Evidence map›Paper›PMID 31922679›Full record

ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2020

A network meta-analysis of the effects of psychotherapies, pharmacotherapies and their combination in the treatment of adult depression.

Pim Cuijpers, Hisashi Noma, Eirini Karyotaki, Christiaan H Vinkers, Andrea Cipriani, Toshi A Furukawa

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07113548 (PERSONAE), which is not on this map. Cited by 227 papers, 36 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
227citing papers in PubMed, 36 pooled it
44.3field-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.

NCT07113548 narecruitingnot on this mapstarted 2025, after this paper: background citation

PERSONAE: a Personalized Adaptation of Stepped Care Internet-based Cognitive Behavioral Therapy for Depression - A Randomized Controlled Trial

TypeinterventionalSponsorRegion of Southern DenmarkRan2025 to 2027Enrolled175ConditionsDepression - Major Depressive DisorderArmsPersonalized iCBT for depression, Standard iCBT
3 · Its place in the literature

Who cites it

227 citing papers in PubMed, 36 syntheses or guidelines pooled it, 510 citations in OpenAlex.

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  3. Magnitude of response in treatment and control groups within psychedelic trials for psychiatric disorders: A meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2026
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  20. 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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167 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 5 institutions in 3 countries.

Pim CuijpersDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Hisashi NomaDepartment of Data Science, Institute of Statistical Mathematics, Tokyo, Japan.
Eirini KaryotakiDepartment of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Christiaan H VinkersDepartment of Psychiatry, Amsterdam UMC (location VUmc), Amsterdam, The Netherlands.
Andrea CiprianiDepartment of Psychiatry,  Warneford Hospital, University of Oxford, Oxford, UK.
Toshi A FurukawaDepartment of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan.
Vrije Universiteit Amsterdam · NLAmsterdam Neuroscience · NLKyoto University · JPOxford Health NHS Foundation Trust · GBThe Institute of Statistical Mathematics · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

No network meta-analysis has examined the relative effects of psychotherapies, pharmacotherapies and their combination in the treatment of adult depression, while this is a very important clinical issue. We conducted systematic searches in bibliographical databases to identify randomized trials in which a psychotherapy and a pharmacotherapy for the acute or long-term treatment of depression were compared with each other, or in which the combination of a psychotherapy and a pharmacotherapy was compared with either one alone. The main outcome was treatment response (50% improvement between baseline and endpoint). Remission and acceptability (defined as study drop-out for any reason) were also examined. Possible moderators that were assessed included chronic and treatment-resistant depression and baseline severity of depression. Data were pooled as relative risk (RR) using a random-effects model. A total of 101 studies with 11,910 patients were included. Depression in most studies was moderate to severe. In the network meta-analysis, combined treatment was more effective than psychotherapy alone (RR=1.27; 95% CI: 1.14-1.39) and pharmacotherapy alone (RR=1.25; 95% CI: 1.14-1.37) in achieving response at the end of treatment. No significant difference was found between psychotherapy alone and pharmacotherapy alone (RR=0.99; 95% CI: 0.92-1.08). Similar results were found for remission. Combined treatment (RR=1.23; 95% CI: 1.05-1.45) and psychotherapy alone (RR=1.17; 95% CI: 1.02-1.32) were more acceptable than pharmacotherapy. Results were similar for chronic and treatment-resistant depression. The combination of psychotherapy and pharmacotherapy seems to be the best choice for patients with moderate depression. More research is needed on long-term effects of treatments (including cost-effectiveness), on the impact of specific pharmacological and non-pharmacological approaches, and on the effects in specific populations of patients.

Indexed as

acceptabilityantidepressantschronic depressioncognitive behavior therapycombined treatmentDepressioninterpersonal therapynetwork meta-analysispharmacotherapypsychotherapytreatment-resistant depression

Identifiers

PMID31922679
PMCPMC6953550
OpenAlexW2971304551

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.