A meta-analysis of the effects of cognitive therapy in depressed patients.
BACKGROUND
Cognitive therapy (CT) has been studied in 78 controlled clinical trials from 1977 to 1996.


METHODS
The meta-analysis used Hedges and Olkin d+ and included 48 high-quality controlled trials. The 2765 patients presented non-psychotic and non-bipolar major depression, or dysthymia of mild to moderate severity.


RESULTS
At post-test CT appeared significantly better than waiting-list, antidepressants (P < 0.0001) and a group of miscellaneous therapies (P < 0.01). But, CT was equal to behaviour therapy. As between-trial homogeneity was not met, the comparisons of CT with waiting-list or placebo, and other therapies should be taken cautiously. In contrast, between-trial homogeneity was high for the comparisons of CT with behaviour therapy and antidepressants. A review of eight follow-up studies comparing CT with antidepressants suggested that CT may prevent relapses in the long-term, while relapse rate is high with antidepressants in naturalistic studies.


CONCLUSIONS
CT is effective in patients with mild or moderate depression.
Gloaguen
V
V
Anxiety Disorder Unit Hopital Neurologique, Lyon, France.
Cottraux
J
J
Cucherat
M
M
Blackburn
I M
IM
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D016001:Confidence Intervals; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011613:Psychotherapy / Q000145:classification / Q000592:standards; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data
D000928:Antidepressive Agents