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. 2013 Jun;12(2):137-48.
doi: 10.1002/wps.20038.

The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons

Pim Cuijpers  1 , Marit Sijbrandij, Sander L Koole, Gerhard Andersson, Aartjan T Beekman, Charles F Reynolds 3rd
Affiliations

The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons

Pim Cuijpers et al. World Psychiatry. 2013 Jun.

Abstract

Although psychotherapy and antidepressant medication are efficacious in the treatment of depressive and anxiety disorders, it is not known whether they are equally efficacious for all types of disorders, and whether all types of psychotherapy and antidepressants are equally efficacious for each disorder. We conducted a meta-analysis of studies in which psychotherapy and antidepressant medication were directly compared in the treatment of depressive and anxiety disorders. Systematic searches in bibliographical databases resulted in 67 randomized trials, including 5,993 patients that met inclusion criteria, 40 studies focusing on depressive disorders and 27 focusing on anxiety disorders. The overall effect size indicating the difference between psychotherapy and pharmacotherapy after treatment in all disorders was g=0.02 (95% CI: -0.07 to 0.10), which was not statistically significant. Pharmacotherapy was significantly more efficacious than psychotherapy in dysthymia (g=0.30), and psychotherapy was significantly more efficacious than pharmacotherapy in obsessive-compulsive disorder (g=0.64). Furthermore, pharmacotherapy was significantly more efficacious than non-directive counseling (g=0.33), and psychotherapy was significantly more efficacious than pharmacotherapy with tricyclic antidepressants (g=0.21). These results remained significant when we controlled for other characteristics of the studies in multivariate meta-regression analysis, except for the differential effects in dysthymia, which were no longer statistically significant.

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Figures

Figure 1
Figure 1
Selection and inclusion of studies
Figure 2
Figure 2
Differential effects of psychotherapy and pharmacotherapy (Hedges' g)
See this image and copyright information in PMC

References

    1. Kessler RC, Berglund P, Demler O, et al. National Comorbidity Survey Replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R) JAMA. 2003;289:3095–105. - PubMed
    1. Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602. - PubMed
    1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442. - PMC - PubMed
    1. Berto P, D'Ilario D, Ruffo P, et al. Depression: cost-of-illness studies in the international literature: a review. J Ment Health Policy Econ. 2000;3:3–10. - PubMed
    1. Greenberg PE, Birnbaum HG. The economic burden of depression in the US: societal and patient perspectives. Exp Opin Pharmacother. 2005;6:369–76. - PubMed