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Are Psychological and Pharmacologic Interventions Equally Effective in the Treatment of Adult Depressive Disorders?: A Meta-Analysis of Comparative Studies
Abstract
OBJECTIVE: A large number of studies suggest that both psychological and pharmacologic therapies are effective in the treatment of mild-to-moderate depressive disorders. Whether both types of intervention are equally effective has not been established definitively. DATA SOURCES: A database was developed through a comprehensive literature search (from 1966 to May 2007) in which 6947 abstracts in PubMed (1244 abstracts), PsycINFO (1736), EMBASE (1911), and the Cochrane Central Register of Controlled Trials (2056) were examined. Abstracts were identified by combining terms indicative of psychological treatment and depression (both MeSH terms and text words). For this database, the primary studies from 22 meta-analyses of psychological treatment for depression were also collected. STUDY SELECTION: For the current study, the abstracts of 832 studies were examined. DATA EXTRACTION: Thirty randomized trials were included in a meta-analysis that compared the effects of a psychological treatment for 3178 adults with a diagnosed depressive disorder (major depressive disorder, dysthymia, minor depressive disorder) with the effects of a pharmacologic treatment. DATA SYNTHESIS: In studies of patients with dysthymia, pharmacotherapy was significantly more effective than psychotherapy (d = -0.28, 95% CI = -0.47 to -0.10). In patients with major depressive disorder, treatments with selective serotonin reuptake inhibitors (SSRIs) were significantly more effective than psychological treatments, while treatment with other antidepressants did not differ significantly. Subgroup and metaregression analyses did not show that pretest severity of depressive symptoms was associated with differential effects of psychological and pharmacologic treatments of major depressive disorder. Dropout rates were smaller in psychological interventions compared with pharmacologic treatments (odds ratio = 0.66, 95% CI = 0.47 to 0.92). CONCLUSIONS: Pharmacologic treatments may be more effective than psychological interventions in the treatment of dysthymia. Pharmacologic treatment with SSRIs may also be more effective in the treatment of major depressive disorder, although these differences are small and probably have little meaning from a clinical point of view. We can conclude that both psychological and pharmacologic therapies are effective in the treatment of depressive disorders and that each has its own merits.
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“In the short-term treatment of depression, psychological and pharmacological therapies have similar efficacy [171].”
From Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy (2024) · cites this paper as [171]
In the citing paper
“Drop-out rates are suggested to be lower in psychological therapy as compared to pharmacological therapy [171].”
From Brain structural and functional outcomes in the offspring of women experiencing psychological distress during pregnancy (2024) · cites this paper as [171]
In the citing paper
“which have proved equally as effective as antidepressants [12]”
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“7 Psychological therapies have been demonstrated to be as effective as antidepressant medication, 8 with one meta-analysis showing a patient preference for psychological over pharmacological treatment 9 in anxiety and depression.”
Schweitz, E. B., Kristjánsdóttir, H., Sigurðsson, J. F., Agnarsdóttir, A., Sigurðsson, E., & Sigurðsson, E. (2013) · Læknablaðið · doi:10.17992/lbl.2013.11.517 · Cited by 1
The use of vitamin D in depression
Lange, K. W., Lange, K. M., Nakamura, Y., & Reißmann, A. (2021) · Journal of Food Bioactives · doi:10.31665/jfb.2021.15278 · Cited by 1
“While pharmacotherapy and/or cognitive behavior psychotherapy have been demonstrated to be efficacious in the treatment of depression (Cuijpers et al., 2008; Cuijpers et al., 2009), some degree of non-response to antidepressant medications may occur in up to 60% of individuals with major depressive disorder (Bschor an…”
BackgroundTreatment Strategies for Depression in Youth
Kemp, G. N., O’Connor, E., Kritikos, T. K., Curren, L. C., & Tompson, M. C. (2017) · Autism and child psychopathology series · doi:10.1007/978-3-319-71210-9_10 · Cited by 1
Pharmacological Interventions versus Combined Treatment of Depression: A Prospective Study
Caselli, I., Bellini, A., Colombo, S., Ielmini, M., & Callegari, C. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4452 · Cited by 1
Social Differentials in the Outcomes of Depression : A Longitudinal Register Study
Moustgaard, H. (2015) · Työväentutkimus Vuosikirja · Cited by 1
Biological Treatment of Mood Disorders
Allan, C. L., Topiwala, A., Ebmeier, K. P., Semple, D. M., & Steele, J. D. (2013) · Wiley eBooks · doi:10.1002/9781118316153.ch6 · Cited by 1
4 Cognitieve therapie bij de depressieve stoornis
Bockting, C., & Berndes, N. B. (2011) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-313-8310-8_4
PET studies of the serotonin system in major depression and its treatment
Tiger, M. (2014) · Figshare
Understanding the use of antidepressants
Haddad, M., & Young, N. (2011) · Practice Nursing · doi:10.12968/pnur.2011.22.7.347
Cuijpers, P. J. (2012) · European Psychiatry · doi:10.1016/s0924-9338(12)74080-4
Self-citationDevelopment of Clinical Practice
Craske, M. G., Crawford, K. A., Kivlahan, D. R., Magnavita, J. J., Ollendick, T. H., Sexton, T. L., Bufka, L. F., Galper, D. I., & Kurtzman, H. S. (2014)
Best Practice & Research Clinical Obstetrics and Gynaecology
Milgrom, J., & Gemmill, A. W. (2013)
Depression Management in the Medical Home
Nash, J. M., Sklar, M., & Evans, D. R. (2015) · Springer eBooks · doi:10.1007/978-3-319-19036-5_8
Metadata
- Authors
- Cuijpers, P., van Straten, A., van Oppen, P., & Andersson, G.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Linköping University (SE)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2008-11-30
- Volume
- 69
- Issue
- 11
- Pages
- 1675-1685
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1986628810
- Cited by
- 219
- References
- 0
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 7 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 5 · 2019: 14 · 2018: 11 · 2017: 14 · 2016: 16 · 2015: 17 · 2014: 25 · 2013: 16 · 2012: 18
- FWCI
- 10.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depressive disorders, major depressive disorder, dysthymia, minor depressive disorder, psychotherapy, antidepressants, selective serotonin reuptake inhibitors, treatment effectiveness comparison, dropout rates, symptom severity
- MeSH terms
- Adult, Antidepressive Agents, Major Depressive Disorder, Depressive Disorder, Major, Depressive Disorder, Humans, Patient Dropouts, Psychotherapy, Regression Analysis, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Dysthymic Disorder
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