Sponsorship bias in the comparative efficacy of psychotherapy and pharmacotherapy for adult depression: meta-analysis.
Sponsorship bias has never been investigated for non-pharmacological treatments like psychotherapy.



We examined industry funding and author financial conflict of interest (COI) in randomised controlled trials directly comparing psychotherapy and pharmacotherapy in depression.



We conducted a meta-analysis with subgroup comparisons for industry v. non-industry-funded trials, and respectively for trial reports with author financial COI v. those without.



In total, 45 studies were included. In most analyses, pharmacotherapy consistently showed significant effectiveness over psychotherapy, g = -0.11 (95% CI -0.21 to -0.02) in industry-funded trials. Differences between industry and non-industry-funded trials were significant, a result only partly confirmed in sensitivity analyses. We identified five instances where authors of the original article had not reported financial COI.



Industry-funded trials for depression appear to subtly favour pharmacotherapy over psychotherapy. Disclosure of all financial ties with the pharmaceutical industry should be encouraged.
Ioana A. Cristea, Department of Clinical Psychology and Psychotherapy, Babes Bolyai University, Cluj-Napoca, Romania, and Department of General Psychology, University of Padova, Padova, Italy; Claudio Gentili, Department of General Psychology, University of Padova, Padova, Italy, Pietro Pietrini, IMT Institute for Advanced Studies, Lucca, Italy; Pim Cuijpers, Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands ioana.cristea@ubbcluj.ro.
Ioana A
IA
Cristea
Ioana A. Cristea, Department of Clinical Psychology and Psychotherapy, Babes Bolyai University, Cluj-Napoca, Romania, and Department of General Psychology, University of Padova, Padova, Italy; Claudio Gentili, Department of General Psychology, University of Padova, Padova, Italy, Pietro Pietrini, IMT Institute for Advanced Studies, Lucca, Italy; Pim Cuijpers, Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
Claudio
C
Gentili
Ioana A. Cristea, Department of Clinical Psychology and Psychotherapy, Babes Bolyai University, Cluj-Napoca, Romania, and Department of General Psychology, University of Padova, Padova, Italy; Claudio Gentili, Department of General Psychology, University of Padova, Padova, Italy, Pietro Pietrini, IMT Institute for Advanced Studies, Lucca, Italy; Pim Cuijpers, Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
Pietro
P
Pietrini
Ioana A. Cristea, Department of Clinical Psychology and Psychotherapy, Babes Bolyai University, Cluj-Napoca, Romania, and Department of General Psychology, University of Padova, Padova, Italy; Claudio Gentili, Department of General Psychology, University of Padova, Padova, Italy, Pietro Pietrini, IMT Institute for Advanced Studies, Lucca, Italy; Pim Cuijpers, Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
Pim
P
Cuijpers
D000928:Antidepressive Agents / Q000191:economics*; D016265:Conflict of Interest / Q000191:economics*; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D004345:Drug Industry / Q000191:economics*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000191:economics*; D011613:Psychotherapy / Q000191:economics*; D016032:Randomized Controlled Trials as Topic / Q000191:economics*
D000928:Antidepressive Agents