Psychotherapies for depression: a network meta?analysis covering efficacy, acceptability and long?term outcomes of all main treatment types

The effects of psychotherapies for depression have been examined in several hundreds randomized trials, but no recent network meta-analysis (NMA) has integrated the results these studies. We conducted an NMA trials comparing cognitive behavioural, interpersonal, psychodynamic, problem-solving, behavioural activation, life-review and “third wave” therapies non-directive supportive counseling with each other care-as-usual, waiting list pill placebo control conditions. Response (50% reduction symptoms) was primary outcome, we also assessed remission, standardized mean difference, acceptability (all-cause dropout rate). Random-effects pairwise meta-analyses were on 331 34,285 patients. All more efficacious than care-as-usual conditions, all – except psychodynamic therapy placebo. Standardized differences compared ranged from –0.81 to –0.32 counseling. Individual did not differ significantly other, only exception counseling, which less therapies. similar when studies low risk bias included. Most still had significant at 12-month follow-up problem-solving found a somewhat higher long-term efficacy some No consistent found. Our conclusion is that most important types psychotherapy are acceptable acute treatment adult depression, few between them. Patient preference availability type may play larger role choice psychotherapy, although it possible detailed characterization patients diagnosis lead precise matching individual psychotherapies.