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Depression: HELP
Articles by Gerhard Andersson
Based on 141 articles published since 2008
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Between 2008 and 2019, Gerhard Andersson wrote the following 141 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Editorial State-of-the-art treatment via the Internet: an optimistic vision of the future. 2011

Carlbring, Per / Andersson, Gerhard / Kaldo, Viktor. ·a Umeå University. ·Cogn Behav Ther · Pubmed #25155811.

ABSTRACT: -- No abstract --

2 Editorial Special issue on computerized treatments of depression. 2009

Cuijpers, Pim / Andersson, Gerhard. · ·Cogn Behav Ther · Pubmed #20183694.

ABSTRACT: -- No abstract --

3 Editorial Pros and cons of online cognitive-behavioural therapy. 2008

Andersson, Gerhard / Cuijpers, Pim. · ·Br J Psychiatry · Pubmed #18827286.

ABSTRACT: Online cognitive-behavioural therapy (CBT) for depression has the potential to serve as an important addition to the care of people with mild to moderate depression. Although some studies show promising results, the need for proper diagnoses and human guidance must be considered when interpreting the modest effects found in studies with little or no guidance from a therapist.

4 Review Do guided internet-based interventions result in clinically relevant changes for patients with depression? An individual participant data meta-analysis. 2018

Karyotaki, Eirini / Ebert, David Daniel / Donkin, Liesje / Riper, Heleen / Twisk, Jos / Burger, Simone / Rozental, Alexander / Lange, Alfred / Williams, Alishia D / Zarski, Anna Carlotta / Geraedts, Anna / van Straten, Annemieke / Kleiboer, Annet / Meyer, Björn / Ünlü Ince, Burçin B / Buntrock, Claudia / Lehr, Dirk / Snoek, Frank J / Andrews, Gavin / Andersson, Gerhard / Choi, Isabella / Ruwaard, Jeroen / Klein, Jan Philipp / Newby, Jill M / Schröder, Johanna / Laferton, Johannes A C / Van Bastelaar, Kim / Imamura, Kotaro / Vernmark, Kristofer / Boß, Leif / Sheeber, Lisa B / Kivi, Marie / Berking, Matthias / Titov, Nickolai / Carlbring, Per / Johansson, Robert / Kenter, Robin / Perini, Sarah / Moritz, Steffen / Nobis, Stephanie / Berger, Thomas / Kaldo, Viktor / Forsell, Yvonne / Lindefors, Nils / Kraepelien, Martin / Björkelund, Cecilia / Kawakami, Norito / Cuijpers, Pim. ·Department of Clinical Psychology, Amsterdam Public Health research institute, VU, Amsterdam, the Netherlands. Electronic address: e.karyotaki@vu.nl. · Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. · The Brain and Mind Research Institute, University of Sydney, NSW 2050, Australia. · Department of Clinical Psychology, Amsterdam Public Health research institute, VU, Amsterdam, the Netherlands. · Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands. · Institute of Child Health, University College London, United Kingdom; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden. · Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands. · Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands. · HumanTotalCare, Utrecht, the Netherlands. · Research Department, Gaia AG, Hamburg, Germany; Department of Psychology, City, University of London, London, United Kingdom. · Informatics Institute, Middle East Technical University, Ankara, Turkey. · Institute of Psychology, Leuphana University Lüneburg, Germany. · Department of Medical Psychology, VU Medical Center, Academic Medical Center, Public Health Research institute, Amsterdam, the Netherlands. · Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Darlinghurst, NSW, Australia. · Department of Behavioral Sciences and Learning, Linköping University, Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institute for Disability Research, Stockholm, Sweden. · Brain and Mind Centre, University of Sydney, Sydney, Australia. · Department of Psychiatry and Psychotherapy, Luebeck University, Luebeck, Germany. · Clinical Research Unit for Anxiety and Depression, School of Psychiatry, University of New South Wales at St Vincent's Hospital, Darlinghurst, NSW, Australia; The MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom; School of Psychology, the University of New South Wales, Sydney, Australia. · Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute for Sex Research and Forensic Psychiatry, Hamburg, Germany. · Department of Medical Psychology, VU Medical Center, Amsterdam, the Netherlands. · Department of Mental Health, School of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyō-ku, Tokyo, Japan. · Department of Behavioural Sciences and Learning, Linkoping University, Linkoping, Sweden. · Oregon Research Institute, Eugene, OR, USA. · Department of Psychology, University of Gothenburg, Göteborg, Sweden. · MindSpot Clinic and eCentreClinic, Department of Psychology, Macquarie University, Australia. · Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, University of Southern Denmark, Denmark. · Department of Behavioral Sciences and Learning, Linköping University, and Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden. · Department of Clinical Psychology, University of Bergen, Bergen, Norway. · Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, New South Wales, Australia. · Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Germany. · Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland. · Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden. · Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden. · Department of Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. ·Clin Psychol Rev · Pubmed #29940401.

ABSTRACT: Little is known about clinically relevant changes in guided Internet-based interventions for depression. Moreover, methodological and power limitations preclude the identification of patients' groups that may benefit more from these interventions. This study aimed to investigate response rates, remission rates, and their moderators in randomized controlled trials (RCTs) comparing the effect of guided Internet-based interventions for adult depression to control groups using an individual patient data meta-analysis approach. Literature searches in PubMed, Embase, PsycINFO and Cochrane Library resulted in 13,384 abstracts from database inception to January 1, 2016. Twenty-four RCTs (4889 participants) comparing a guided Internet-based intervention with a control group contributed data to the analysis. Missing data were multiply imputed. To examine treatment outcome on response and remission, mixed-effects models with participants nested within studies were used. Response and remission rates were calculated using the Reliable Change Index. The intervention group obtained significantly higher response rates (OR = 2.49, 95% CI 2.17-2.85) and remission rates compared to controls (OR = 2.41, 95% CI 2.07-2.79). The moderator analysis indicated that older participants (OR = 1.01) and native-born participants (1.66) were more likely to respond to treatment compared to younger participants and ethnic minorities respectively. Age (OR = 1.01) and ethnicity (1.73) also moderated the effects of treatment on remission.Moreover, adults with more severe depressive symptoms at baseline were more likely to remit after receiving internet-based treatment (OR = 1.19). Guided Internet-based interventions lead to substantial positive treatment effects on treatment response and remission at post-treatment. Thus, such interventions may complement existing services for depression and potentially reduce the gap between the need and provision of evidence-based treatments.

5 Review Is self-guided internet-based cognitive behavioural therapy (iCBT) harmful? An individual participant data meta-analysis. 2018

Karyotaki, Eirini / Kemmeren, Lise / Riper, Heleen / Twisk, Jos / Hoogendoorn, Adriaan / Kleiboer, Annet / Mira, Adriana / Mackinnon, Andrew / Meyer, Björn / Botella, Cristina / Littlewood, Elizabeth / Andersson, Gerhard / Christensen, Helen / Klein, Jan P / Schröder, Johanna / Bretón-López, Juana / Scheider, Justine / Griffiths, Kathy / Farrer, Louise / Huibers, Marcus J H / Phillips, Rachel / Gilbody, Simon / Moritz, Steffen / Berger, Thomas / Pop, Victor / Spek, Viola / Cuijpers, Pim. ·Department of Clinical Psychology,VU Amsterdam and Institute for Public Health Research,Amsterdam,the Netherlands. · Department of Psychiatry,GGZ inGeest and VU University Medical Centre, Amsterdam Public Health research institute,Amsterdam,the Netherlands. · Department of Epidemiology and Biostatistics and Amsterdam Institute for Public Health Research,VU University Amsterdam,Amsterdam,the Netherlands. · Department of Psychology and Technology,Jaume University,Castellon,Spain. · Black Dog Institute and University of New South Wales, Prince of Wales Hospital,Sydney,Australia. · Research Department, Germany and Department of Psychology,City University,Gaia AG, Hamburg, London,UK. · Department of Health Sciences,University of York,York,UK. · Department of Behavioural Sciences and Learning,Sweden Institute for Disability Research, Linköping University,Linköping,Sweden. · Department of Psychiatry and Psychotherapy,Lübeck University,Lübeck,Germany. · Department of Psychiatry and Psychotherapy,University Medical Center Hamburg-Eppendorf,Hamburg,Germany. · Institute of Mental Health, University of Nottingham,Nottingham,UK. · Research School of Psychology, College of Biology, Medicine & Environment, Australian National University,Canberra,Australia. · Centre for Mental Health Research, The Australian National University,Canberra,Australia. · Department of Primary Care and Public Health Sciences,King's College London,London,UK. · Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland. · CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University,Tilburg,the Netherlands. ·Psychol Med · Pubmed #29540243.

ABSTRACT: BACKGROUND: Little is known about potential harmful effects as a consequence of self-guided internet-based cognitive behaviour therapy (iCBT), such as symptom deterioration rates. Thus, safety concerns remain and hamper the implementation of self-guided iCBT into clinical practice. We aimed to conduct an individual participant data (IPD) meta-analysis to determine the prevalence of clinically significant deterioration (symptom worsening) in adults with depressive symptoms who received self-guided iCBT compared with control conditions. Several socio-demographic, clinical and study-level variables were tested as potential moderators of deterioration. METHODS: Randomised controlled trials that reported results of self-guided iCBT compared with control conditions in adults with symptoms of depression were selected. Mixed effects models with participants nested within studies were used to examine possible clinically significant deterioration rates. RESULTS: Thirteen out of 16 eligible trials were included in the present IPD meta-analysis. Of the 3805 participants analysed, 7.2% showed clinically significant deterioration (5.8% and 9.1% of participants in the intervention and control groups, respectively). Participants in self-guided iCBT were less likely to deteriorate (OR 0.62, p < 0.001) compared with control conditions. None of the examined participant- and study-level moderators were significantly associated with deterioration rates. CONCLUSIONS: Self-guided iCBT has a lower rate of negative outcomes on symptoms than control conditions and could be a first step treatment approach for adult depression as well as an alternative to watchful waiting in general practice.

6 Review Long-term effects of internet-supported cognitive behaviour therapy. 2018

Andersson, Gerhard / Rozental, Alexander / Shafran, Roz / Carlbring, Per. ·a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden. · b Department of Clinical Neuroscience, Psychiatry Section , Karolinska Institutet , Stockholm , Sweden. · c Department of Clinical Psychology , Stockholm University , Stockholm , Sweden. · d UCL Institute of Child Health , University College London , London , England. ·Expert Rev Neurother · Pubmed #29094622.

ABSTRACT: INTRODUCTION: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer. Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8-15 weeks). The pre-to follow-up effect size was Hedge's g = 1.52, but with a significant heterogeneity. The average symptom improvement across studies was 50%. Treatment seeking in the follow-up period was not documented and few studies mentioned negative effects. Expert commentary: While effects may be overestimated, it is likely that therapist-supported ICBT can have enduring effects. Long-term follow-up data should be collected for more conditions and new technologies like smartphone-delivered treatments.

7 Review Internet-Assisted Cognitive Behavioral Therapy. 2017

Andersson, Gerhard / Carlbring, Per. ·Department of Behavioural Sciences and Learning, Linköping University, Campus Valla, SE-581 83, Linköping SE-581 83, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. Electronic address: gerhard.andersson@liu.se. · Department of Psychology, Stockholm University, Stockholm SE-106 91, Sweden. ·Psychiatr Clin North Am · Pubmed #29080594.

ABSTRACT: Internet-assisted cognitive-behavioral therapy (ICBT) is a way to deliver cognitive-behavioral therapy (CBT) that has been found to generate similar effects as face-to-face CBT in some studies. Results have been replicated by different research groups. This article presents the treatment format and reviews evidence for mood and anxiety disorders. Future developments are discussed, including the lack of theories specific for the treatment format and ways to handle comorbidity. Although some programs have been implemented there is a need for further studies in clinical settings. Overall, clinician-assisted ICBT is becoming one of the most evidence-based forms of psychological treatment.

8 Review Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials. 2017

Furukawa, Toshi A / Weitz, Erica S / Tanaka, Shiro / Hollon, Steven D / Hofmann, Stefan G / Andersson, Gerhard / Twisk, Jos / DeRubeis, Robert J / Dimidjian, Sona / Hegerl, Ulrich / Mergl, Roland / Jarrett, Robin B / Vittengl, Jeffrey R / Watanabe, Norio / Cuijpers, Pim. ·Toshi A. Furukawa, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Erica S. Weitz, MA, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Shiro Tanaka, PhD, Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Stefan G. Hofmann, PhD, Department of Psychological and Brain Science, Boston University, Massachusetts, USA; Gerhard Andersson, PhD, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden and Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stokholm, Sweden; Jos Twisk, PhD, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Sona Dimidjian, PhD, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; Ulrich Hegerl, MD, PhD, Roland Mergl, PhD, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; Robin B. Jarrett, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Jeffrey R. Vittengl, PhD, Department of Psychology, Truman State University, Kirksville, Missouri, USA; Norio Watanabe, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Pim Cuijpers, PhD, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands furukawa@kuhp.kyoto-u.ac.jp. · Toshi A. Furukawa, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Erica S. Weitz, MA, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Shiro Tanaka, PhD, Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Stefan G. Hofmann, PhD, Department of Psychological and Brain Science, Boston University, Massachusetts, USA; Gerhard Andersson, PhD, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden and Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stokholm, Sweden; Jos Twisk, PhD, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Sona Dimidjian, PhD, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; Ulrich Hegerl, MD, PhD, Roland Mergl, PhD, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; Robin B. Jarrett, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Jeffrey R. Vittengl, PhD, Department of Psychology, Truman State University, Kirksville, Missouri, USA; Norio Watanabe, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Pim Cuijpers, PhD, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands. ·Br J Psychiatry · Pubmed #28104735.

ABSTRACT:

9 Review Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials. 2017

Păsărelu, Costina Ruxandra / Andersson, Gerhard / Bergman Nordgren, Lise / Dobrean, Anca. ·a Doctoral School Evidence-Based Assessment and Psychological Interventions , Babeș-Bolyai University , Cluj-Napoca , Romania. · b Department of Behavioural Sciences and Learning , Linköping University , Linkoping , Sweden. · c Psychiatry Section, Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden. · d Department of Clinical Psychology and Psychotherapy , Babeș-Bolyai University , Cluj-Napoca , Romania. ·Cogn Behav Ther · Pubmed #27712544.

ABSTRACT: Anxiety and depressive disorders are often comorbid. Transdiagnostic and tailored treatments seem to be promising approaches in dealing with comorbidity. Although several primary studies have examined the effects of Internet-delivered cognitive behavior therapy (iCBT) for anxiety and depression, no meta-analysis including different types of iCBT that address comorbidity has been conducted so far. We conducted systematic searches in databases up to 1 July 2016. Only randomized trials comparing transdiagnostic/tailored iCBT for adult anxiety and/or depression with control groups were included. Nineteen randomized trials with a total of 2952 participants that met inclusion criteria were analyzed. The quality of the studies was high, however the blinding criteria were not fulfilled. The uncontrolled effect size (Hedges' g) of transdiagnostic/tailored iCBT on anxiety and depression outcomes was large and medium for quality of life. The controlled effect size for iCBT on anxiety and depression outcomes was medium to large (anxiety: g = .82, 95% CI: .58-1.05, depression: g = .79, 95% CI: .59-1.00) and medium on quality of life (g = .56, 95% CI: .37-.73). Heterogeneity was small (quality of life) to moderate (anxiety, depression). There was a large effect on generic outcome measures and a moderate effect on comorbidities. When compared to disorder-specific treatments there were no differences on anxiety and quality of life outcomes, however there were differences in depression outcomes. Transdiagnostic and tailored iCBT are effective interventions for anxiety disorders and depression. Future studies should investigate mechanisms of change and develop outcome measures for these interventions.

10 Review Personalized Psychotherapy for Adult Depression: A Meta-Analytic Review. 2016

Cuijpers, Pim / Ebert, David D / Acarturk, Ceren / Andersson, Gerhard / Cristea, Ioana A. ·VU University Amsterdam, EMGO Institute for Health and Care Research, and Innovation Incubator. Electronic address: p.cuijpers@vu.nl. · Innovation Incubator and Friedrich-Alexander University Erlangen-Nüremberg. · Istanbul Sehir University. · Linköping University and Karolinska Institutet. · Babes-Bolyai University and University of Pisa. ·Behav Ther · Pubmed #27993344.

ABSTRACT: Personalized medicine is aimed at identifying which characteristics of an individual predict the outcome of a specific treatment, in order to get a better match between the individual and the treatment received. We conducted a systematic review and meta-analysis of randomized trials comparing two psychotherapies directly in a group of depressed patients with a specific characteristic. We focused on the six most examined types of psychotherapy for adult depression. Our searches resulted in 41 studies with 2,741 patients who met inclusion criteria. These 41 studies examined 27 specific characteristics of patients. Power calculations indicated that we would need 4 studies for each characteristic to find a clinically relevant effect size set at g = 0.50 and 16 studies for an effect size of 0.24. Only 3 patient characteristics were found to have sufficient power and to significantly moderate treatment outcomes. Cognitive-behavioral therapy was found to be more effective than other therapies in older adults (g = 0.29), in patients with comorbid addictive disorders (g = 0.31), and in university students (g = 0.46). Risk of bias was considerable in most of the included studies. It was estimated that it will take another 326 years to have sufficient statistical power for showing an effect size of g = 0.50 of the 27 characteristics, and 1,372 years to show an effect size of 0.24. Although several dozens of studies have compared the effects of psychotherapies in specific target groups, we will need to develop more powerful alternatives to comparative outcome studies in order to identify personalized treatments for depression.

11 Review Psychological Treatment of Depression in People Aged 65 Years and Over: A Systematic Review of Efficacy, Safety, and Cost-Effectiveness. 2016

Jonsson, Ulf / Bertilsson, Göran / Allard, Per / Gyllensvärd, Harald / Söderlund, Anne / Tham, Anne / Andersson, Gerhard. ·Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden. · Department of Neuroscience, Child and adolescent psychiatry, Uppsala University, Uppsala, Sweden. · National Board of Health and Welfare, Stockholm, Sweden. · Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden. · Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden. · Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. · School of Health, Care and Social Welfare, Physiotherapy, Mälardalen University, Mälardalen, Våsterås, Sweden. · Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. · Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden. ·PLoS One · Pubmed #27537217.

ABSTRACT: OBJECTIVES: Depression in elderly people is a major public health concern. As response to antidepressants is often unsatisfactory in this age group, there is a need for evidence-based non-pharmacological treatment options. Our objectives were twofold: firstly, to synthesize published trials evaluating efficacy, safety and cost-effectiveness of psychological treatment of depression in the elderly and secondly, to assess the quality of evidence. METHOD: The electronic databases PubMed, EMBASE, Cochrane Library, CINAL, Scopus, and PsycINFO were searched up to 23 May 2016 for randomized controlled trials (RCTs) of psychological treatment for depressive disorders or depressive symptoms in people aged 65 years and over. Two reviewers independently assessed relevant studies for risk of bias. Where appropriate, the results were synthesized in meta-analyses. The quality of the evidence was graded according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). RESULTS: Twenty-two relevant RCTs were identified, eight of which were excluded from the synthesis due to a high risk of bias. Of the remaining trials, six evaluated problem-solving therapy (PST), five evaluated other forms of cognitive behavioural therapy (CBT), and three evaluated life review/reminiscence therapy. In frail elderly with depressive symptoms, the evidence supported the efficacy of PST, with large but heterogeneous effect sizes compared with treatment as usual. The results for life-review/reminiscence therapy and CBT were also promising, but because of the limited number of trials the quality of evidence was rated as very low. Safety data were not reported in any included trial. The only identified cost-effectiveness study estimated an incremental cost per additional point reduction in Beck Depression Inventory II score for CBT compared with talking control and treatment as usual. CONCLUSION: Psychological treatment is a feasible option for frail elderly with depressive symptoms. However, important questions about efficacy, generalizability, safety and cost-effectiveness remain.

12 Review Efficacy and tolerability of antidepressants in people aged 65 years or older with major depressive disorder - A systematic review and a meta-analysis. 2016

Tham, Anne / Jonsson, Ulf / Andersson, Gerhard / Söderlund, Anne / Allard, Per / Bertilsson, Göran. ·Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. · Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden. · Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden. · School of Health, Care and Social Welfare, Physiotherapy, Mälardalen University, Västerås, Sweden. · Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden. · Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden. Electronic address: goran.bertilsson@sbu.se. ·J Affect Disord · Pubmed #27389296.

ABSTRACT: BACKGROUND: There has been a steady increase in the prescription of antidepressants for the elderly. This study comprises a systematic review of randomized, placebo-controlled trials of antidepressants for treatment of depressive disorder in people aged 65 years or more. METHODS: PubMed, EMBASE, Cochrane Library, CINAL, and PsycINFO were searched until May 2016. Where appropriate, the results were synthesized in meta-analyses. RESULTS: Twelve trials met the inclusion criteria. For patients with major depressive disorder, selective serotonin re-uptake inhibitors (SSRI) were not superior to placebo in achieving remission (OR: 0.79, 95% CI: 0.61-1.03) or response (OR=0.86, 95% CI: 0.51-1.10) after 8 weeks of treatment (three trials). However, maintenance treatment with SSRIs was superior to placebo in preventing relapse (OR: 0.22, 95% CI: 0.13-0.36; NNT=5, 95% CI: 3-6; two trials). Duloxetine was superior to placebo in achieving remission (OR: 1.78, 95% CI: 1.20-2.65; NNT=9, 95% CI: 6-20; three trials) and response (OR: 1.83, 95% CI: 1.96-4.08; two trials) in recurrent major depression after 8 weeks, but increased the risk of adverse events that can be problematic in the elderly. LIMITATIONS: The quality of evidence was generally low or moderate, emphasizing the uncertainty of the results. Study populations only partly covered the heterogeneous population of elderly with depressed mood, limiting the generalizability. CONCLUSION: The results underscore the importance of close monitoring of the effects of antidepressants in treatment of elderly patients with a depressive disorder. Methods for early detection of non-responders and effective treatment options for this group are needed.

13 Review Internet-supported versus face-to-face cognitive behavior therapy for depression. 2016

Andersson, Gerhard / Topooco, Naira / Havik, Odd / Nordgreen, Tine. ·a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden. · b Department of Clinical Neuroscience, Psychiatry Section , Karolinska Institutet , Stoclholm , Sweden. · c Department of Clinical Psychology , University of Bergen , Bergen , Norway. · d Anxiety Disorders Research Network , Haukeland University Hospital , Bergen , Norway. ·Expert Rev Neurother · Pubmed #26610160.

ABSTRACT: Major depression and depressive symptoms are highly prevalent and there is a need for different forms of psychological treatments that can be delivered from a distance at a low cost. In the present review the authors contrast face-to-face and Internet-delivered cognitive behavior therapy (ICBT) for depression. A total of five studies are reviewed in which guided ICBT was directly compared against face-to-face CBT. Meta-analytic summary statistics were calculated for the five studies involving a total of 429 participants. The average effect size difference was Hedge's g = 0.12 (95% CI: -0.06-0.30) in the direction of favoring guided ICBT. The small difference in effect has no implication for clinical practice. The overall empirical status of clinician-guided ICBT for depression is commented on and future challenges are highlighted. Among these are developing treatments for patients with more severe and long-standing depression and for children, adolescents and the elderly. Also, there is a need to investigate mechanisms of change.

14 Review Borderline personality disorder: Prevalence and psychiatric comorbidity among male offenders on probation in Sweden. 2015

Wetterborg, Dan / Långström, Niklas / Andersson, Gerhard / Enebrink, Pia. ·Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden. Electronic address: dan.wetterborg@ki.se. · Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden; Swedish Prison and Probation Services R&D Unit, 601 80 Norrköping, Sweden. Electronic address: niklas.langstrom@ki.se. · Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, 581 83 Linköping, Sweden. Electronic address: gerhard.andersson@liu.se. · Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden. Electronic address: pia.enebrink@ki.se. ·Compr Psychiatry · Pubmed #26343468.

ABSTRACT: INTRODUCTION: Borderline personality disorder (BPD) is a severely disabling condition, associated with substantially increased risk of deliberate self-harm and, particularly in men, also with interpersonal violence and other criminal behavior. Although BPD might be common among prison inmates, little is known about prevalence and psychiatric comorbidity in probationers and parolees. METHOD: In 2013, a consecutive sample of 109 newly admitted adult male offenders on probation or parole in all three probation offices of Stockholm, Sweden, completed self-report screening questionnaires for BPD and other psychiatric morbidity. Participants scoring over BPD cut-off participated in a psychiatric diagnostic interview. RESULTS: We ascertained a final DSM-5 BPD prevalence rate of 19.8% (95% CI: 12.3-27.3%). The most common current comorbid disorders among subjects with BPD were antisocial personality disorder (91%), major depressive disorder (82%), substance dependence (73%), attention deficit hyperactivity disorder (ADHD) (70%), and alcohol dependence (64%). Individuals diagnosed with BPD had significantly more current psychiatric comorbidity (M=6.2 disorders) than interviewed participants not fulfilling BPD criteria (M=3.6). Participants with BPD also reported substantially more symptoms of ADHD, anxiety and depression compared to all subjects without BPD. CONCLUSIONS: BPD affected one fifth of probationers and was related to serious mental ill-health known to affect recidivism risk. The findings suggest further study of possible benefits of improved identification and treatment of BPD in offender populations.

15 Review The effects of cognitive behavior therapy for adult depression on dysfunctional thinking: A meta-analysis. 2015

Cristea, Ioana A / Huibers, Marcus J H / David, Daniel / Hollon, Steven D / Andersson, Gerhard / Cuijpers, Pim. ·Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania; Clinical Psychology Branch, Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Pisa, Italy. Electronic address: ioana.cristea@ubbcluj.ro. · Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, The Netherlands. · Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania. · Department of Psychology, Vanderbilt University, Nashville, USA. · Department of Behavioural Sciences and Learning, Linköping University, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. ·Clin Psychol Rev · Pubmed #26319193.

ABSTRACT: BACKGROUND: It is not clear whether cognitive behavior therapy (CBT) works through changing dysfunctional thinking. Although several primary studies have examined the effects of CBT on dysfunctional thinking, no meta-analysis has yet been conducted. METHOD: We searched for randomized trials comparing CBT for adult depression with control groups or with other therapies and reporting outcomes on dysfunctional thinking. We calculated effect sizes for CBT versus control groups, and separately for CBT versus other psychotherapies and respectively, pharmacotherapy. RESULTS: 26 studies totalizing 2002 patients met inclusion criteria. The quality of the studies was less than optimal. We found a moderate effect of CBT compared to control groups on dysfunctional thinking at post-test (g=0.50; 95% CI: 0.38-0.62), with no differences between the measures used. This result was maintained at follow-up (g=0.46; 95% CI: 0.15-0.78). There was a strong association between the effects on dysfunctional thinking and those on depression. We found no significant differences between CBT and other psychotherapies (g=0.17; p=0.31), except when restrict in outcomes to the Dysfunctional Attitudes Scale (g=0.29). There also was no difference between CBT and pharmacotherapy (g=0.04), though this result was based on only 4 studies. DISCUSSION: While CBT had a robust and stable effect on dysfunctional thoughts, this was not significantly different from what other psychotherapies or pharmacotherapy achieved. This result can be interpreted as confirming the primacy of cognitive change in symptom change, irrespective of how it is attained, as well as supporting the idea that dysfunctional thoughts are simply another symptom that changes subsequent to treatment.

16 Review Can cognitive behaviour therapy be beneficial for heart failure patients? 2015

Lundgren, Johan / Andersson, Gerhard / Johansson, Peter. ·Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. ·Curr Heart Fail Rep · Pubmed #25475179.

ABSTRACT: This review aims to summarize the theory of cognitive behavioural therapy (CBT) as well as the current evidence for whether CBT can be beneficial for patients with heart failure (HF). Depression and/or anxiety are common in HF patients. However, participation in disease management programmes does not seem to be beneficial for these problems. CBT, which focuses on the identification and changing of dysfunctional beliefs and thoughts and on behaviour therapy, is a possible treatment option. The number of CBT studies on HF is small and they are often not designed as randomized controlled trials. However, the studies on HF indicate that CBT can decrease depression as well as anxiety and suggest that relaxation exercises with elements of CBT may decrease symptom burden. Before implementation in clinical practice, more knowledge is needed about how CBT programmes should be designed, where CBT should be delivered and who should deliver CBT.

17 Review The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. 2014

Cuijpers, Pim / Karyotaki, Eirini / Weitz, Erica / Andersson, Gerhard / Hollon, Steven D / van Straten, Annemieke. ·Department of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands; Leuphana University, Lüneburg, Germany. Electronic address: p.cuijpers@vu.nl. · Department of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands. · Department of Behavioral Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. · Vanderbilt University, Nashville, Tennessee, USA. ·J Affect Disord · Pubmed #24679399.

ABSTRACT: BACKGROUND: Standardised effect sizes have been criticized because they are difficult to interpret and offer little clinical information. This meta-analyses examine the extent of actual improvement, the absolute numbers of patients no longer meeting criteria for major depression, and absolute rates of response and remission. METHODS: We conducted a meta-analysis of 92 studies with 181 conditions (134 psychotherapy and 47 control conditions) with 6937 patients meeting criteria for major depressive disorder. Within these conditions, we calculated the absolute number of patients no longer meeting criteria for major depression, rates of response and remission, and the absolute reduction on the BDI, BDI-II, and HAM-D. RESULTS: After treatment, 62% of patients no longer met criteria for MDD in the psychotherapy conditions. However, 43% of participants in the control conditions and 48% of people in the care-as-usual conditions no longer met criteria for MDD, suggesting that the additional value of psychotherapy compared to care-as-usual would be 14%. For response and remission, comparable results were found, with less than half of the patients meeting criteria for response and remission after psychotherapy. Additionally, a considerable proportion of response and remission was also found in control conditions. In the psychotherapy conditions, scores on the BDI were reduced by 13.42 points, 15.12 points on the BDI-II, and 10.28 points on the HAM-D. In the control conditions, these reductions were 4.56, 4.68, and 5.29. DISCUSSION: Psychotherapy contributes to improvement in depressed patients, but improvement in control conditions is also considerable.

18 Review Treatment of comorbid alcohol use disorders and depression with cognitive-behavioural therapy and motivational interviewing: a meta-analysis. 2014

Riper, Heleen / Andersson, Gerhard / Hunter, Sarah B / de Wit, Jessica / Berking, Matthias / Cuijpers, Pim. ·Department of Clinical Psychology, VU University Amsterdam, Amsterdam, the Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, the Netherlands; Division of Online Health Training, Innovation Incubator, Leuphana University Lüneburg, Lüneburg, Germany. ·Addiction · Pubmed #24304463.

ABSTRACT: BACKGROUND AND AIMS: To review published studies on the effectiveness of combining cognitive-behavioural therapy (CBT) and motivational interviewing (MI) to treat comorbid clinical and subclinical alcohol use disorder (AUD) and major depression (MDD) and estimate the effect of this compared with usual care. METHODS: We conducted systematic literature searches in PubMed, PsycINFO and Embase up to June 2013 and identified additional studies through cross-references in included studies and systematic reviews. Twelve studies comprising 1721 patients met our inclusion criteria. The studies had sufficient statistical power to detect small effect sizes. RESULTS: CBT/MI proved effective for treating subclinical and clinical AUD and MDD compared with controls, with small overall effect sizes at post-treatment [g=0.17, confidence interval (CI)=0.07-0.28, P<0.001 for decrease of alcohol consumption and g=0.27, CI: 0.13-0.41, P<0.001 for decrease of symptoms of depression, respectively]. Subgroup analyses revealed no significant differences for both AUD and MDD. However, digital interventions showed a higher effect size for depression than face-to-face interventions (g= 0.73 and g=0.23, respectively, P=0.030). CONCLUSIONS: Combined cognitive-behavioural therapy and motivational interviewing for clinical or subclinical depressive and alcohol use disorders has a small but clinically significant effect in treatment outcomes compared with treatment as usual.

19 Review A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. 2013

Cuijpers, Pim / Berking, Matthias / Andersson, Gerhard / Quigley, Leanne / Kleiboer, Annet / Dobson, Keith S. ·Department of Clinical Psychology, VU University, Amsterdam, the Netherlands. p.cuijpers@vu.nl ·Can J Psychiatry · Pubmed #23870719.

ABSTRACT: OBJECTIVE: No recent meta-analysis has examined the effects of cognitive-behavioural therapy (CBT) for adult depression. We decided to conduct such an updated meta-analysis. METHODS: Studies were identified through systematic searches in bibliographical databases (PubMed, PsycINFO, Embase, and the Cochrane library). We included studies examining the effects of CBT, compared with control groups, other psychotherapies, and pharmacotherapy. RESULTS: A total of 115 studies met inclusion criteria. The mean effect size (ES) of 94 comparisons from 75 studies of CBT and control groups was Hedges g = 0.71 (95% CI 0.62 to 0.79), which corresponds with a number needed to treat of 2.6. However, this may be an overestimation of the true ES as we found strong indications for publication bias (ES after adjustment for bias was g = 0.53), and because the ES of higher-quality studies was significantly lower (g = 0.53) than for lower-quality studies (g = 0.90). The difference between high- and low-quality studies remained significant after adjustment for other study characteristics in a multivariate meta-regression analysis. We did not find any indication that CBT was more or less effective than other psychotherapies or pharmacotherapy. Combined treatment was significantly more effective than pharmacotherapy alone (g = 0.49). CONCLUSIONS: There is no doubt that CBT is an effective treatment for adult depression, although the effects may have been overestimated until now. CBT is also the most studied psychotherapy for depression, and thus has the greatest weight of evidence. However, other treatments approach its overall efficacy.

20 Review [Depression treatment--then, now and in the future]. 2013

Mårtensson, Björn / Andersson, Gerhard / Wålinder, Jan / Agren, Hans. ·Karolinska Institutet, institutionen far klinisk neurovetenskap, Psykiatri Nordväst, Karolinska universitetssjukhuset, Solna. Bjorn.Martensson@ki.se ·Lakartidningen · Pubmed #23540034.

ABSTRACT: -- No abstract --

21 Review The effects of psychotherapy for adult depression on suicidality and hopelessness: a systematic review and meta-analysis. 2013

Cuijpers, Pim / de Beurs, Derek P / van Spijker, Bregje A J / Berking, Matthias / Andersson, Gerhard / Kerkhof, Ad J F M. ·Department of Clinical Psychology, VU University Amsterdam, The Netherlands. p.cuijpers@vu.nl ·J Affect Disord · Pubmed #22832172.

ABSTRACT: BACKGROUND: Although treatment guidelines suggest that suicidal patients with depression should be treated for depression with psychotherapy, it is not clear whether these psychological treatments actually reduce suicidal ideation or suicide risk. METHODS: We conducted a systematic review and meta-analysis of studies on psychotherapy for depression in which outcomes on suicidality were reported. We also focused on outcomes on hopelessness because this is strongly associated with suicidal behavior in depression. RESULTS: Thirteen studies (with 616 patients) were included, three of which examined the effects of psychotherapy for depression on suicidal ideation and suicide risk, and eleven on hopelessness. No studies were found with suicide attempts or completed suicides as the outcome variables. The effects on suicidal ideation and suicide risk were small (g=0.12; 95% CI: -0.20-0.44) and not statistically significant. A power calculation showed that these studies only had sufficient power to find an effect size of g=0.47. The effects on hopelessness were large (g=1.10; 95% CI: 0.72-1.48) and significant, although heterogeneity was very high. Furthermore, significant publication bias was found. After adjustment of publication bias the effect size was reduced to g=0.60. DISCUSSION: At this point, there is insufficient evidence for the assumption that suicidality in depressed patients can be reduced with psychotherapy for depression. Although psychotherapy of depression may have small positive effects on suicidality, available data suggest that psychotherapy for depression cannot be considered to be a sufficient treatment. The effects on hopelessness are probably higher.

22 Review Internet-based psychological treatments for depression. 2012

Johansson, Robert / Andersson, Gerhard. ·Department of Behavioural Sciences and Learning, Linköping University, SE-58183 Linköping, Sweden. ·Expert Rev Neurother · Pubmed #22853793.

ABSTRACT: Major depression is highly prevalent, and is associated with high societal costs and individual suffering. Evidence-based psychological treatments obtain good results, but access to these treatments is limited. One way to solve this problem is to provide internet-based psychological treatments, for example, with therapist support via email. During the last decade, internet-delivered cognitive-behavioral therapy (ICBT) has been tested in a series of controlled trials. However, the ICBT interventions are delivered with different levels of contact with a clinician, ranging from nonexisting to a thorough pretreatment assessment in addition to continuous support during treatment. In this review, the authors have found an evidence for a strong correlation between the degree of support and outcome. The authors have also reviewed how treatment content in ICBT varies among treatments, and how various therapist factors may influence outcome. Future possible applications of ICBT for depression and future research needs are also discussed.

23 Review Personalized treatment of adult depression: medication, psychotherapy, or both? A systematic review. 2012

Cuijpers, Pim / Reynolds, Charles F / Donker, Tara / Li, Juan / Andersson, Gerhard / Beekman, Aartjan. ·Department of Clinical Psychology, VU University Amsterdam, 1081 BT Amsterdam, The Netherlands. p.cuijpers@vu.nl ·Depress Anxiety · Pubmed #22815247.

ABSTRACT: BACKGROUND: Personalized medicine aims to identify which characteristics of an individual predict the outcome of a specific treatment, in order to get a better match between the individual and the treatment received. We conducted a systematic review and meta-analysis of randomized trials comparing two treatments directly in a group of patients with a specific characteristic. METHODS: We searched relevant studies from bibliographical databases and included trials comparing (1) medication with psychotherapy, (2) medication with combined treatment, and (3) psychotherapy with combined treatment, in specific target groups (a) with a predefined sociodemographic characteristic, (b) a specific type of depression, (c) a comorbid mental or somatic disorder, or (d) from a specific setting (outpatients, primary care). RESULTS: We included 52 studies with 4,734 depressed patients. In these studies, 20 characteristics of the target groups were examined. The results showed that medication is probably the best treatment for dysthymia, and combined treatments are more effective in depressed outpatients, as well as in depressed older adults. However, in order to examine the 20 characteristics in the three categories of comparisons, 254 studies would be needed for having sufficient statistical power to show an effect size of g = 0.5. Currently, only 20.1% of these studies have been conducted. CONCLUSIONS: Although a considerable number of studies have compared medication, psychotherapy, and combined treatments, and some preliminary results are useful for deciding which treatment is best for which patient, the development of personalized treatment of depression has only just begun.

24 Review Psychological treatment of depression in inpatients: a systematic review and meta-analysis. 2011

Cuijpers, Pim / Clignet, Frans / van Meijel, Berno / van Straten, Annemieke / Li, Juan / Andersson, Gerhard. ·Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, Amsterdam, The Netherlands. p.cuijpers@psy.vu.nl ·Clin Psychol Rev · Pubmed #21382540.

ABSTRACT: Research on psychological treatment of depression in inpatients is not conclusive, with some studies finding clear positive effects and other studies finding no significant benefit compared to usual care or structured pharmacotherapy. The results of a meta-analysis investigating how effective psychological treatment is for depressed inpatients are presented. A systematic search in bibliographical databases resulted in 12 studies with a total of 570 respondents. This set of studies had sufficient statistical power to detect small effect sizes. Psychological treatments had a small (g=0.29), but statistically significant additional effect on depression compared to usual care and structured pharmacological treatments only. This corresponded with a numbers-needed-to-be-treated of 6.17. Heterogeneity was zero in most analyses, and not significant in all analyses. There was no indication for significant publication bias. Effects were not associated with characteristics of the population, the interventions and the design of the studies. Although the number of studies was small, and the quality of many studies was not optimal, it seems safe to conclude that psychological treatments have a small but robust effect on depression in depressed inpatients. More high-quality research is needed to verify these results.

25 Review Interpersonal psychotherapy for depression: a meta-analysis. 2011

Cuijpers, Pim / Geraedts, Anna S / van Oppen, Patricia / Andersson, Gerhard / Markowitz, John C / van Straten, Annemieke. ·Department of Clinical Psychology, Vrije Universiteit Amsterdam, the Netherlands. p.cuijpers@psy.vu.nl ·Am J Psychiatry · Pubmed #21362740.

ABSTRACT: OBJECTIVE: Interpersonal psychotherapy (IPT), a structured and time-limited therapy, has been studied in many controlled trials. Numerous practice guidelines have recommended IPT as a treatment of choice for unipolar depressive disorders. The authors conducted a meta-analysis to integrate research on the effects of IPT. METHOD: The authors searched bibliographical databases for randomized controlled trials comparing IPT with no treatment, usual care, other psychological treatments, and pharmacotherapy as well as studies comparing combination treatment using pharmacotherapy and IPT. Maintenance studies were also included. RESULTS: Thirty-eight studies including 4,356 patients met all inclusion criteria. The overall effect size (Cohen's d) of the 16 studies that compared IPT and a control group was 0.63 (95% confidence interval [CI]=0.36 to 0.90), corresponding to a number needed to treat of 2.91. Ten studies comparing IPT and other psychological treatments showed a nonsignificant differential effect size of 0.04 (95% CI=-0.14 to 0.21; number needed to treat=45.45) favoring IPT. Pharmacotherapy (after removal of one outlier) was more effective than IPT (d=-0.19, 95% CI=-0.38 to -0.01; number needed to treat=9.43), and combination treatment was not more effective than IPT alone, although the paucity of studies precluded drawing definite conclusions. Combination maintenance treatment with pharmacotherapy and IPT was more effective in preventing relapse than pharmacotherapy alone (odds ratio=0.37; 95% CI=0.19 to 0.73; number needed to treat=7.63). CONCLUSIONS: There is no doubt that IPT efficaciously treats depression, both as an independent treatment and in combination with pharmacotherapy. IPT deserves its place in treatment guidelines as one of the most empirically validated treatments for depression.

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