A2 Vertaisarvioitu katsausartikkeli tieteellisessä lehdessä
Antidepressant medication or short-term psychodynamic psychotherapy for depression? A systematic review and meta-analysis of individual participant data.
Tekijät: Wienicke, Frederik J.; Dekker, Jack J. M.; Peen, Jaap; Van, Henricus L.; Barber, Jacques P.; McCarthy, Kevin S.; Solomonov, Nili; Karlsson, Hasse; Hietala, Jarmo; Lopez-Rodriguez, Jaime; Villamil-Salcedo, Valerio; Burk, William J.; Spijker, Jan; Twisk, Jos W. R.; Cohen, Zachary D.; Cuijpers, Pim; Driessen, Ellen
Kustantaja: American Psychological Association (APA)
Kustannuspaikka: WASHINGTON
Julkaisuvuosi: 2025
Journal: Clinical Psychology: Science and Practice
Tietokannassa oleva lehden nimi: Clinical Psychology: Science and Practice
Lehden akronyymi: CLIN PSYCHOL-SCI PR
Sivujen määrä: 14
ISSN: 0969-5893
eISSN: 1468-2850
DOI: https://doi.org/10.1037/cps0000281
Verkko-osoite: https://doi.org/10.1037/cps0000281
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/499248178
Antidepressant medication and short-term psychodynamic psychotherapy (STPP) are frequently used to treat depression, but it is unclear which works best for whom. This preregistered individual participant data (IPD) meta-analysis (PROSPERO No.: CRD42017056029) examined efficacy and moderators of antidepressants versus STPP for adult depression. Randomized comparisons of antidepressants and STPP on standardized measures for depressed adults were included. A systematic literature search was performed on May 1, 2024. IPD were requested and analyzed using mixed-effects models. Of the six trials identified (n = 472), IPD were obtained for four (n = 310; 65.7%). At posttreatment, antidepressants were slightly more efficacious than STPP regarding depressive symptom levels (d = 0.28, 95% confidence interval = [0.03, 0.53], p = .031), but no significant differences were observed at follow-up nor for self-reported depression or any of the secondary outcomes at posttreatment. Baseline depression severity was found to moderate posttreatment outcomes (d = 0.24, 95% confidence interval = [0.08, 0.40], p = .004), such that antidepressants were more efficacious than STPP for participants with higher severity levels rather than those with lower baseline severity. This is the first study examining moderators across trials comparing antidepressants and STPP. The findings suggest that baseline severity might be a factor to consider when choosing between these treatments. However, this finding is observational and requires validation in future studies before it can be used to inform treatment selection for depression.
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This research was funded in whole, or in part, by the Netherlands Organisation for Scientific Research (NWO) (Grant 016.Veni.195.215 6806). For the purpose of open access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission.Recruitment of individual participant data for this work was supported by the American Psychoanalytic Association. This work was further supported by the Netherlands Organization of Scientific Research (NWO; Grant 016.Veni.195.215 6806) and the U.S. National Institute of Mental Health (Grant K23 MH123864). The funding sponsors had no role in the study design, collection, analysis, or interpretation of data, writing the article, or the decision to submit the article for publication. Ellen Driessen received a fund for Psychoanalytic Research of the American Psychoanalytic Association supporting the recruitment of individual participant data for this work. Jack J. M. Dekker, Henricus L. Van, and Jacques P. Barber receive royalties from books on STPP they have coauthored. Henricus L. Van is a trainer and registered supervisor of short-term psychodynamic supportive psychotherapy. Zachary D. Cohen previously held stock options in Joyable and AbleTo, which he received as compensation for advice on the clinical content of a digital cognitive therapy. The other authors have no conflicts of interest to declare. This systematic review and meta-analysis of individual participant data were preregistered in the International Prospective Register of Systematic Reviews (PROSPERO; registration: CRD42017056029). The authors do not have any previously published or currently in-press works stemming from this same data set. The syntax for the analyses and the collective anonymized individual participant database developed for this study, as well as a data dictionary and relevant related documents (e.g., study protocol), are available for use by other researchers with the publication of this article. Data requests can be made to the corresponding author. Access (with limited investigator support) will be granted after approval of a study proposal by all authors and a signed data access agreement.
