Yasuyuki Okumura1, Kanako Ichikura2. 1. Research Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo 105-0003, Japan. Electronic address: yokumura@blue.zero.jp. 2. Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; Japan Society for the Promotion of Science, Tokyo 102-0083, Japan.
Abstract
BACKGROUND: Despite treatment guidelines for depression placing group cognitive behavioral therapy (group CBT) between low- and high-intensity evidence-based psychological interventions, the validity of the placement remains unknown. We aimed to systematically review evidence for the efficacy and acceptability of group CBT in patients with depression compared to four intensity levels of psychosocial interventions. METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and Web of Science and hand-searched the references in identified publications. We selected randomized controlled trials comparing group CBT with four levels of interventions for adult patients with depression. Two authors independently assessed risk of bias. RESULTS: From 7953 records, we identified 35 studies that compared group CBT to non-active (k=30), low-intensity (k=2), middle-intensity (k=8), and high-intensity (k=1) interventions. Group CBT had a superior efficacy (standardized mean difference [SMD]=-0.68) and a similar acceptability compared to non-active controls. Pooled results showed a small but non-significant excess of group CBT relative to middle-intensity interventions (SMD=-0.21). LIMITATIONS: Over 60% of studies did not report enough information to judge selection and selective reporting bias. CONCLUSIONS: These results suggest the need for high-quality trials of group CBT compared to low- and high-intensity interventions.
BACKGROUND: Despite treatment guidelines for depression placing group cognitive behavioral therapy (group CBT) between low- and high-intensity evidence-based psychological interventions, the validity of the placement remains unknown. We aimed to systematically review evidence for the efficacy and acceptability of group CBT in patients with depression compared to four intensity levels of psychosocial interventions. METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and Web of Science and hand-searched the references in identified publications. We selected randomized controlled trials comparing group CBT with four levels of interventions for adult patients with depression. Two authors independently assessed risk of bias. RESULTS: From 7953 records, we identified 35 studies that compared group CBT to non-active (k=30), low-intensity (k=2), middle-intensity (k=8), and high-intensity (k=1) interventions. Group CBT had a superior efficacy (standardized mean difference [SMD]=-0.68) and a similar acceptability compared to non-active controls. Pooled results showed a small but non-significant excess of group CBT relative to middle-intensity interventions (SMD=-0.21). LIMITATIONS: Over 60% of studies did not report enough information to judge selection and selective reporting bias. CONCLUSIONS: These results suggest the need for high-quality trials of group CBT compared to low- and high-intensity interventions.
Authors: Sagar V Parikh; Lena C Quilty; Paula Ravitz; Michael Rosenbluth; Barbara Pavlova; Sophie Grigoriadis; Vytas Velyvis; Sidney H Kennedy; Raymond W Lam; Glenda M MacQueen; Roumen V Milev; Arun V Ravindran; Rudolf Uher Journal: Can J Psychiatry Date: 2016-08-02 Impact factor: 4.356
Authors: Jason Bantjes; Alan E Kazdin; Pim Cuijpers; Elsie Breet; Munita Dunn-Coetzee; Charl Davids; Dan J Stein; Ronald C Kessler Journal: JMIR Ment Health Date: 2021-05-27