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Effects of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder: a systematic review of randomized clinical trials with meta-analyses and trial sequential analyses

  • J. C. Jakobsen (a1) (a2), J. L. Hansen (a2), S. Simonsen (a1), E. Simonsen (a1) and C. Gluud (a2)...
Abstract
Background

Major depressive disorder afflicts an estimated 17% of individuals during their lifetime at tremendous suffering and cost. Cognitive therapy and interpersonal psychotherapy are treatment options, but their effects have only been limitedly compared in systematic reviews.

Method

Using Cochrane systematic review methodology we compared the benefits and harm of cognitive therapy versus interpersonal psychotherapy for major depressive disorder. Trials were identified by searching the Cochrane Library's CENTRAL, Medline via PubMed, EMBASE, Psychlit, PsycInfo, and Science Citation Index Expanded until February 2010. Continuous outcome measures were assessed by mean difference and dichotomous outcomes by odds ratio. We conducted trial sequential analysis to control for random errors.

Results

We included seven trials randomizing 741 participants. All trials had high risk of bias. Meta-analysis of the four trials reporting data at cessation of treatment on the Hamilton Rating Scale for Depression showed no significant difference between the two interventions [mean difference −1.02, 95% confidence interval (CI) −2.35 to 0.32]. Meta-analysis of the five trials reporting data at cessation of treatment on the Beck Depression Inventory showed comparable results (mean difference −1.29, 95% CI −2.73 to 0.14). Trial sequential analysis indicated that more data are needed to definitively settle the question of a differential effect. None of the included trial reported on adverse events.

Conclusions

Randomized trials with low risk of bias and low risk of random errors are needed, although the effects of cognitive therapy and interpersonal psychotherapy do not seem to differ significantly regarding depressive symptoms. Future trials should report on adverse events.

Copyright
Corresponding author
*Address for correspondence: J. C. Jakobsen, M.D., Psychiatric Research Unit, Copenhagen University Hospital, Region Zealand, Roskilde, Denmark. (Email: janusjakobsen@mac.com)
References
Hide All
Altman DG, Bland JM (2003). Interaction revisited: the difference between two estimates. British Medical Journal 326, 219.
Anonymous (1999). ICH Harmonised Tripartite Guideline. Statistical principles for clinical trials. International Conference on Harmonisation E9 Expert Working Group. Statistics in Medicine 18, 19051942.
APA (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. American Psychological Association: Washington, DC.
APA (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn, revised. American Psychological Association: Washington, DC.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. American Psychological Association: Washington, DC.
Arnow BA, Constantino MJ (2003). Effectiveness of psychotherapy and combination treatment for chronic depression. Journal of Clinical Psychology 59, 893905.
Bagby RM, Ryder AG, Schuller DR, Marshall MB (2004). The Hamilton Depression Rating Scale: has the gold standard become a lead weight? American Journal of Psychiatry 161, 21632177.
Barber JP, Muenz LR (1996). The role of avoidance and obsessiveness in matching patients to cognitive and interpersonal psychotherapy: empirical findings from the treatment for depression collaborative research program. Journal of Consulting and Clinical Psychology 64, 951958.
Bech P (1999). Stress og livskvalitet (Stress and Quality of Life). Psykiatrifondens Forlag: Copenhagen.
Beck AT, Rush AJ, Shaw BF, Emery G (1979). Cognitive therapy of depression. Australian and New Zealand Journal of Psychiatry 36, 275278.
Beck AT, Ward CH, Mendelson M, Mick J, Erbaigh J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.
Bellino S, Zizza M, Rinaldi C, Bogetto F (2006). Combined treatment of major depression in patients with borderline personality disorder: a comparison with pharmacotherapy. Canadian Journal of Psychiatry 51, 453460.
Bellino S, Zizza M, Rinaldi C, Bogetto F (2007). Combined therapy of major depression with concomitant borderline personality disorder: comparison of interpersonal and cognitive psychotherapy. Canadian Journal of Psychiatry 52, 718725.
Berk M, Ng F, Dodd S, Callaly T, Campbell S, Bernardo M, Trauer T (2008). The validity of the CGI severity and improvement scales as measures of clinical effectiveness suitable for routine clinical use. Journal of Evaluation in Clinical Practice 14, 979983.
Boutron I, Moher D, Altman DG, Schulz KF, Ravaud P (2008). Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine 148, 295309.
Brok J, Thorlund K, Gluud C, Wetterslev J (2008). Trial sequential analysis reveals insufficient information size and potentially false positive results in many meta-analysis. Journal of Clinical Epidemiology 61, 763769.
Chakraborty R, Chatterjee A (2007). Predictors of suicide attempt among those with depression in an Indian sample: a brief report. Internet Journal of Mental Health, volume 4, number 2. Published online: 11 October 2007.
Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, Churchill R, Barbui C (2009). Escitalopram versus other antidepressive agents for depression. Cochrane Database of Systematic Reviews, issue 2, art. no.: CD006532. doi:10.1002/14651858.CD006532.pub2.
Cornes C, Frank E (1994). Interpersonal psychotherapy for depression. Clinical Psychologist 47, 910.
Covi L, Lipman RS (1987). Cognitive behavioral group psychotherapy combined with imipramine in major depression. Psychopharmacology Bulletin 23, 173176.
Cutler JL, Goldyne A, Markowitz JC, Devlin MJ, Glick RA (2004). Comparing cognitive behavior therapy, interpersonal psychotherapy, and psychodynamic psychotherapy. American Journal of Psychiatry 161, 15671573.
Davidson KW, Rieckmann N, Clemow L, Schwartz JE, Shimbo D, Medina V, Albanese G, Kronish I, Hegel M, Burg MM (2010). Enhanced depression care for patients with acute coronary syndrome and persistent depressive symptoms: coronary psychosocial evaluation studies randomized controlled trial. Archives of Internal Medicine 170, 600608.
Elkin I, Parloff MB, Hadley SW, Autry JH (1985). NIMH treatment of Depression Collaborative Research Program: background and research plan. Archives of General Psychiatry 42, 305316.
Elkin I, Shea MT, Watkins JT, Imber SD (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: general effectiveness of treatments. Archives of General Psychiatry 46, 971982.
Fawcett J (1993). The morbitity and mortality of clinical depression. International Clinical Psychopharmacology 8, 217220.
Fitzgibbon ML, Cella DF, Sweeney JA (1988). Redundancy in measures of depression. Journal of Clinical Psychology 44, 372374.
Gallagher TD, Steffen AM (1994). Comparative effects of cognitive-behavioral and brief psychodynamic psychotherapies for depressed family caregivers. Journal of Consulting and Clinical Psychology 62, 543549.
Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E, Goodwin GM (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 361, 653661.
Gluud C (2006 a). The culture of designing hepato-biliary randomised trials. Journal of Hepatology 44, 607615.
Gluud LL (2006 b). Bias in clinical intervention research. American Journal of Epidemiology 163, 493501.
Greenberg P, Stiglin LE, Finkelstein SN, Berndt ER (1993). The economic burden of depression in 1990. Journal of Clinical Psychiatry 54, 405418.
Hamilton M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5661.
Hardy GE, Barkham M, Shapiro DA, Stiles WB, Rees A, Reynolds S (1995). Impact of cluster C personality disorders on outcomes of contrasting brief psychotherapies for depression. Journal of Consulting and Clinical Psychology 63, 9971004.
Heo M, Murphy CF, Meyers BS (2007). Relationship between the Hamilton Depression Rating Scale and the Montgomery–Asberg Depression Rating Scale in depressed elderly: a meta-analysis. American Journal of Geritric Psychiatry 15, 899905.
Higgins J, Green S (2008). Cochrane Handbook for Systematic Reviews of Interventions, Version 5.0.0. The Cochrane Collaboration, 2008 (http://www.cochrane-handbook.org). Accessed 29 May 2011.
Higginson IJ, Carr AJ (2001). Measuring quality of life: using quality of life measures in the clinical setting. BMJ 322, 12971300.
Hogg JA, Deffenbacher JL (1988). A comparison of cognitive and interpersonal-process group therapies in the treatment of depression among college students. Journal of Counseling Psychology 35, 304310.
Hopewell S, Wolfenden L, Clarke M (2008). Reporting of adverse events in systematic reviews can be improved: survey results. Journal of Clinical Epidemiology 61, 597602.
Howard M, Battle CL, Pearlstein T, Rosene-Montella K (2006). A psychiatric mother–baby day hospital for pregnant and postpartum women. Archives of Woman's Mental Health 9, 213218.
Imber SD, Pilkonis PA, Sotsky SM, Elkin I, Watkins JT, Collins JF, Shea MT, Leber WR, Glass DR (1990). Mode-specific effects among three treatments for depression. Journal of Consulting and Clinical Psychology 58, 352359.
International Conference on Harmonisation E9 Expert Working Group (1997). Code of Federal Regulations and Guidelines, vol. 1. Barnett International/PAREXEL: Philadelphia, PA.
Jakobsen J, Lindschou Hansen J, Simonsen S, Simonsen E (2010). The effect of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder. A systematic review of randomised clinical trials with meta-analyses and trial sequential analyses (http://www.ctu.dk). Accessed February 2010.
Joyce PR, McKenzie JM, Carter JD, Rae AM, Luty SE, Frampton CMA, Mulder RT (2007). Temperament, character and personality disorders as predictors of response to interpersonal psychotherapy and cognitive-behavioural therapy for depression. British Journal of Psychiatry 190, 503508.
Kellet S, Clarke S, Matthews L (2007). Delivering group psychoeducational CBT in primary care: comparing outcomes with individual CBT and individual psychodynamic-interpersonal psychotherapy. British Journal of Clinical Psychology 46, 211222.
Kessler RC, McGnagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen H-U, Kendler KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 819.
Keus F, Wetterslev J, Gluud C, van Laarhoven CJ (2010). Evidence at a glance: error matrix approach for overviewing available evidence. BMC Medical Research Methodology 10, 90.
Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine 5, e45.
Kjaergaard L, Villumsen J, Gluud C (2001). Reported methodologic quality and discrepancies between large and small randomized trials in meta-analysis. Annals of Internal Medicine 135, 982989.
Levav I, Rutz W (2002). The WHO World Health Report 2001. New understanding – new hope. Israel Journal of Psychiatry and Related Sciences 39, 5056.
Levenson H, Butler SF, Powers TA, Beitman BD (2002). Concise Guide to Brief Dynamic and Interpersonal Therapy. American Psychiatric Publishing Inc.: Washington, DC.
Luty SE, Carter JD, McKenzie JM, Rae AM, Frampton CMA, Mulder RT, Joyce PR (2007). Randomised controlled trial of interpersonal psychotherapy and cognitive-behavioural therapy for depression. British Journal of Psychiatry 190, 496502.
Majani G, Pierobon A, Giardini A, Callegari S (2000). Satisfaction profile (SAT-P) in 732 patients: focus on subjectivity in HRQoL assessment. Psychology and Health 15, 409422.
Marshall MB, Zuroff DC, McBride C, Bagby RM (2008). Self-criticism predicts differential response to treatment for major depression. Journal of Clinical Psychology 64, 231244.
McBride C, Atkinson L, Quilty LC, Bagby RM (2006). Attachment as moderator of treatment outcome in major depression: a randomized control trial of interpersonal psychotherapy versus cognitive behavior therapy. Journal of Consulting and Clinical Psychology 74, 10411054.
Neimeyer RA, Feixas G (1990). The role of homework and skill acquisition in the outcome of group cognitive therapy for depression. Behavior Therapy 21, 281292.
Neimeyer RA, Weiss ME (1990). Cognitive and symptomatic predictors of outcome of group therapies for depression. Journal of Cognitive Psychotherapy: An International Quarterly 4, 2332.
Quilty LC, McBride C, Bagby RM (2008). Evidence for the cognitive mediational model of cognitive behavioural therapy for depression. Psychological Medicine 38, 15311541.
Rose SC, Bisson J, Churchill R, Wessely S (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, issue 2, art. no.: CD000560. doi:10.1002/14651858.CD000560.
Shapiro DA, Barkham M, Hardy GE, Morrison LA (1990). The second Sheffield psychotherapy project: rationale, design and preliminary outcome data. British Journal of Medical Psychology 63, 97108.
Shapiro DA, Barkham M, Rees A, Hardy GE, Reynolds S, Startup M (1994). Effects of treatment duration and severity of depression on the effectiveness of cognitive-behavioral and psychodynamic-interpersonal psychotherapy. Journal of Consulting and Clinical Psychology 62, 522534.
Shapiro DA, Rees A, Barkham M, Hardy G (1995). Effects of treatment duration and severity of depression on the maintenance of gains after cognitive-behavioral and psychodynamic-interpersonal psychotherapy. Journal of Consulting and Clinical Psychology 63, 378387.
Shea MT, Elkin I, Imber SD, Sotsky SM (1992). Course of depressive symptoms over follow-up: findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Archives of General Psychiatry 49, 782787.
Shea MT, Pilkonis PA, Beckham E, Collins JF (1990). Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program. American Journal of Psychiatry 147, 711718.
Sofuoglu M, Sugarman DE, Carroll KM (2010). Cognitive function as an emerging treatment target for marijuana addiction. Experimental and Clinical Psychopharmacology 18, 109119.
Sotsky SM, Glass DR, Shea MT, Pilkonis PA (1991). Patient predictors of response to psychotherapy and pharmacotherapy: findings in the NIMH Treatment of Depression Collaborative Research Program. American Journal of Psychiatry 148, 9971008.
Spijker J, de Graaf R, Bijl RV, Beekman AT, Ormel J, Nolen WA (2002). Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). British Journal of Psychiatry 181, 208213.
Stewart JW, Garfinkel R, Nunes EV, Donovan S, Klein DF (1998). Atypical features and treatment response in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Clinical Psychopharmacology 18, 429434.
Thorlund K, Devereaux PJ, Wetterslev J, Guyatt G, Ioannidis JP, Thabane L, Gluud LL, Als-Nielsen B, Gluud C (2009). Can trial sequential monitoring boundaries reduce spurious inferences from meta-analyses? International Journal of Epidemiology 38, 276286.
Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R (2008). Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine 358, 252260.
Walwyn R, Roberts C (2010). Therapist variation within randomised trials of psychotherapy: implications for precision, internal and external validity. Statistical Methods in Medical Research 19, 291315.
Weissman M, Markowitz J, Klerman G (2000). Comprehensive Guide to Interpersonal Psychotherapy. Basic Books: New York.
Wetterslev J, Thorlund K, Brok J, Gluud C (2008). Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis. Journal of Clinical Epidemiology 61, 6475.
WHO (1992). International Statistical Classification of Diseases and Related Health Problems (ICD-10), 10th revision. World Health Organization: Geneva.
Wilkins CH, Mathews J, Sheline YI (2009). Late life depression with cognitive impairment: evaluation and treatment. Journal of Clinical Interventions in Aging 4, 5157.
Wiser S, Goldfried MR (1998). Therapist interventions and client emotional experiencing in expert psychodynamic-interpersonal and cognitive-behavioral therapies. Journal of Consulting and Clinical Psychology 66, 634640.
Wood L, Egger M, Gluud LL, Schulz KF, Juni P, Altman DG, Gluud C, Martin RM, Wood AJ, Sterne JA (2008). Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. British Medical Journal 336, 601605.
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