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34 results

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  • Comparative efficacy of interpersonal psychotherapy and antidepressant medication for adult depression: a systematic review and individual participant data meta-analysis

  • Zachary D. Cohen, Jasmijn Breunese, John C. Markowitz, Erica S. Weitz, Steven D. Hollon, Dillon T. Browne, Paola Rucci, Carolina Corda, Marco Menchetti, Myrna M. Weissman, R. Michael Bagby, Lena C. Quilty, Marc B. J. Blom, Mario Altamura, Ingo Zobel, Elisabeth Schramm, Carlos Gois, Jos W. R. Twisk, Frederik J. Wienicke, Pim Cuijpers, Ellen Driessen
  • Journal:
    Psychological Medicine / Volume 54 / Issue 14 / October 2024
    Published online by Cambridge University Press:
    04 November 2024, pp. 3785-3794
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  • Interpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses. This IPD meta-analysis compared the efficacy of IPT and antidepressants on various outcomes at post-treatment and follow-up (PROSPERO: CRD42020219891). A systematic literature search conducted May 1st, 2023 identified randomized trials comparing IPT and antidepressants in acute-phase treatment of adults with depression. Anonymized IPD were requested and analyzed using mixed-effects models. The prespecified primary outcome was post-treatment depression symptom severity. Secondary outcomes were all post-treatment and follow-up measures assessed in at least two studies. IPD were obtained from 9 of 15 studies identified (N = 1536/1948, 78.9%). No significant comparative treatment effects were found on post-treatment measures of depression (d = 0.088, p = 0.103, N = 1530) and social functioning (d = 0.026, p = 0.624, N = 1213). In smaller samples, antidepressants performed slightly better than IPT on post-treatment measures of general psychopathology (d = 0.276, p = 0.023, N = 307) and dysfunctional attitudes (d = 0.249, p = 0.029, N = 231), but not on any other secondary outcomes, nor at follow-up. This IPD meta-analysis is the first to examine the acute and longer-term efficacy of IPT v. antidepressants on a broad range of outcomes. Depression treatment trials should routinely include multiple outcome measures and follow-up assessments.

  • The efficacy of antidepressant medication and interpersonal psychotherapy for adult acute-phase depression: study protocol of a systematic review and meta-analysis of individual participant data

  • Ellen Driessen, Zachary D. Cohen, Myrna M. Weissman, John C. Markowitz, Erica S. Weitz, Steven D. Hollon, Dillon T. Browne, Paola Rucci, Carolina Corda, Marco Menchetti, R. Michael Bagby, Lena C. Quilty, Michael W. O'Hara, Caron Zlotnick, Teri Pearlstein, Marc B. J. Blom, Mario Altamura, Carlos Gois, Lon S. Schneider, Jos W. R. Twisk, Pim Cuijpers
  • Journal:
    BJPsych Open / Volume 7 / Issue 2 / March 2021
    Published online by Cambridge University Press:
    19 February 2021, e56
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  • Background

    Antidepressant medication and interpersonal psychotherapy (IPT) are both recommended interventions in depression treatment guidelines based on literature reviews and meta-analyses. However, ‘conventional’ meta-analyses comparing their efficacy are limited by their reliance on reported study-level information and a narrow focus on depression outcome measures assessed at treatment completion. Individual participant data (IPD) meta-analysis, considered the gold standard in evidence synthesis, can improve the quality of the analyses when compared with conventional meta-analysis.

    Aims

    We describe the protocol for a systematic review and IPD meta-analysis comparing the efficacy of antidepressants and IPT for adult acute-phase depression across a range of outcome measures, including depressive symptom severity as well as functioning and well-being, at both post-treatment and follow-up (PROSPERO: CRD42020219891).

    Method

    We will conduct a systematic literature search in PubMed, PsycINFO, Embase and the Cochrane Library to identify randomised clinical trials comparing antidepressants and IPT in the acute-phase treatment of adults with depression. We will invite the authors of these studies to share the participant-level data of their trials. One-stage IPD meta-analyses will be conducted using mixed-effects models to assess treatment effects at post-treatment and follow-up for all outcome measures that are assessed in at least two studies.

    Conclusions

    This will be the first IPD meta-analysis examining antidepressants versus IPT efficacy. This study has the potential to enhance our knowledge of depression treatment by comparing the short- and long-term effects of two widely used interventions across a range of outcome measures using state-of-the-art statistical techniques.

  • Personality traits in psychosis and psychosis risk linked to TSPO expression: a neuroimmune marker

  • Part of
  • Cory Gerritsen, Yajur Iyengar, Tania DaSilva, Alex Koppel, Pablo Rusjan, R. Michael Bagby, Romina Mizrahi
  • Journal:
    Personality Neuroscience / Volume 3 / 2020
    Published online by Cambridge University Press:
    24 November 2020, e14
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  • Personality has been correlated with differences in cytokine expression, an indicator of peripheral inflammation; however, the associations between personality and central markers of inflammation have never been investigated in vivo in humans. Microglia are the resident macrophages of the central nervous system, and the first responders to tissue damage and brain insult. Microglial activation is associated with elevated expression of translocator protein 18kDa (TSPO), which can be imaged with positron emission tomography (PET) to quantify immune activation in the human brain. This study aimed to investigate the association between personality and TSPO expression across the psychosis spectrum. A total of 61 high-resolution [18F]FEPPA PET scans were conducted in 28 individuals at clinical high risk (CHR) for psychosis, 19 First-Episode Psychosis (FEP), and 14 healthy volunteers (HVs), and analyzed using a two-tissue compartment model and plasma input function to obtain a total volume of distribution (VT) as an index of brain TSPO expression (controlling for the rs6971 TSPO polymorphism). Personality was assessed using the Revised NEO Personality Inventory (NEO-PI-R). We found TSPO expression to be specifically associated with neuroticism. A positive association between TSPO expression and neuroticism was found in HVs, in contrast to a nonsignificant, negative association in CHR and significant negative association in FEP. The TSPO-associated neuroticism trait indicates an unexplored connection between neuroimmune activation and personality that varies across the psychosis spectrum.

  • 9 - Writing a Psychological Report Using Evidence-Based Psychological Assessment Methods

  • from Part I - General Issues in Clinical Assessment and Diagnosis
  • Edited by Martin Sellbom, University of Otago, New Zealand, Julie A. Suhr, Ohio University
  • Book:
    The Cambridge Handbook of Clinical Assessment and Diagnosis
    Published online:
    06 December 2019
    Print publication:
    19 December 2019, pp 101-110

  • Summary

    Psychological assessment and report writing are arguably two of the more important tasks of clinical psychologists. The overall purpose of this chapter is to provide some recommendations and guidelines on how to write a psychological report using evidence-based assessment methods. Principles on psychological report writing derived from seminal papers in the field of psychological assessment were adapted and used as an organizing tool to create a template on how to write all varieties of psychological reports that incorporate evidence-based assessment methods. Report writers who share similar approaches to evidence-based assessment methods may find this template helpful when formatting their psychological reports.

  • Cognitive change in cognitive-behavioural therapy v. pharmacotherapy for adult depression: a longitudinal mediation analysis

  • Leanne Quigley, David J. A. Dozois, R. Michael Bagby, Daniela S. S. Lobo, Lakshmi Ravindran, Lena C. Quilty
  • Journal:
    Psychological Medicine / Volume 49 / Issue 15 / November 2019
    Published online by Cambridge University Press:
    18 December 2018, pp. 2626-2634
  • Background

    Although cognitive-behavioural therapy (CBT) is a well-established treatment for adult depression, its efficacy and efficiency may be enhanced by better understanding its mechanism(s) of action. According to the theoretical model of CBT, symptom improvement occurs via reductions in maladaptive cognition. However, previous research has not established clear evidence for this cognitive mediation model.

    Methods

    The present study investigated the cognitive mediation model of CBT in the context of a randomized controlled trial of CBT v. antidepressant medication (ADM) for adult depression. Participants with major depressive disorder were randomized to receive 16 weeks of CBT (n = 54) or ADM (n = 50). Depression symptoms and three candidate cognitive mediators (dysfunctional attitudes, cognitive distortions and negative automatic thoughts) were assessed at week 0 (pre-treatment), week 4, week 8 and week 16 (post-treatment). Longitudinal associations between cognition and depression symptoms, and mediation of treatment outcome, were evaluated in structural equation models.

    Results

    Both CBT and ADM produced significant reductions in maladaptive cognition and depression symptoms. Cognitive content and depression symptoms were moderately correlated within measurement waves, but cross-lagged associations between the variables and indirect (i.e. mediated) treatment effects were non-significant.

    Conclusions

    The results provide support for concurrent relationships between cognitive and symptom change, but not the longitudinal relationships hypothesized by the cognitive mediation model. Results may be indicative of an incongruence between the timing of measurement and the dynamics of cognitive and symptom change.

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