Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials.
BACKGROUND
Meta-analyses on psychological treatment for depression in individuals with a somatic disease are limited to specific underlying somatic diseases, thereby neglecting the generalisability of the interventions.


OBJECTIVE
To examine the effectiveness of cognitive-behavioural therapy (CBT) for depression in people with a diversity of somatic diseases.


METHODS
Meta-analysis of randomised controlled trials evaluating CBT for depression in people with a somatic disease. Severity of depressive symptoms was pooled using the standardised mean difference (SMD).


RESULTS
Twenty-nine papers met inclusion criteria. Cognitive-behavioural therapy was superior to control conditions with larger effects in studies restricted to participants with depressive disorder (SMD = -0.83, 95% CI -1.36 to -0.31, P<0.001) than in studies of participants with depressive symptoms (SMD = -0.16, 95% CI -0.27 to -0.06, P = 0.001). Subgroup analyses showed that CBT was not superior to other psychotherapies.


CONCLUSIONS
Cognitive-behavioural therapy significantly reduces depressive symptoms in people with a somatic disease, especially in those who meet the criteria for a depressive disorder.
Beltman
Matthijs W
MW
Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands. mw.beltman@psy.umcn.nl
Voshaar
Richard C Oude
RC
Speckens
Anne E
AE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000209:etiology / Q000628:therapy*; D003866:Depressive Disorder / Q000209:etiology / Q000628:therapy*; D004194:Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D016896:Treatment Outcome