The efficacy of adding short-term psychodynamic psychotherapy to antidepressants in the treatment of depression: A systematic review and meta-analysis of individual participant data.
Antidepressant medication
Combined treatment
Depression
Efficacy
Individual participant data meta-analysis
Short-term psychodynamic psychotherapy (STPP)
Journal
Clinical psychology review
ISSN: 1873-7811
Titre abrégé: Clin Psychol Rev
Pays: United States
ID NLM: 8111117
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
29
05
2019
revised:
03
06
2020
accepted:
17
06
2020
pubmed:
11
7
2020
medline:
31
8
2021
entrez:
11
7
2020
Statut:
ppublish
Résumé
We examined the efficacy of adding short-term psychodynamic psychotherapy (STPP) to antidepressants in the treatment of depression by means of a systematic review and meta-analysis of individual participant data, which is currently considered the most reliable method for evidence synthesis. A thorough systematic literature search resulted in 7 studies comparing combined treatment of antidepressants and STPP versus antidepressant mono-therapy (n = 3) or versus antidepressants and brief supportive psychotherapy (n = 4). Individual participant data were obtained for all these studies and totaled 482 participants. Across the total sample of studies, combined treatment of antidepressants and STPP was found significantly more efficacious in terms of depressive symptom levels at both post-treatment (Cohen's d = 0.26, SE = 0.10, p = .01) and follow-up (d = 0.50, SE = 0.10, p < .001). This effect was most apparent at follow-up and in studies examining STPP's specific treatment efficacy. Effects were still apparent in analyses that controlled for risk of bias and STPP quality in the primary studies. These findings support the evidence-base of adding STPP to antidepressants in the treatment of depression. However, further studies are needed, particularly assessing outcome measures other than depression and cost-effectiveness, as well as examining the relative merits of STPP versus other psychotherapies as added to antidepressants.
Identifiants
pubmed: 32650213
pii: S0272-7358(20)30074-X
doi: 10.1016/j.cpr.2020.101886
pii:
doi:
Substances chimiques
Antidepressive Agents
0
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
101886Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Ellen Driessen and Pim Cuijpers received a Fund for Psychoanalytic Research of the American Psychoanalytic Association supporting the recruitment of individual participant data for this study. Giuseppe Maina was a speaker/consultant and Gianluca Rosso was a speaker for Angelini, Janssen, Lundbeck, and Otsuka within the last three years, but both report that this did not result in conflicts of interest for the present study. All other authors declare that they have no conflicts of interest for this study.