A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia.

J Affect Disord

Department of Counseling Psychology, 321 Education Building, University of Wisconsin-Madison, 1000 Bascom Mall Madison, WI 53706, United States.

Published: October 2008

Background: There remains considerable disagreement regarding the relative efficacy of psychotherapy and medication across types of depression.

Method: We used random effects meta-analysis to examine the relative efficacy of psychotherapy vis-à-vis medication at post-treatment and follow-up. We also estimated the relative efficacy of continued medication versus discontinued psychotherapy. As twenty-eight studies (39 effects, n=3,381) met inclusion criteria, we were able to conduct an adequately powered test of between-study heterogeneity and examine if the type of depression influenced relative efficacy.

Results: Psychotherapy and medication were not significantly different at post-treatment, however effect sizes were not consistent. Although there was no association between severity and relative efficacy, a small but significant advantage for medications in the treatment of dysthymia did emerge. However, psychotherapy showed a significant advantage over medication at follow-up and this advantage was positively associated with length of follow-up. Moreover, discontinued acute phase psychotherapy did not differ from continued medication at follow-up.

Limitations: Limitations included relatively fewer studies of severe and chronic depression, as well as dysthymia. In addition, only a minority of studies reported follow-up data.

Conclusions: Our results indicated that both psychotherapy and medication are viable treatments for unipolar depression and that psychotherapy may offer a prophylactic effect not provided by medication. However, our analyses diverged from previous findings in that effects were not consistent and medication was significantly more efficacious than psychotherapy in the treatment of dysthymia.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jad.2008.03.018DOI Listing

Publication Analysis

Top Keywords

psychotherapy medication
16
relative efficacy
16
medication
10
psychotherapy
9
unipolar depression
8
efficacy psychotherapy
8
medication post-treatment
8
continued medication
8
treatment dysthymia
8
relative
5

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!