Combination of pharmacotherapy and psychotherapy in the treatment of chronic depression: A systematic review and meta-analysis Full Text
BMC Psychiatry, 06/14/2012
Evidence Based Medicine
von Wolff A et al. – This systematic review could not provide clear evidence for the combination of pharmacotherapy and psychotherapy.Methods
- A systematic search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, ISI Web of Science, BIOSIS, PsycINFO, and CINAHL.
- Primary efficacy outcome was a response to treatment; primary acceptance outcome was dropping out of the study.
- Only randomized controlled trials were considered.
- The authors identified 8 studies with a total of 9 relevant comparisons.
- The analysis revealed small, but statistically not significant effects of combined therapies on outcomes directly related to depression (BR=1.20) with substantial heterogeneity between studies (I^2=67%).
- Three treatment effect modifiers were identified: target disorders, the type of psychotherapy and the type of pharmacotherapy.
- Small but statistically significant effects of combined therapies on quality of life (SMD=0.18) were revealed.
- No differences in acceptance rates and the long–term effects between combined treatments and pure pharmacological interventions were observed.