Evidence map›Paper›PMID 24497254›Full record

ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2014

Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis.

Pim Cuijpers, Marit Sijbrandij, Sander L Koole, Gerhard Andersson, Aartjan T Beekman, Charles F Reynolds

2 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 136 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
136citing papers in PubMed, 17 pooled it
31.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02614443 nacompletednot on this mapstarted 2015, after this paper: background citation

Effectiveness and Acceptability of Internet-delivered Treatment for Depression, Anxiety and Stress in University Students: Protocol for an Open Feasibility Trial

TypeinterventionalSponsorSilver Cloud HealthRan2015 to 2017Enrolled120ConditionsDepression, Anxiety, StressArmsSpace from Depression, Space from Anxiety, Space from Stress
NCT06042283 nacompletednot on this mapstarted 2023, after this paper: background citation

Assessing the Efficacy of Metacognitive Training on Depressive Symptoms, Dysfunctional Attitudes and Metacognition in Older Adults Diagnosed With Depression

TypeinterventionalSponsorIstanbul University - CerrahpasaRan2023 to 2024Enrolled50ConditionsDepression in Old AgeArmsMetacognitive Training-Silver
3 · Its place in the literature

Who cites it

136 citing papers in PubMed, 17 syntheses or guidelines pooled it, 418 citations in OpenAlex.

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  7. Does the use of pharmacotherapy interact with the effects of psychotherapy? A meta-analytic review.European psychiatry : the journal of the Association of European Psychiatrists · 2023
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  9. Digital interventions in mental health: evidence syntheses and economic modelling.Health technology assessment (Winchester, England) · 2022
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  14. Couple therapy for depression.The Cochrane database of systematic reviews · 2018
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76 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

Pim CuijpersDepartment of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands; Leuphana University, Lünebrug, Germany.
Marit Sijbrandij
Sander L Koole
Gerhard Andersson
Aartjan T Beekman
Charles F Reynolds
Amsterdam UMC Location VUmc · NLKarolinska Institutet · SELeuphana University of Lüneburg · DEUniversity of Pittsburgh · US

Funding

University of Pittsburgh Clinical and Translational Science InstituteUL1TR000005 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2012 to 2015
$50.8M
RESEARCH METHODS COREP30MH090333 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REYNOLDS, CHARLES F · 2011 to 2015
$8.3M
NCATS NIH HHS UL1 TR000005NIMH NIH HHS P30 MH090333
6 · The paper itself

Abstract

We conducted a meta-analysis of randomized trials in which the effects of treatment with antidepressant medication were compared to the effects of combined pharmacotherapy and psychotherapy in adults with a diagnosed depressive or anxiety disorder. A total of 52 studies (with 3,623 patients) met inclusion criteria, 32 on depressive disorders and 21 on anxiety disorders (one on both depressive and anxiety disorders). The overall difference between pharmacotherapy and combined treatment was Hedges' g = 0.43 (95% CI: 0.31-0.56), indicating a moderately large effect and clinically meaningful difference in favor of combined treatment, which corresponds to a number needed to treat (NNT) of 4.20. There was sufficient evidence that combined treatment is superior for major depression, panic disorder, and obsessive-compulsive disorder (OCD). The effects of combined treatment compared with placebo only were about twice as large as those of pharmacotherapy compared with placebo only, underscoring the clinical advantage of combined treatment. The results also suggest that the effects of pharmacotherapy and those of psychotherapy are largely independent from each other, with both contributing about equally to the effects of combined treatment. We conclude that combined treatment appears to be more effective than treatment with antidepressant medication alone in major depression, panic disorder, and OCD. These effects remain strong and significant up to two years after treatment. Monotherapy with psychotropic medication may not constitute optimal care for common mental disorders.

Indexed as

antidepressant medicationanxiety disordersCombined treatmentdepressive disordersdysthymiameta-analysisobsessive-compulsive disorderpsychotherapy

Identifiers

PMID24497254
PMCPMC3918025
OpenAlexW2053011811

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.