. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“results of the most recent large trial (N ¼ 491 in 3 conditions) are inconsistent with previous results and do not support the efficacy of CBASP.75”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Partly supportedcites [75] 75. Kocsis JH, Gelenberg AJ, Rothbaum BO, et al. Cognitive behavioral analysis system of psychotherapy and brief sup- portive psychotherapy for augmentation of antidepressant nonresponse in chronic depression: the REVAMP Trial. Arch Gen Psychiatry. 2009;66:1178-1188. sourceExperimental — accuracy not yet measured
The Results table lists 96 patients receiving medication alone, 195 receiving medication plus BSP, and 200 receiving medication plus CBASP—491 across three conditions. The Results discussion says adding CBASP did not significantly improve outcomes and that the findings contradicted predictions from previous studies. But the trial tested CBASP only as an addition to medication for chronically depressed patients who had not fully responded to initial medication; it does not establish a general lack of CBASP efficacy. (LLM, conf=0.88)
plainn = 491- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, group therapy was less effective than individual therapy at the end of treatment and had a higher dropout rate, although no differences were found at follow-up.77”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.8. Does Group or Individual Format for Psychological Treatment Influence Outcome?
What the sources say
- Partly supportedcites [77] 77. Huntley AL, Araya R, Salisbury C. Group psychological therapies for depression in the community: systematic review and meta-analysis. Br J Psychiatry. 2012;200:184-190. sourceExperimental — accuracy not yet measured
The “Group CBT v. individual CBT therapy” section reports better outcomes for individual CBT immediately after treatment and no evidence of a difference at short- or longer-term follow-up. It does not report a higher dropout rate for group therapy; the “Individual CBT v. group CBT” section instead notes that four of seven studies gave no dropout details. The comparison also concerns CBT specifically, rather than group and individual therapy generally. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“using a different definition of bona-fide therapy, supportive therapy was less effective than other types of therapy, with no differences between CBT, IPT, and psychodynamic psychotherapy (PDT).60”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Partly supportedcites [60] 60. Braun SR, Gregor B, Tran US. Comparing bona fide psy- chotherapies of depression in adults with two meta- analytical approaches. PLoS One. 2013;8:e68135. sourceExperimental — accuracy not yet measured
The Results (Type I Meta-Analyses; page unavailable) report no efficacy difference among CBT, IPT, and psychodynamic therapy, and lower efficacy for some supportive-therapy subtypes on specific post-treatment measures. The Abstract (Results; page unavailable) says there were no significant differences at follow-up, while the Discussion describes the supportive-therapy finding as small and tentative. The claim omits those limits and states the lower efficacy categorically. (LLM, conf=0.85)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“With several meta-analyses demonstrating efficacy 67,68 and a large, high-quality RCT (N ¼ 424) 69 demonstrating equal efficacy of MBCT to medication as maintenance treatment for recurrent MDD”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Supportedcites [67] 67. Galante J, Iribarren SJ, Pearce PF. Effects of mindfulness- based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. J Res Nurs. 2013;18:133-155. source
This source is one of the meta-analyses cited for MBCT efficacy, not the separately cited RCT (citation 69). Its Abstract (Results and Conclusion) reports reduced relapse after one year and concludes that MBCT is effective for patients with three or more previous episodes of major depression. (LLM, conf=0.91)
- Not checked — no full text of the sourcecites [68] 68. Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depres- sive disorder: a systematic review and meta-analysis. Clin Psychol Rev. 2011;31:1032-1040. source
- Partly supportedcites [69] 69. Kuyken W, Hayes R, Barrett B, et al. Effectiveness and cost- effectiveness of mindfulness-based cognitive therapy com- pared with maintenance antidepressant treatment in the pre- vention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. Lancet. 2015;386:63-73. sourceExperimental — accuracy not yet measured
The Results report that the trial recruited 424 patients, and the Discussion describes MBCT with support to taper antidepressants (MBCT-TS) as not superior to maintenance antidepressants over two years. The paper supports MBCT-TS as an alternative, but the trial did not establish equal efficacy; its finding of no superiority does not prove equivalence. The meta-analyses in the citing sentence have separate citations and are not judged here. (LLM, conf=0.85)
boosteddirectn = 424- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“An RCT of 469 primary care patients with depression with poor response to medication found CBT improved response and remission, 63 with sustained effects at 3-year follow-up.89”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.10. What Is Cognitive-Behavioural Therapy (CBT) and Its Efficacy in the Acute and Maintenance Phases of MDD Treatment?
What the sources say
- Not checked — no full text of the sourcecites [63] 63. Wiles N, Thomas L, Abel A, et al. Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: results of the CoBalT randomised controlled trial. Lancet. 2013;381: 375-384. source
- Supportedcites [89] 89. Wiles NJ, Thomas L, Turner N, et al. Long-term effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depres- sion in primary care: follow-up of the CoBalT randomised controlled trial. Lancet Psychiatry. 2016;3:137-144. source
The Results (p. 5) state that 469 participants were randomized, although long-term follow-up data were available for 59% of them. The Results (p. 6) report higher odds of response and remission with CBT than with usual care over 46 months, and the paper describes the follow-up period as 3–5 years (p. 3). (LLM, conf=0.93)
plaindirectn = 469- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, there is only weak evidence, and only after prolonged treatment, for efficacy of long-term PDT for acute treatment of MDD.74,109”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.13. What Are Short-Term Psychodynamic Psychotherapy (STPP) and Long-Term Psychodynamic Therapy (PDT) and Their Efficacy in the Acute and Maintenance Phases of MDD Treatment?
What the sources say
- Partly supportedcites [74] 74. Fonagy P, Rost F, Carlyle J, et al. Pragmatic randomized con- trolled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry. 2015;14:312-321. sourceExperimental — accuracy not yet measured
The Abstract says evidence for longer-term psychoanalytic treatment was at an early stage and suggests benefits particularly over longer follow-up. The Outcomes section reports no significant difference in partial remission at the end of treatment, with differences emerging during follow-up. However, this trial studied treatment-resistant depression, not acute treatment of MDD generally, so it does not support that broader setting. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [109] 109. Leichsenring F, Ablon S, Barber JP, et al. Developing a pro- totype for short-term psychodynamic (supportive-expressive) therapy: an empirical study with the psychotherapy process Q-set. Psychother Res. 2015;26:500-510. source
plainconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Since the first CBASP trial published in 2000, 114 5 CBASP studies have been published that provide only mixed results supporting CBASP.75,[115][116][117][118]”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.15. What Is the Overall Level of Efficacy for Cognitive-Behavioural Analysis System of Psychotherapy (CBASP) in the Acute and Maintenance Phases of MDD Treatment?
What the sources say
- Partly supportedcites [75] 75. Kocsis JH, Gelenberg AJ, Rothbaum BO, et al. Cognitive behavioral analysis system of psychotherapy and brief sup- portive psychotherapy for augmentation of antidepressant nonresponse in chronic depression: the REVAMP Trial. Arch Gen Psychiatry. 2009;66:1178-1188. sourceExperimental — accuracy not yet measured
The Results (Comment; page unavailable) say this trial found no added benefit from CBASP and that its findings contradicted previous studies, supporting the characterization of mixed results. The paper does not establish that exactly five CBASP studies had been published since the first trial in 2000. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [115] 115. Schatzberg AF, Rush AJ, Arnow BA, et al. Chronic depres- sion: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not. Arch Gen Psychiatry. 2005; 62:513-520. source
- Not checked — no full text of the sourcecites [116] 116. Schramm E, Zobel I, Dykierek P, et al. Cognitive behavioral analysis system of psychotherapy versus interpersonal psy- chotherapy for early-onset chronic depression: a randomized pilot study. J Affect Disord. 2011;129:109-116. source
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Clinical trials have supported its therapeutic value as an adjunct to treatment as usual 94,95 and its comparability to maintenance antidepressant medication 69,96 in this context.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.11. What Is Mindfulness-Based Cognitive Therapy (MBCT) and Its Efficacy in the Acute and Maintenance Phases of MDD Treatment?
What the sources say
- Supportedcites [94] 94. Bondolfi G, Jermann F, der Linden MV, et al. Depression relapse prophylaxis with mindfulness-based cognitive ther- apy: replication and extension in the Swiss health care system. J Affect Disord. 2010;122:224-231. source
The Introduction reports trials in which MBCT plus treatment as usual reduced relapse among patients with three or more previous depressive episodes. It also reports a separate trial finding comparable relapse rates for MBCT and maintenance antidepressant medication in that population. The medication comparison is reported by this paper, not tested in its own trial. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [95] 95. Godfrin KA, van Heeringen C. The effects of mindfulness- based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: a randomized controlled study. Behav Res Ther. 2010;48:738-746. source
- Supportedcites [69] 69. Kuyken W, Hayes R, Barrett B, et al. Effectiveness and cost- effectiveness of mindfulness-based cognitive therapy com- pared with maintenance antidepressant treatment in the pre- vention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. Lancet. 2015;386:63-73. source
The citation to this paper is attached to MBCT’s comparability with maintenance antidepressant medication, not the separate claim about adjunctive treatment. The Discussion reports that MBCT with support to taper or discontinue antidepressants was not superior to maintenance antidepressants over two years, while both groups had comparatively good outcomes. The Additional information section describes it as an alternative for preventing relapse or recurrence. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“An initial meta-analysis of peer support for depression was positive, but subsequent results are mixed.[134][135][136]”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.18. What Are Peer Interventions and Their Efficacy for Depression?
What the sources say
- Supportedcites [134] source
The Results report that peer support reduced depressive symptoms more than usual care, and the Discussion describes the pooled results as positive. This supports the initial meta-analysis portion of the sentence; the statement about subsequent results is associated with the later citations, not this 2011 paper. (LLM, conf=0.91)
- Partly supportedcites [135] 135. Fuhr DC, Salisbury TT, De Silva MJ, et al. Effectiveness of peer-delivered interventions for severe mental illness and depression on clinical and psychosocial outcomes: a systematic review and meta-analysis. Soc Psychiatry Psy- chiatr Epidemiol. 2014;49:1691-1702. sourceExperimental — accuracy not yet measured
The Results section, ‘Effect of peer-delivered interventions on depression’ (page not provided), reports no significant effect on clinical outcomes or loneliness, supporting the claim that later findings were not uniformly positive. The Introduction mentions earlier reviews but does not say an initial meta-analysis of peer support for depression was positive. (LLM, conf=0.84)
- Partly supportedcites [136] 136. Valenstein M, Pfeiffer PN, Brandfon S, et al. Augmenting ongoing depression care with a mutual peer support interven- tion versus self-help materials alone: a randomized trial. Psy- chiatr Serv. 2016;67:236-239. sourceExperimental — accuracy not yet measured
The paper’s discussion of prior evidence (page unavailable) says findings for peer-support interventions have been mixed, and its Results report no significant difference between its intervention and comparison groups. Its References list a meta-analysis of peer support for depression, but the available text does not say that the meta-analysis was positive. (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Both telephone-delivered and in-person PST were effective for treating MDD in low-income homebound older adults.139”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.19. What Is Problem-Solving Therapy (PST) and Its Efficacy?
What the sources say
- Partly supportedcites [139] 139. Choi NG, Marti CN, Bruce ML, et al. Six-month postinter- vention depression and disability outcomes of in-home tele- health problem-solving therapy for depressed, low-income homebound older adults. Depress Anxiety. 2014;31:653-661. sourceExperimental — accuracy not yet measured
The Discussion (page not available) reports that both tele-PST and in-person PST were effective for depression in low-income homebound older adults. But the Intervention section specifies that tele-PST used Skype video calls, not telephone delivery; telephone calls were a separate support-only comparison group. The Participants and Settings section defines eligibility by a depression-rating score, rather than an MDD diagnosis. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In 16 studies of various diagnoses, there was improvement in depressive symptoms and anxiety with ACT, although less than with CBT.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.16. What Is Acceptance and Commitment Therapy (ACT) and Its Efficacy?
What the sources say
- Not checked — no full text of the sourcecites [120] 120. Powers MB, Zum Vorde Sive Vording MB, Emmelkamp PMG. Acceptance and commitment therapy: a meta- analytic review. Psychother Psychosom. 2009;78:73-80. source
- Not matchedcites [121] 121. Ruiz FJ. Acceptance and commitment therapy versus tradi- tional cognitive behavioral therapy: a systematic review and meta-analysis of current empirical evidence. Int J Psychol Psychol Ther. 2012;12:333-357.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Partly supportedcites [122] 122. A-Tjak JGL, Davis ML, Morina N, et al. A meta-analysis of the efficacy of acceptance and commitment therapy for clini- cally relevant mental and physical health problems. Psy- chother Psychosom. 2015;84:30-36. sourceExperimental — accuracy not yet measured
The Effect Size as a Function of Target Problem section reports better anxiety/depression outcomes with ACT than with control conditions, supporting the improvement claim. But this paper analyzed 39 trials, not 16; its Discussion identifies 16 as the number in a separate meta-analysis by Ruiz. The Discussion also reports no significant difference between ACT and established treatments such as CBT, with effect sizes appearing slightly larger for ACT—not less improvement than with CBT. Page numbers were not available in our copy. (LLM, conf=0.90)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“The broader application of such technologies to psychiatry has been extensively reviewed and found to be acceptable and generally equivalent to face-to-face care for many psychiatric conditions. 155,,156”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.22. How Effective Is Remote Interactive Psychological Treatment for Depression (Phone, Video, Internet) Compared to Face-to-Face Therapy?
What the sources say
- Supportedcites [155] 155. Gajaria A, Conn DK, Madan R. Telepsychiatry: effectiveness and feasibility. Smart Homecare Technol TeleHealth. 2015; 2015:59-67. source
The Treatment using telepsychiatry section reports a review of 39 outcome studies finding videoconferencing appears as effective as in-person care on most measures, including satisfaction and clinical outcomes. The Abstract describes telepsychiatry as generally well accepted and effective across multiple age groups and settings. Page numbers were not provided in our copy. (LLM, conf=0.91)
- Supportedcites [156] 156. Chakrabarti S. Usefulness of telepsychiatry: a critical evalua- tion of videoconferencing-based approaches. World J Psy- chiatry. 2015;5:286-304. source
The Clinical outcomes section concludes that the bulk of the evidence finds videoconferencing-based telepsychiatry no less effective than face-to-face treatment, while acknowledging limitations in the studies. The discussion on p. 293 reports high patient satisfaction and describes videoconferencing psychotherapy as useful across different disorders and patient populations. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Another large primary care trial compared the effects of group MBCT and maintenance antidepressant therapy on time to relapse; while there were no significant differences between the 2 conditions, the risk of relapse was greater in those who had prematurely discontinued antidepressant treatment.69”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.25. Is Sequential Treatment Superior to Monotherapy?
What the sources say
- Partly supportedcites [69] 69. Kuyken W, Hayes R, Barrett B, et al. Effectiveness and cost- effectiveness of mindfulness-based cognitive therapy com- pared with maintenance antidepressant treatment in the pre- vention of depressive relapse or recurrence (PREVENT): a randomised controlled trial. Lancet. 2015;386:63-73. sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“CBT remains the most established evidence-based, first-line treatment for depression, both acute and maintenance.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A key limitation of the STPP literature is the conflation of different models of psychodynamic therapy (PDT) into the broad term STPP, whereby no single model has a replicated large RCT with positive findings for MDD, unlike CBT and IPT.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“very few bibliotherapy trials have been published since 2009.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.20. What Is Bibliotherapy and What Is Its Efficacy?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“PST has been tested most extensively in primary care settings in individuals with a variety of depressive symptoms spanning subclinical depression, adjustment disorders, and MDD, with clear efficacy in reducing depressive symptoms.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.19. What Is Problem-Solving Therapy (PST) and Its Efficacy?
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Although the meta-analysis aimed to examine the effect of any type of psychological treatment, the evidence was limited to CBT and MBCT.161”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.25. Is Sequential Treatment Superior to Monotherapy?
What the sources say
- Not checked — no full text of the sourcecites [161] 161. Guidi J, Fava GA, Fava M, et al. Efficacy of the sequential integration of psychotherapy and pharmacotherapy in major depressive disorder: a preliminary meta-analysis. Psychol Med. 2011;41:321-331. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“recruitment of individuals in standard MDD RCTs often excludes people with current suicidality, substance use, and other comorbidities.5 This limits the generalizability of these studies.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > Methods
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Zimmerman M, Mattia JI, Posternak MA. Are subjects in pharmacological treatment trials of depression representative of patients in routine clinical practice? Am J Psychiatry. 2002;159:469-473. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a large individual-level meta-analysis confirmed that men and women derive similar benefits from CBT and from antidepressants.11”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.2. Which Individuals with Depression Are Most Likely to Benefit from Psychological Treatment?
What the sources say
- Not checked — no full text of the sourcecites [11] 11. Cuijpers P, Weitz E, Twisk J, et al. Gender as predictor and moderator of outcome in cognitive behavior therapy and pharmacotherapy for adult depression: an ''individual patient data'' meta-analysis. Depress Anxiety. 2014;31: 941-951. source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“For ADHD, CBT can improve both depressive and ADHD symptoms.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.3. How Do Co-occurring Psychiatric and Medical Conditions Affect the Efficacy of Psychological Treatments?
What the sources say
- Not checked — no full text of the sourcecites [22] 22. Bond DJ, Hadjipavlou G, Lam RW, et al. The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid attention- deficit/hyperactivity disorder. Ann Clin Psychiatry. 2012; 24:23-37. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“concluded that the best outcomes are likely to come from the concurrent use of evidence-based therapy relationships, not just evidence-based treatments.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.5. What Are the Key Therapist Factors That Improve Clinical Outcomes?
What the sources say
- Not matchedcites [45] 45. Norcross JC.Psychotherapy relationships that work: evidence-based responsiveness. 2nd ed. New York (NY): Oxford University Press; 2011.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Three evidence-based common factors found to predict positive outcomes are establishing a strong therapeutic alliance, using empathy, and collecting client feedback (Table 4).[46][47][48][49]”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.5. What Are the Key Therapist Factors That Improve Clinical Outcomes?
What the sources say
- Not checked — no full text of the sourcecites [46] 46. Norcross JC, Lambert MJ. Psychotherapy relationships that work II. Psychotherapy. 2011;48:4-8. source
- Not checked — no full text of the sourcecites [47] 47. Norcross JC, Wampold BE. Evidence-based therapy relation- ships: research conclusions and clinical practices. Psychother- apy. 2011;48:98-102. source
- Not checked — no full text of the sourcecites [48] 48. Elliott R, Bohart AC, Watson JC, et al. Empathy. Psychother- apy (Chic). 2011;48:43-49. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“many pregnant women prefer psychological treatment and report fear of potential adverse effects of antidepressants on the developing fetus or on their newborn via lactation, general worries about a negative outcome, and fears of dependency as well as balancing concerns about their own health or the fetus.41,42”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.4. How Do Gender and Age Influence the Decision to Use Psychological Treatment?
What the sources say
- Not checked — no full text of the sourcecites [41] 41. Battle CL, Salisbury AL, Schofield CA, et al. Perinatal anti- depressant use: understanding women's preferences and con- cerns. J Psychiatr Pract. 2013;19:443-453. source
- Not checked — no full text of the sourcecites [42] 42. Walton GD, Ross LE, Stewart DE, et al. Decisional con- flict among women considering antidepressant medication use in pregnancy. Arch Womens Ment Health. 2014;17: 493-501. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“When only bona-fide therapies (defined as delivered by trained therapists, based on psychological principles, and designed to be a viable treatment) were considered, there were no differences between CBT and IPT, but CBT was more effective than other psychotherapies considered as a group 59”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Not checked — no full text of the sourcecites [59] 59. Tolin DF. Is cognitive-behavioral therapy more effective than other therapies? A meta-analytic review. Clin Psychol Rev. 2010;30:710-720. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The evidence base for STPP has expanded with recent studies, including comparisons with CBT 72 and antidepressant medication 73 and a recently updated meta-analysis.61”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.7. How Do Psychological Treatments for MDD Compare in Efficacy?
What the sources say
- Not checked — no full text of the sourcecites [72] 72. Driessen E, Van HL, Don FJ, et al. The efficacy of cognitive- behavioral therapy and psychodynamic therapy in the outpa- tient treatment of major depression: a randomized clinical trial. Am J Psychiatry. 2013;170:1041-1050. source
- Not checked — no full text of the sourcecites [73] 73. Barber JP, Barrett MS, Gallop R, et al. Short-term dynamic psychotherapy versus pharmacotherapy for major depressive disorder: a randomized, placebo-controlled trial. J Clin Psy- chiatry. 2012;73:66-73. source
- Not checked — no full text of the sourcecites [61] 61. Driessen E, Hegelmaier LM, Abbass AA, et al. The efficacy of short-term psychodynamic psychotherapy for depression: a meta-analysis update. Clin Psychol Rev. 2015;42:1-15. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“given the gap between needed and available psychological treatments, group psychotherapy could improve access to treatment.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.8. Does Group or Individual Format for Psychological Treatment Influence Outcome?
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: There is a gap between needed and available psychological treatments.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Studies comparing 8 versus 16 or more sessions are rare but suggestive of similar effectiveness.[84][85][86]”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.9. How Many Sessions of Psychological Treatment Are Required to Be Effective?
What the sources say
- Not checked — no full text of the sourcecites [84] 84. Dekker J, Molenaar PJ, Kool S, et al. Dose-effect relations in time-limited combined psycho-pharmacological treatment for depression. Psychol Med. 2005;35:47-58. source
- Not checked — no full text of the sourcecites [85] 85. Molenaar PJ, Boom Y, Peen J, et al. Is there a dose-effect relationship between the number of psychotherapy sessions and improvement of social functioning? Br J Clin Psychol. 2011;50:268-282. source
- Not checked — no full text of the sourcecites [86] 86. Dimidjian S, Hollon SD, Dobson KS, et al. Randomized trial of behavioral activation, cognitive therapy, and anti- depressant medication in the acute treatment of adults with major depression. J Consult Clin Psychol. 2006; 74:658-670. source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A meta-analysis of 10 trials demonstrated a reduction in the risk of relapse by 21% in the first year and by 28% in the first 2 years.90”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.10. What Is Cognitive-Behavioural Therapy (CBT) and Its Efficacy in the Acute and Maintenance Phases of MDD Treatment?
What the sources say
- Not checked — no full text of the sourcecites [90] 90. Clarke K, Mayo-Wilson E, Kenny J, et al. Can non- pharmacological interventions prevent relapse in adults who have recovered from depression? A systematic review and meta-analysis of randomised controlled trials. Clin Psychol Rev. 2015;39:58-70. source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is insufficient evidence to recommend STPP or PDT as a maintenance treatment for MDD.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.13. What Are Short-Term Psychodynamic Psychotherapy (STPP) and Long-Term Psychodynamic Therapy (PDT) and Their Efficacy in the Acute and Maintenance Phases of MDD Treatment?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“CBASP was developed specifically for the treatment of chronic depression.113”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.15. What Is the Overall Level of Efficacy for Cognitive-Behavioural Analysis System of Psychotherapy (CBASP) in the Acute and Maintenance Phases of MDD Treatment?
What the sources say
- Not checked — no full text of the sourcecites [113] 113. McCullough JP. Treatment for chronic depression using cog- nitive behavioral analysis system of psychotherapy (CBASP). J Clin Psychol. 2003;59:833-846. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Two separate meta-analyses found that the use of PST as an acute treatment for late life depression resulted in a significant reduction of depressive symptoms as well as disability in comparison to control treatments.138,140”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.19. What Is Problem-Solving Therapy (PST) and Its Efficacy?
What the sources say
- Not checked — no full text of the sourcecites [138] 138. Bell AC, D'Zurilla TJ. Problem-solving therapy for depres- sion: a meta-analysis. Clin Psychol Rev. 2009;29:348-353. source
- Not checked — no full text of the sourcecites [140] 140. Kirkham JG, Choi N, Seitz DP. Meta-analysis of problem solving therapy for the treatment of major depressive disorder in older adults. Int J Geriatr Psychiatry. 2015;31:526-535. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The rationale for BA is that depression is caused and maintained by escape and avoidance of aversive emotions and stimuli that become self-reinforced and also prevents positive reinforcement of nondepressive behaviour, consequently causing longstanding patterns of inertia, avoidance, and social withdrawal.123”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.17. What Is Behavioural Activation (BA) for Depression and Its Efficacy?
What the sources say
- Not checked — no full text of the sourcecites [123] 123. Ferster CB. A functional analysis of depression. Am Psychol. 1973;28:857-870. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“One meta-analysis (34 studies, N > 2000 patients with depressive symptoms, but not necessarily MDD) 127 found similar large effect sizes for BA and CBT compared to control conditions, as well as a similar effect to CBT.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.17. What Is Behavioural Activation (BA) for Depression and Its Efficacy?
What the sources say
- Not checked — no full text of the sourcecites [127] 127. Mazzucchelli T, Kane R, Rees C. Behavioral activation treat- ments for depression in adults: a meta-analysis and review. Clin Psychol Sci Pract. 2009;16:383-411. source
plainn = 2,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PST is recommended as a second-line acute treatment in primary care and geriatric depression (Level 2 Evidence)”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.19. What Is Problem-Solving Therapy (PST) and Its Efficacy?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Collectively, telephone-delivered CBT has Level 1 Evidence, while other therapies have Level 2 Evidence”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.22. How Effective Is Remote Interactive Psychological Treatment for Depression (Phone, Video, Internet) Compared to Face-to-Face Therapy?
plainn = 600- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In one of the first large trials (600 patients starting antidepressants in primary care offices), both 8-session CBT and disease management by phone improved clinical efficacy and satisfaction, compared to medication alone.79”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.22. How Effective Is Remote Interactive Psychological Treatment for Depression (Phone, Video, Internet) Compared to Face-to-Face Therapy?
What the sources say
- Not checked — no full text of the sourcecites [79] 79. Simon GE, Ludman EJ, Tutty S, et al. Telephone psychother- apy and telephone care management for primary care patients starting antidepressant treatment: a randomized controlled trial. JAMA. 2004;292:935-942. source
plaindirectn = 600- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a large pragmatic trial found that a course of up to 18 sessions of face-to-face individual CBT significantly reduced depressive symptoms and increased the likelihood of therapeutic response to antidepressants in treatment-resistant depression.63”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.25. Is Sequential Treatment Superior to Monotherapy?
What the sources say
- Not checked — no full text of the sourcecites [63] 63. Wiles N, Thomas L, Abel A, et al. Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: results of the CoBalT randomised controlled trial. Lancet. 2013;381: 375-384. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“When the Internet therapy is guided by a clinician, both adherence and efficacy are much more substantial.88”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.21. How Effective Is Internet-and Computer-Delivered Therapy for Depression?
What the sources say
- Not checked — no full text of the sourcecites [88] 88. Cuijpers P. Psychotherapies for adult depression: recent developments. Curr Opin Psychiatry. 2015;28:24-29. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Older patients with depression are more vulnerable to medication side effects and drug interactions because many may already be taking multiple medications for comorbid medical disorders.
“older patients with depression are more vulnerable to medication side effects and drug interactions, as many may already be taking multiple medications for comorbid medical disorders.”
The paper relies on this without support.
The evidence for psychological therapies for depression is based on studies with highly competent therapists.
“Most importantly, the evidence for psychological therapies for depression is based on studies with highly competent therapists”
The paper relies on this without support.
All high-quality evidence in psychotherapy research is based on studies where extensively trained therapists receive regular supervision and adhere to principles of the given therapeutic model with high fidelity.
“All high-quality evidence in psychotherapy research is based on studies where extensively trained therapists receive regular supervision and adhere to principles of the given therapeutic model with high fidelity.”
The paper relies on this without support.
Comparisons of different psychological treatments are fewer in number and quality, and are complicated by methodological challenges including lack of blinding and allegiance to a particular model.
“Comparisons of different psychological treatments are fewer in number and quality, as well as complicated by methodological challenges, including lack of blinding and the effects of allegiance to a particular model.”
The paper relies on this without support.
There is a gap between needed and available psychological treatments.
“given the gap between needed and available psychological treatments”
The paper relies on this without support.
The core of psychotherapy remains unchanged when delivered in a group format.
“the core of the psychotherapy remains unchanged, so group interventions are not evaluated in these guidelines as a separate ''group therapy.''”
The paper relies on this without support.
Context-specific therapies do not generalize to the average person with depression.
“context-specific therapies (such as marital therapy for MDD coinciding with a severe marital dispute) are not evaluated, since such therapies do not generalize to the average person with depression.”
The paper relies on this without support.
MI has been used in conjunction with CBT, IPT, or medications to improve treatment engagement or adherence and for treatment of depression and comorbid substance misuse.
“it has been used in conjunction with CBT, IPT, or medications to improve treatment engagement or adherence and for treatment of depression and comorbid substance misuse.”
The paper relies on this without support.
Peer support can be beneficial either alone or as a complement to clinical care.
“Peer support can be beneficial either alone or as a complement to clinical care.”
The paper relies on this without support.
Bibliotherapy has practical utility due to ease of use and low cost.
“bibliotherapy has practical utility due to ease of use and low cost”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“As such, MBCT is included in the clinical guidelines as a recommended option for relapse prevention in a number of different countries, including the UK, Netherlands, Canada, Australia and New Zealand (Malhi et al. 2015; NICE 2009; Parikh et al. 2016), and has been endorsed by the American Psychiatric Association (Lu 2015).”
From The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services (2020) · cites this paper as Parikh et al. 2016
In the citing paper
“Indeed, individuals with inflammatory and metabolic comorbidities are at greater risks of mood disorders and cognitive dysfunction.13,14”
From Cognitive Impairment in Major Depressive Disorder (2019) · cites this paper as [14]
In the citing paper
“Moreover, evidence from a recent meta-analysis showed that reductions in cognitive function are predictive of poorer functional and metabolic outcomes.14”
From Cognitive Impairment in Major Depressive Disorder (2019) · cites this paper as [14]
In the citing paper
“CBT is the first-line psychological treatment recommended by the guidelines of depression, anxiety, and PTSD (ie, Canadian Network for Mood and Anxiety Treatments and National Institute of Health and Care Excellence guideline [49,50].”
From The Efficacy of Computerized Cognitive Behavioral Therapy for Depressive and Anxiety Symptoms in Patients With COVID-19: Randomized Controlled Trial (2021) · cites this paper as [49]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > 2.13. What Are Short-Term Psychodynamic Psychotherapy (STPP) and Long-Term Psychodynamic Therapy (PDT) and Their Efficacy in the Acute and Maintenance Phases of MDD Treatment?
“There is insufficient evidence to recommend STPP or PDT as a maintenance treatment for MDD.”
§ Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments > Disclosures
“| Long-term psychodynamic | Third line | Third line (Level 3) | | psychotherapy (PDT) | (Level 3) | |”
Cited works that were retracted
Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.
A note, not an issue: for example, a cited work that was retracted only after this paper was published, which its authors could not have known.
In the paper
“10.1001/jamapsychiatry.2014.1054”
Cited work 10.1001/jamapsychiatry.2014.1054 · retraction date not known · this paper published 2016-08-11
Citations
Cites
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Pharmacotherapy, Somatic Therapies, and Psychotherapy in Late Life
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Trastornos depresivos y ansiosos en población con discapacidad intelectual
de Antioquia, U., Escamilla-Soto, M. C., Montoya-Rojas, Y. A., de Antioquia, U., Quintero-Cadavid, C. P., de Antioquia, U., Valencia, J. G., & de Antioquia, U. (2024) · IATREIA · doi:10.17533/udea.iatreia.269
Swainson, J. (2024) · Canadian Primary Care Today · doi:10.58931/cpct.2024.2123
Safe Deprescribing of Antidepressants
(2024) · Wiley eBooks · doi:10.1002/9781394291052.mdg002
Nixon, E., Patel, S., Patel, P., Roe, J., Nixon, N. L., Sweeney, T., Bernard, P., Strauss, C., Craven, M. P., Malins, S., et al. (2025) · JMIR Research Protocols · doi:10.2196/67695
Computational Neuropharmacology in Psychiatry
Gholap, A. D., Khuspe, P. R., Bharati, D. K., Pardeshi, S. R., Ahmad, M. D., Hossain, A. B. M. S., Prajapati, B. G., & Faiyazuddin, M. (2025) · Wiley eBooks · doi:10.1002/9781394242474.ch7
Yisma, E., Muyambi, K., Othman, S. M. E., Walsh, S., Bressington, D. T., Steen, M., Gray, R. J., Fereday, J. A., Lassi, Z. S., & Jones, M. (2025) · medRxiv · doi:10.1101/2025.07.09.25331226
No-pharmacological treatments for mood disorders
Vázquez, G. H. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-33580-8.00003-9
Lifestyle interventions for treatment-resistant depression
Toups, M. S. P. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-824067-0.00038-4
Zhang, M., Xu, R., Wang, J., Wu, C., Ren, H., Zhang, Z., & Li, J. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1587179 · Cited by 1
Chen, L., Thomas, E., & Cerins, A. (2025) · Handbook of behavioral neuroscience · doi:10.1016/b978-0-443-26602-7.00030-0
Vigo, D., Kazdin, A. E., Sampson, N. A., Hwang, I. H., Alonso, J., Andrade, L. H., Ayinde, O. O., Borges, G., Bruffaerts, R., Bunting, B., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20154227
Hibbert, P. D., Molloy, C. J., Cameron, I. D., Gray, L., Reed, R. L., Wiles, L., Westbrook, J., Arnolda, G., Bilton, R. L., Ash, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25045570
Hibbert, P. D., Molloy, C. J., Cameron, I. D., Gray, L., Reed, R. L., Wiles, L., Westbrook, J., Arnolda, G., Bilton, R. L., Ash, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26667688
Hibbert, P. D., Molloy, C. J., Cameron, I. D., Gray, L., Reed, R. L., Wiles, L., Westbrook, J., Arnolda, G., Bilton, R. L., Ash, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26667691
Hibbert, P. D., Molloy, C. J., Cameron, I. D., Gray, L., Reed, R. L., Wiles, L., Westbrook, J., Arnolda, G., Bilton, R. L., Ash, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26667697
Hibbert, P. D., Molloy, C. J., Cameron, I. D., Gray, L., Reed, R. L., Wiles, L., Westbrook, J., Arnolda, G., Bilton, R. L., Ash, R., et al. (2024) · Figshare · doi:10.6084/m9.figshare.25045615
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Top 50 Cited Articles on the Treatment of Major Depressive Disorder
Albesher, A. A., Muflehi, N. A., Hakami, Y. A., Barnawi, J. A., Softah, R. E., Ghalib, L. H. A., Bukhari, M., Almotiri, R. A. M., Algethami, M. S., Mahboob, S. W., et al. (2026) · Cureus · doi:10.7759/cureus.107337
“The CANMAT guidelines remain among the most influential frameworks guiding evidence-based treatment of MDD [19,25,27,37,38,43].”
Morasse-Bégis, M., Trottier-Duclos, F., & Ngô, T.-L. (2026) · L Encéphale · doi:10.1016/j.encep.2026.02.017
Introduction to Disability Care in Major Depressive Disorder
Kumar, A., Israr, J., & Alam, S. (2026) · SpringerBriefs in modern perspectives on disability research. · doi:10.1007/978-981-95-8955-5_1
Mindfulness-Based Intervention for Depression
Yun, J.-A. (2026) · Springer eBooks · doi:10.1007/978-981-95-7147-5_17
Polycystic ovary syndrome: from hormonal imbalance to psychological problems
Романченко, А. А., & Sulima, A. N. (2026) · Сибирский научный медицинский журнал · doi:10.18699/ssmj20260404
Weitere wissenschaftlich fundierte Psychotherapiemethoden und -verfahren
Rief, W., Schramm, E., & Strauss, B. M. (2026) · Elsevier eBooks · doi:10.1016/b978-3-437-21352-6.00034-1
Metadata
- Authors
- Parikh, S. V., Quilty, L. C., Ravitz, P., Rosenbluth, M., Pavlova, B., Grigoriadis, S., Velyvis, V., Kennedy, S. H., Lam, R. W., MacQueen, G. M., Milev, R. V., Ravindran, A. V., Uher, R., & the CANMAT Depression Work Group
- Affiliations
- University of Toronto (CA)
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
- CBT Associates, Toronto, Ontario
- University of British Columbia (CA)
- University of Calgary (CA)
- Queen's University (CA)
- Dalhousie University (CA)
- ORCID
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2016-08-11
- Volume
- 61
- Issue
- 9
- Pages
- 524-539
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- PMC
- PMC4994791
- OpenAlex
- W2485472464
- Cited by
- 562
- References
- 264
- Citations by year
- 2026: 15 · 2025: 18 · 2024: 54 · 2023: 45 · 2022: 77 · 2021: 82 · 2020: 101 · 2019: 73 · 2018: 49 · 2017: 39 · 2016: 9
- FWCI
- 6.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- Sunovion
- Valeant Pharmaceuticals International
- Canadian Network for Mood and Anxiety Treatments
- Queen's University
- Grand Challenges Canada
- Ministero dello Sviluppo Economico
- Vancouver Coastal Health Research Institute
- H. Lundbeck A/S
- St. Jude Medical
- Allergan
- University Health Network Foundation
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Keywords
- major depressive disorder, neurostimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, electroconvulsive therapy, magnetic seizure therapy, vagus nerve stimulation, deep brain stimulation, treatment-resistant depression, antidepressant-refractory depression, CANMAT guidelines
- MeSH terms
- Canada, Major Depressive Disorder, Humans, Psychotherapy, Societies, Medical, Practice Guidelines as Topic, Evidence-Based Medicine
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.
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Statistics and arithmetic are recomputed, not judged.
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