Antidepressants, Cognitive-Behavior Therapy And Combination Treatment For Depressed Patients: A Systematic Review And Meta-Analysis

摘要

Background: The comparative effectiveness of antidepressant medication and cognitive-behavior therapy for the acute treatment of depression is contentious. Objective: To compare the acute outcomes of antidepressant medication, cognitive-behavior therapy (CBT), and the combination of the two, in adult, depressed patients. Methods: Sixteen electronic databases together with reference lists were searched for randomised and other clinical trials that compared CBT, antidepressants, or their combination. Results: In the comparison between CBT and antidepressants, 8 studies met inclusion criteria. Five studies met the inclusion criteria for the second comparison between single therapy and combination therapy. In the antidepressant and CBT comparison, effect sizes favored CBT over antidepressants with a significant advantage for CBT on some outcome measures. Combined treatment appeared more effective than antidepressants. However, combined treatment did not emerge more effective than CBT. Conclusions: Antidepressants may not be considered more efficacious than CBT for the acute treatment of depressed patients nor can combination therapy be regarded as more effective than CBT alone.