Effectiveness of psychological treatments for depressive disorders in primary care: systematic review and meta-analysis.
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PURPOSE: We performed a systematic review of the currently available evidence on whether psychological treatments are effective for treating depressed primary care patients in comparison with usual care or placebo, taking the type of therapy and its delivery mode into account. METHODS: Randomized controlled trials comparing a psychological treatment with a usual care or a placebo control in adult, depressed, primary care patients were identified by searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO up to December 2013. At least 2 reviewers extracted information from included studies and assessed the risk of bias. Random effects meta-analyses were performed using posttreatment depression scores as outcome. RESULTS: A total of 30 studies with 5,159 patients met the inclusion criteria. Compared with control, the effect (standardized mean difference) at completion of treatment was -0.30 (95% CI, -0.48 to -0.13) for face-to-face cognitive behavioral therapy (CBT), -0.14 (-0.40 to 0.12) for face-to-face problem-solving therapy, -0.24 (-0.47 to -0.02) for face-to-face interpersonal psychotherapy, -0.28 (-0.44 to -0.12) for other face-to-face psychological interventions, -0.43 (-0.62 to -0.24) for remote therapist-led CBT, -0.56 (-1.57 to 0.45) for remote therapist-led problem-solving therapy, -0.40 (-0.69 to -0.11) for guided self-help CBT, and -0.27 (-0.44 to -0.10) for no or minimal contact CBT. CONCLUSIONS: There is evidence that psychological treatments are effective in depressed primary care patients. For CBT approaches, substantial evidence suggests that interventions that are less resource intensive might have effects similar to more intense treatments.
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Three reviews found that web-based CBT with remote monitoring and remote therapist support was as effective as usual care in reducing symptoms of depression.
“Similarly, three other reviews found web-based CBT with remote monitoring, and remote therapist support was as effective as usual care in reducing symptoms of depression [41–43].”
From Telemedicine in the OECD: An umbrella review of clinical and cost-effectiveness, patient experience and implementation (2020) · cites this paper as [43]
The Efficacy / Effectiveness section reports that remote therapist-led CBT reduced depressive symptoms more than usual care, not merely as effectively (pooled standardized mean difference −0.43, 95% CI −0.62 to −0.24). The Study Selection section also identifies only one of its three remote therapist-led CBT trials as online; the other two used telephone CBT. Page numbers are unavailable in our copy. (LLM, conf=0.88)
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- Authors
- Linde, K., Sigterman, K., Kriston, L., Rucker, G., Jamil, S., Meissner, K., & Schneider, A.
- Affiliations
- Technical University of Munich (DE)
- University Medical Center Hamburg-Eppendorf (DE)
- Institut für Medizinische Psychologie (DE)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2015-01-01
- Volume
- 13
- Issue
- 1
- Pages
- 56-68
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC4291267
- OpenAlex
- W2210769035
- Cited by
- 196
- References
- 47
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 5 · 2023: 12 · 2022: 15 · 2021: 29 · 2020: 16 · 2019: 30 · 2018: 20 · 2017: 25 · 2016: 14 · 2015: 18
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, psychological intervention, primary care, cognitive behavioral therapy, problem-solving therapy, interpersonal psychotherapy, remote therapy, guided self-help, usual care, treatment effectiveness, resource intensity
- MeSH terms
- Depressive Disorder, Humans, Primary Health Care, Psychotherapy, Cognitive Behavioral Therapy, Treatment Outcome, Telemedicine
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