Psychological treatment of depression: Results of a series of meta-analyses
Abstract
BACKGROUND: In the past few decades, a considerable number of studies have examined the effects of psychotherapies for adult depression. AIM: We described the results of a series of meta-analyses examining what this large body of research has contributed to our knowledge of these treatments of depression. RESULTS: We found that different types of psychotherapy are efficacious in the treatment of adult depression, including cognitive behavior therapy, interpersonal psychotherapy, problem-solving therapy, non-directive supportive therapy and behavioral activation therapy. Differences between types of psychotherapy are small. The efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of pharmacotherapy, and that combined treatment is more effective than psychotherapy alone and pharmacotherapy alone. Psychotherapy is not only effective in depressed adults in general, but also in older adults, women with postpartum depression, patients with general medical disorders, in inpatients, in primary care patients, patients with chronic depression and in subthreshold depression. CONCLUSIONS: We found no evidence showing that psychotherapy is less efficacious in severe depression (with mean baseline Hamilton Depression Rating Scale scores up to 31, mean Beck Depression Inventory scores up to 35.85 and mean Beck Depression Inventory-II scores up to 36.50), but effects are smaller in chronic depression. We also found that the effects of psychotherapy are probably overestimated because of publication bias and the relatively low quality of many studies in the field.
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The efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of pharmacotherapy.
“Another meta-analysis study also concludes that the efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of pharmacotherapy, and that combined treatment is more effective than psychotherapy alone or pharmacotherapy alone [191].”
From Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy (2024) · cites this paper as [191]
Combined treatment is more effective than psychotherapy alone or pharmacotherapy alone.
“Another meta-analysis study also concludes that the efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of pharmacotherapy, and that combined treatment is more effective than psychotherapy alone or pharmacotherapy alone [191].”
From Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy (2024) · cites this paper as [191]
Internet-based interventions are effective in treating depression.
“The results obtained so far are consistent and promising, showing that Internet-based interventions are effective in treating depression.”
CBT has robust evidence of efficacy for depression.
“Studies have shown robust evidence of its efficacy [3, 11–13].”
Hundreds of controlled and comparative studies have examined the efficacy of psychological treatments for depression.
“Hundreds of controlled and comparative studies have examined the efficacy of psychological treatments for depression [3, 4].”
Evidence-based interventions for depression include CBT, BA, interpersonal therapy, and problem-solving therapy.
“Thus, we have evidence-based interventions for depression, including cognitive behavior therapy (CBT) [5, 6] and behavioral activation (BA) [7, 8], as well as interpersonal [3, 9] or problem-solving therapy [10].”
All psychotherapies are more or less equally effective in treating depression, and any small differences are not very stable.
“A recent review of a series of meta-analyses (Cuijpers et al. , 2011) demonstrated that all psychotherapies (e.g., CBT, psychodynamic therapy, interpersonal psychotherapy) are more or less equally effective in treating depression, and although there may be small differences, such differences are not very stable.”
From A meta-analysis of third wave mindfulness-based cognitive behavioral therapies for older people (2017) · cites this paper as Cuijpers et al. , 2011
When compared to effect sizes in recent meta-analyses, the overall effect size difference compared to control conditions is slightly lower than the 0.84 large effect size for reduction in anxiety symptoms across psychological treatments for GAD (Cuijpers et al., 2014), but higher than average effect sizes for psychological interventions for depression (0.53) (Cuijpers et al., 2011).
“When compared to the effect sizes found in recent meta-analyses of disorder-specific interventions, the overall effect size difference compared to control conditions is slightly lower than the 0.84 large effect size for reduction in anxiety symptoms across psychological treatments for GAD (Cuijpers et al., 2014), but higher than average effect sizes for psychological interventions for depression (”
From Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood (2015) · cites this paper as Cuijpers, Andersson, Donker, & Van Straten, 2011
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- Authors
- Cuijpers, P., Andersson, G., Donker, T., & van Straten, A.
- Affiliations
- Amsterdam Public Health (NL)
- Linköping University (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Cuijpers, Pim
- Venue
- Nordic Journal of Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2011-07-20
- Volume
- 65
- Issue
- 6
- Pages
- 354-364
- ISSN
- 0029-1455 (ISSN-L)
- 0803-9488
- 1502-4725
- OpenAlex
- W2001447430
- Cited by
- 335
- References
- 51
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 12 · 2023: 22 · 2022: 27 · 2021: 37 · 2020: 30 · 2019: 34 · 2018: 23 · 2017: 25 · 2016: 21 · 2015: 22 · 2014: 24 · 2013: 19 · 2012: 15
- FWCI
- 20.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nordic Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- depression, psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, problem-solving therapy, supportive therapy, behavioral activation, pharmacotherapy, combined psychotherapy and pharmacotherapy, chronic depression, postpartum depression, older adults, publication bias, treatment efficacy
- MeSH terms
- Adult, Combined Modality Therapy, Depression, Depressive Disorder, Female, Humans, Psychotherapy, Randomized Controlled Trials as Topic
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