SynthesisThe American journal of psychiatry2016
Divergent Outcomes in Cognitive-Behavioral Therapy and Pharmacotherapy for Adult Depression.
Open access · bronzeAbstract readMeta-Analysis
In one paragraph
Synthesis in The American journal of psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
6.7field-weighted citation impact, top 3% of its field
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 97 citations in OpenAlex.
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- Exploring young women's experiences of a mindful yoga intervention for depression in the Netherlands: Qualitative analysis of positive and negative effects.The British journal of clinical psychology · 2026Trial
- Sequential Interventions for Major Depression and Heart Failure Self-Care: A Randomized Clinical Trial.Circulation. Heart failure · 2022Trial
- Anxiety, Obsessive-Compulsive, and Depressive Symptom Presentation and Change Throughout Routine Eating Disorder Treatment.European eating disorders review : the journal of the Eating Disorders Association · 2025Article
- ILF-neurofeedback in clinical practice: examining symptom change and performance metrics across diagnostic groups.Frontiers in human neuroscience · 2025Article
- Video-Delivered Family Therapy for Perinatal Women With Depressive Symptoms and Family Conflict: Feasibility, Acceptability, Safety, and Tolerability Results From a Pilot Randomized Trial.JMIR formative research · 2023Article
- The Contribution of "Individual Participant Data" Meta-Analyses of Psychotherapies for Depression to the Development of Personalized Treatments: A Systematic Review.Journal of personalized medicine · 2022Review
- Negative effects in internet-based interventions for depression: A qualitative content analysis.Internet interventions · 2021Article
- One (effect) size does not fit at all: Interpreting clinical significance and effect sizes in depression treatment trials.Journal of psychopharmacology (Oxford, England) · 2020Article
- Mental and personality disorders in infertile women with polycystic ovary: a case-control study.African health sciences · 2020Article
- Concordance between clinician-rated and patient reported outcome measures of depressive symptoms in treatment resistant depression.Journal of affective disorders · 2020Article
- Targets and outcomes of psychotherapies for mental disorders: an overview.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2019Article
- Stress, Depression, Sexual Function, and Alexithymia in Infertile Females with and without Polycystic Ovary Syndrome: A Case-Control Study.International journal of fertility & sterility · 2019Article
- Estimating outcome probabilities from early symptom changes in cognitive therapy for recurrent depression.Journal of consulting and clinical psychology · 2019Article
- Redefining Therapeutic Outcomes of Depression Treatment.Journal for person-oriented research · 2019Article
- Pre-post effect sizes should be avoided in meta-analyses.Epidemiology and psychiatric sciences · 2017Article
- Article
- The Effects of Mindfulness-Based Cognitive Therapy on Depression and Anxiety in Women with Premenstrual Syndrome.Depression research and treatment · 2016Article
Corrections and comments
- Commented on by
Authors and funding
22 authors at 1 institution in 2 countries.
Jeffrey R VittenglFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Robin B JarrettFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Erica WeitzFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Steven D HollonFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Jos TwiskFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Ioana CristeaFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Daniel DavidFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Robert J DeRubeisFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Sona DimidjianFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Boadie W DunlopFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Mahbobeh FaramarziFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Ulrich HegerlFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Sidney H KennedyFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Farzan KheirkhahFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Roland MerglFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Jeanne MirandaFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
David C MohrFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
A John RushFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Zindel V SegalFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Juned SiddiqueFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Anne D SimonsFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Pim CuijpersFrom the Department of Psychology, Truman State University, Kirksville, Mo.; the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Clinical Psychology and the EMGO Institute for Health and Care Research, VU University Amsterdam, the Netherlands; the Department of Psychology, Vanderbilt University, Nashville, Tenn.; the Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj, Romania; the Department of Psychology, University of Pennsylvania, Philadelphia; the Department of Psychology and Neuroscience, University of Colorado, Boulder; the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta; the Fatemeh Zahra Infertility and Reproductive Health Research Center and the Department of Psychiatry, Babol University of Medical Sciences, Babol, Iran; the Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; the Department of Psychiatry, Faculty of Medicine, University of Toronto; the Department of Psychology, University of Toronto-Scarborough; the Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles; the Department of Preventive Medicine and the Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago; the Duke-National University of Singapore Graduate Medical School, Singapore; and the Department of Psychology, University of Notre Dame, Notre Dame, Ind.
Babeș-Bolyai University · RO
Funding
PREVENTION OF RECURRENCE IN DEPRESSION WITH DRUGS AND CTR01MH060998 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI DERUBEIS, ROBERT J · 2002 to 2011
$6.5MPrevention of Recurrence in Depression with Drugs and CTR01MH060713 · NIMH · VANDERBILT UNIVERSITY · PI HOLLON, STEVEN DENNIS · 2002 to 2011
$5.2MTechnology Assisted intervention for the Treatment and Prevention of DepressionP20MH090318 · NIMH · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MOHR, DAVID CURTIS · 2011 to 2015
$4.7MStepped Telemental Health Care Intervention for DepressionR01MH095753 · NIMH · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MOHR, DAVID CURTIS · 2012 to 2016
$3.4MArtificial Intelligence in a Mobile Intervention for Depression (AIM)R01MH100482 · NIMH · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MOHR, DAVID CURTIS · 2013 to 2017
$3.1MPrevention of Recurrence in Depression with Drugs and CTK02MH001697 · NIMH · VANDERBILT UNIVERSITY · PI HOLLON, STEVEN DENNIS · 2000 to 2009
$1.2MMobile Intervention to Engage Patients and Providers in Antidepressant TreatmentR34MH095907 · NIMH · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MOHR, DAVID CURTIS · 2012 to 2014
$686kNIMH NIH HHS K02 MH001697NIMH NIH HHS P20 MH090318NIMH NIH HHS R01 MH060713NIMH NIH HHS R01 MH060998NIMH NIH HHS R01 MH095753NIMH NIH HHS R01 MH100482NIMH NIH HHS R34 MH095907
Abstract
objectiveAlthough the average depressed patient benefits moderately from cognitive-behavioral therapy (CBT) or pharmacotherapy, some experience divergent outcomes. The authors tested frequencies, predictors, and moderators of negative and unusually positive outcomes.
methodSixteen randomized clinical trials comparing CBT and pharmacotherapy for unipolar depression in 1,700 patients provided individual pre- and posttreatment scores on the Hamilton Depression Rating Scale (HAM-D) and/or Beck Depression Inventory (BDI). The authors examined demographic and clinical predictors and treatment moderators of any deterioration (increase ≥1 HAM-D or BDI point), reliable deterioration (increase ≥8 HAM-D or ≥9 BDI points), extreme nonresponse (posttreatment HAM-D score ≥21 or BDI score ≥31), superior improvement (HAM-D or BDI decrease ≥95%), and superior response (posttreatment HAM-D or BDI score of 0) using multilevel models.
resultsAbout 5%-7% of patients showed any deterioration, 1% reliable deterioration, 4%-5% extreme nonresponse, 6%-10% superior improvement, and 4%-5% superior response. Superior improvement on the HAM-D only (odds ratio=1.67) and attrition (odds ratio=1.67) were more frequent in pharmacotherapy than in CBT. Patients with deterioration or superior response had lower pretreatment symptom levels, whereas patients with extreme nonresponse or superior improvement had higher levels.
conclusionsDeterioration and extreme nonresponse and, similarly, superior improvement and superior response, both occur infrequently in randomized clinical trials comparing CBT and pharmacotherapy for depression. Pretreatment symptom levels help forecast negative and unusually positive outcomes but do not guide selection of CBT versus pharmacotherapy. Pharmacotherapy may produce clinician-rated superior improvement and attrition more frequently than does CBT.
Indexed as
Cognitive Behavioral TherapyAdultAntidepressive AgentsDepressive DisorderFemaleHumansMajor Depressive DisorderMalePsychiatric Status Rating ScalesRandomized Controlled Trials as TopicTreatment OutcomeYoung AdultAntidepressive Agents
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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.