title: Effectiveness of psychological treatments for depressive disorders in primary care: systematic review and meta-analysis.
abstract: OBJECTIVE
  We performed a systematic review of the currently available evidence on whether psychological treatments are effective for treating depressed primary care patients in comparison with usual care or placebo, taking the type of therapy and its delivery mode into account.
  
  
  METHODS
  Randomized controlled trials comparing a psychological treatment with a usual care or a placebo control in adult, depressed, primary care patients were identified by searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO up to December 2013. At least 2 reviewers extracted information from included studies and assessed the risk of bias. Random effects meta-analyses were performed using posttreatment depression scores as outcome.
  
  
  RESULTS
  A total of 30 studies with 5,159 patients met the inclusion criteria. Compared with control, the effect (standardized mean difference) at completion of treatment was -0.30 (95% CI, -0.48 to -0.13) for face-to-face cognitive behavioral therapy (CBT), -0.14 (-0.40 to 0.12) for face-to-face problem-solving therapy, -0.24 (-0.47 to -0.02) for face-to-face interpersonal psychotherapy, -0.28 (-0.44 to -0.12) for other face-to-face psychological interventions, -0.43 (-0.62 to -0.24) for remote therapist-led CBT, -0.56 (-1.57 to 0.45) for remote therapist-led problem-solving therapy, -0.40 (-0.69 to -0.11) for guided self-help CBT, and -0.27 (-0.44 to -0.10) for no or minimal contact CBT.
  
  
  CONCLUSIONS
  There is evidence that psychological treatments are effective in depressed primary care patients. For CBT approaches, substantial evidence suggests that interventions that are less resource intensive might have effects similar to more intense treatments.
authors.affiliation: Institute of General Practice, Technische Universität München, Munich, Germany Klaus.Linde@tum.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Linde
authors.affiliation: Institute of General Practice, Technische Universität München, Munich, Germany.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Sigterman
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Levente
authors.initials: L
authors.lastname: Kriston
authors.affiliation: Institute of Medical Biometry and Statistics, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Gerta
authors.initials: G
authors.lastname: Rücker
authors.affiliation: Institute of General Practice, Technische Universität München, Munich, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Jamil
authors.affiliation: Institute of General Practice, Technische Universität München, Munich, Germany Institute of Medical Psychology, Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Meissner
authors.affiliation: Institute of General Practice, Technische Universität München, Munich, Germany.
authors.forename: Antonius
authors.initials: A
authors.lastname: Schneider
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods; D003866:Depressive Disorder / Q000628:therapy*; D006801:Humans; D011320:Primary Health Care / Q000379:methods*; D011613:Psychotherapy / Q000379:methods*; D017216:Telemedicine / Q000379:methods; D016896:Treatment Outcome
keywords: cognitive therapy; depression; depressive disorders; primary health care; psychotherapy; review, systematic; therapeutics