Quantified superiority of cognitive behaviour therapy to antidepressant drugs: a challenge to an earlier meta-analysis.
OBJECTIVE
The study aimed to review the conclusion of a previously published meta-analysis which quantified distinct superiority of cognitive therapy to antidepressant drug-therapy (P < 0.0001).


METHODS
We sought to include all studies used in the original meta-analysis. Adopting both that study's inclusion criteria and additional criteria resulted in a reduced set of studies. We analysed both 'completer' and 'intention to treat' data, using effect size and odds ratio quantification.


RESULTS
There was an overall trend for cognitive therapy to be superior to antidepressant drug-therapy, but this was significant for only one of the four meta-analyses (an intention to treat analysis). We demonstrated considerable heterogeneity between studies, and a significantly higher drop-out rate in the antidepressant groups.


CONCLUSIONS
The previous interpretation--cognitive therapy being distinctly superior to antidepressant medication--cannot be sustained from the currently analysed data set.
Parker
G B
GB
School of Psychiatry, University of New South Wales and Black Dog Institute, Prince of Wales Hospital, Sydney, Australia. g.parker@unsw.edu.au
Crawford
J
J
Hadzi-Pavlovic
D
D
D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003627:Data Interpretation, Statistical; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D015201:Meta-Analysis as Topic; D016896:Treatment Outcome
D000928:Antidepressive Agents