Cochrane · systematic review · CD010558
Psychological therapies for treatment‐resistant depression in adults
Ijaz, S, Davies, P, Williams, CJ, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
17
current version
GRADE rated
17
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 10 · 58.8%Moderate 6 · 35.3%High 1 · 5.9%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Psychotherapy as an adjunct to usual care compared with usual care alone for treatment‐resistant depression in adults ‐ short‐term effects
Population: adults with treatment‐resistant depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Self‐reported depressive symptoms short term (up to 6 months) ‐ BDI (BDI) Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 5 studies · 575 participants | Moderate Downgraded: risk of bias |
Self‐reported depressive symptoms short term (up to 6 months) ‐ SMD (BDI & PHQ9) Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 6 studies · 635 participants | Moderate Downgraded: risk of bias |
Observer‐rated depressive symptoms short term (up to 6 months) ‐ PHQ‐9 Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 2 studies · 482 participants | Moderate Downgraded: risk of bias |
Observer‐rated depressive symptoms short term (up to 6 months) ‐ HAMD Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 4 studies · 193 participants | Low Downgraded: risk of bias |
Dropout short term (up to 6 months) Psychotherapy as an adjunct to usual care vs usual care alone | RR 0.85 [0.58, 1.24] | 6 studies · 698 participants | High |
Response (50% reduction in depressive symptoms from baseline) short term (up to 6 months) Psychotherapy as an adjunct to usual care vs usual care alone | RR 1.8 [1.2, 2.69] | 4 studies · 556 participants | Low Downgraded: risk of bias |
Remission (< 7 on HAMD or < 10 on BDI) short term (up to 6 months) Psychotherapy as an adjunct to usual care vs usual care alone | RR 1.92 [1.46, 2.52] | 6 studies · 635 participants | Moderate Downgraded: risk of bias |
Psychotherapy as an adjunct to usual care compared with usual care alone for treatment‐resistant depression in adults ‐ medium‐ to long‐term effects
Population: adults with treatment‐resistant depression
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Self‐reported depressive symptoms medium term (7 to 12 months) ‐ BDI Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 2 studies · 475 participants | Low Downgraded: risk of bias |
Observer‐rated depressive symptoms medium term (7 to 12 months) ‐ PHQ‐9 Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 1 study · 395 participants | Low Downgraded: risk of bias |
Self (patient)‐reported depressive symptoms long term (longer than 12 months) ‐ BDI Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 1 study · 248 participants | Low Downgraded: risk of bias |
Observer‐rated depressive symptoms long term (longer than 12 months) ‐ PHQ‐9 Psychotherapy as an adjunct to usual care vs usual care alone | no estimate extracted | 1 study · 252 participants | Low Downgraded: risk of bias |
Dropout medium term (7 to 12 months)* Psychotherapy as an adjunct to usual care vs usual care alone | RR 0.98 [0.66, 1.47] | 2 studies · 549 participants | Moderate Downgraded: risk of bias, imprecision |
Dropout long term (longer than 12 months)* Psychotherapy as an adjunct to usual care vs usual care alone | RR 0.8 [0.66, 0.97] | 1 study · 469 participants | Low Downgraded: risk of bias, imprecision |
Response (50% reduction in BDI) medium term (7 to 12 months)* Psychotherapy as an adjunct to usual care vs usual care alone | RR 1.73 [1.42, 2.1] | 2 studies · 475 participants | Low Downgraded: risk of bias |
Response (50% reduction in BDI) long term (longer than 12 months)* Psychotherapy as an adjunct to usual care vs usual care alone | RR 1.62 [1.13, 2.32] | 1 study · 248 participants | Low Downgraded: risk of bias |
Remission (< 7 on HAMD or < 10 on BDI) medium term (7 to 12 months)* Psychotherapy as an adjunct to usual care vs usual care alone | RR 1.97 [1.51, 2.56] | 2 studies · 475 participants | Moderate Downgraded: risk of bias |
Remission (< 7 on HAMD or < 10 on BDI) long term (longer than 12 months)* Psychotherapy as an adjunct to usual care vs usual care alone | RR 1.56 [0.97, 2.53] | 1 study · 248 participants | Low Downgraded: risk of bias |