title: THE LONG-TERM EFFICACY OF ACUTE-PHASE PSYCHOTHERAPY FOR DEPRESSION: A META-ANALYSIS OF RANDOMIZED TRIALS.
abstract: Understanding the effectiveness of treatment for depression in both the short term and long term is essential for clinical decision making. The present meta-analysis examined treatment effects on depression and quality of life in acute-phase psychotherapeutic interventions compared to no treatment control groups for adult depression at 6 months or longer postrandomization.
  
  
  
  A systematic literature search resulted in 44 randomized controlled trials with 6,096 participants. Acute-phase psychotherapy was compared to control groups at 6-month or longer postrandomization. Odds ratios of a positive outcome were calculated.
  
  
  
  Psychotherapy outperformed control groups at 6 months or longer postrandomization (OR = 1.92, 95% CI: 1.60-2.31, P < .001). Heterogeneity was moderate (I²: 65, 95% CI: 53-74, P < .001). However, effects significantly decreased with longer follow-up periods. Additionally, a small positive effect of psychotherapy was observed for quality of life, while similar effects were obtained in separate analyses of each type of psychotherapy, with the exception of nondirective supportive therapy. Studies that provided booster sessions had better treatment results compared with studies that did not provide any further sessions. Finally, we found that trials on psychotherapy aimed at major depressive disorder (MDD) had better outcomes than those that were aimed at elevated depressive symptoms.
  
  
  
  There is substantial evidence that acute-phase psychotherapy results in a better treatment effects on depression and quality of life in the long term for adult patients with depression.
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, The Netherlands.|EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Eirini
authors.initials: E
authors.lastname: Karyotaki
authors.affiliation: Independent Researcher, The Netherlands.
authors.forename: Yolba
authors.initials: Y
authors.lastname: Smit
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, The Netherlands.|EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Derek P
authors.initials: DP
authors.lastname: de Beurs
authors.affiliation: ME-TA DK, Danish Centre for Medical and Health Technology Medical and Health Technology Assessment, Denmark.
authors.forename: Kirsten Holdt
authors.initials: KH
authors.lastname: Henningsen
authors.affiliation: Belgian Health Care Knowledge Centre, KCE, Brussels, Belgium.
authors.forename: Jo
authors.initials: J
authors.lastname: Robays
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, The Netherlands.|EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Marcus J H
authors.initials: MJ
authors.lastname: Huibers
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, The Netherlands.|EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Erica
authors.initials: E
authors.lastname: Weitz
authors.affiliation: Department of Clinical Psychology, VU University Amsterdam, The Netherlands.|EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
mesh_terms: D000208:Acute Disease; D000328:Adult; D003866:Depressive Disorder / Q000628:therapy*; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: depression; long-term; psychotherapy