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Effects of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder: a systematic review of randomized clinical trials with meta-analyses and trial sequential analyses

Published online by Cambridge University Press:  04 November 2011

J. C. Jakobsen*
Affiliation:
The Psychiatric Research Unit, Copenhagen University Hospital and Region Zealand, Roskilde, Denmark The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344 Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
J. L. Hansen
Affiliation:
The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344 Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
S. Simonsen
Affiliation:
The Psychiatric Research Unit, Copenhagen University Hospital and Region Zealand, Roskilde, Denmark
E. Simonsen
Affiliation:
The Psychiatric Research Unit, Copenhagen University Hospital and Region Zealand, Roskilde, Denmark
C. Gluud
Affiliation:
The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 3344 Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
*
*Address for correspondence: J. C. Jakobsen, M.D., Psychiatric Research Unit, Copenhagen University Hospital, Region Zealand, Roskilde, Denmark. (Email: janusjakobsen@mac.com)

Abstract

Background

Major depressive disorder afflicts an estimated 17% of individuals during their lifetime at tremendous suffering and cost. Cognitive therapy and interpersonal psychotherapy are treatment options, but their effects have only been limitedly compared in systematic reviews.

Method

Using Cochrane systematic review methodology we compared the benefits and harm of cognitive therapy versus interpersonal psychotherapy for major depressive disorder. Trials were identified by searching the Cochrane Library's CENTRAL, Medline via PubMed, EMBASE, Psychlit, PsycInfo, and Science Citation Index Expanded until February 2010. Continuous outcome measures were assessed by mean difference and dichotomous outcomes by odds ratio. We conducted trial sequential analysis to control for random errors.

Results

We included seven trials randomizing 741 participants. All trials had high risk of bias. Meta-analysis of the four trials reporting data at cessation of treatment on the Hamilton Rating Scale for Depression showed no significant difference between the two interventions [mean difference −1.02, 95% confidence interval (CI) −2.35 to 0.32]. Meta-analysis of the five trials reporting data at cessation of treatment on the Beck Depression Inventory showed comparable results (mean difference −1.29, 95% CI −2.73 to 0.14). Trial sequential analysis indicated that more data are needed to definitively settle the question of a differential effect. None of the included trial reported on adverse events.

Conclusions

Randomized trials with low risk of bias and low risk of random errors are needed, although the effects of cognitive therapy and interpersonal psychotherapy do not seem to differ significantly regarding depressive symptoms. Future trials should report on adverse events.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2011

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References

Altman, DG, Bland, JM (2003). Interaction revisited: the difference between two estimates. British Medical Journal 326, 219.CrossRefGoogle ScholarPubMed
Anonymous (1999). ICH Harmonised Tripartite Guideline. Statistical principles for clinical trials. International Conference on Harmonisation E9 Expert Working Group. Statistics in Medicine 18, 19051942.Google Scholar
APA (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. American Psychological Association: Washington, DC.Google Scholar
APA (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn, revised. American Psychological Association: Washington, DC.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. American Psychological Association: Washington, DC.Google Scholar
Arnow, BA, Constantino, MJ (2003). Effectiveness of psychotherapy and combination treatment for chronic depression. Journal of Clinical Psychology 59, 893905.CrossRefGoogle ScholarPubMed
Bagby, RM, Ryder, AG, Schuller, DR, Marshall, MB (2004). The Hamilton Depression Rating Scale: has the gold standard become a lead weight? American Journal of Psychiatry 161, 21632177.CrossRefGoogle ScholarPubMed
Barber, JP, Muenz, LR (1996). The role of avoidance and obsessiveness in matching patients to cognitive and interpersonal psychotherapy: empirical findings from the treatment for depression collaborative research program. Journal of Consulting and Clinical Psychology 64, 951958.CrossRefGoogle ScholarPubMed
Bech, P (1999). Stress og livskvalitet (Stress and Quality of Life). Psykiatrifondens Forlag: Copenhagen.Google Scholar
Beck, AT, Rush, AJ, Shaw, BF, Emery, G (1979). Cognitive therapy of depression. Australian and New Zealand Journal of Psychiatry 36, 275278.Google Scholar
Beck, AT, Ward, CH, Mendelson, M, Mick, J, Erbaigh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.CrossRefGoogle ScholarPubMed
Bellino, S, Zizza, M, Rinaldi, C, Bogetto, F (2006). Combined treatment of major depression in patients with borderline personality disorder: a comparison with pharmacotherapy. Canadian Journal of Psychiatry 51, 453460.CrossRefGoogle ScholarPubMed
Bellino, S, Zizza, M, Rinaldi, C, Bogetto, F (2007). Combined therapy of major depression with concomitant borderline personality disorder: comparison of interpersonal and cognitive psychotherapy. Canadian Journal of Psychiatry 52, 718725.CrossRefGoogle ScholarPubMed
Berk, M, Ng, F, Dodd, S, Callaly, T, Campbell, S, Bernardo, M, Trauer, T (2008). The validity of the CGI severity and improvement scales as measures of clinical effectiveness suitable for routine clinical use. Journal of Evaluation in Clinical Practice 14, 979983.CrossRefGoogle ScholarPubMed
Boutron, I, Moher, D, Altman, DG, Schulz, KF, Ravaud, P (2008). Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine 148, 295309.CrossRefGoogle Scholar
Brok, J, Thorlund, K, Gluud, C, Wetterslev, J (2008). Trial sequential analysis reveals insufficient information size and potentially false positive results in many meta-analysis. Journal of Clinical Epidemiology 61, 763769.CrossRefGoogle Scholar
Chakraborty, R, Chatterjee, A (2007). Predictors of suicide attempt among those with depression in an Indian sample: a brief report. Internet Journal of Mental Health, volume 4, number 2. Published online: 11 October 2007.Google Scholar
Cipriani, A, Santilli, C, Furukawa, TA, Signoretti, A, Nakagawa, A, McGuire, H, Churchill, R, Barbui, C (2009). Escitalopram versus other antidepressive agents for depression. Cochrane Database of Systematic Reviews, issue 2, art. no.: CD006532. doi:10.1002/14651858.CD006532.pub2.CrossRefGoogle ScholarPubMed
Cornes, C, Frank, E (1994). Interpersonal psychotherapy for depression. Clinical Psychologist 47, 910.Google Scholar
Covi, L, Lipman, RS (1987). Cognitive behavioral group psychotherapy combined with imipramine in major depression. Psychopharmacology Bulletin 23, 173176.Google ScholarPubMed
Cutler, JL, Goldyne, A, Markowitz, JC, Devlin, MJ, Glick, RA (2004). Comparing cognitive behavior therapy, interpersonal psychotherapy, and psychodynamic psychotherapy. American Journal of Psychiatry 161, 15671573.CrossRefGoogle ScholarPubMed
Davidson, KW, Rieckmann, N, Clemow, L, Schwartz, JE, Shimbo, D, Medina, V, Albanese, G, Kronish, I, Hegel, M, Burg, MM (2010). Enhanced depression care for patients with acute coronary syndrome and persistent depressive symptoms: coronary psychosocial evaluation studies randomized controlled trial. Archives of Internal Medicine 170, 600608.CrossRefGoogle ScholarPubMed
Elkin, I, Parloff, MB, Hadley, SW, Autry, JH (1985). NIMH treatment of Depression Collaborative Research Program: background and research plan. Archives of General Psychiatry 42, 305316.CrossRefGoogle ScholarPubMed
Elkin, I, Shea, MT, Watkins, JT, Imber, SD (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: general effectiveness of treatments. Archives of General Psychiatry 46, 971982.CrossRefGoogle ScholarPubMed
Fawcett, J (1993). The morbitity and mortality of clinical depression. International Clinical Psychopharmacology 8, 217220.CrossRefGoogle Scholar
Fitzgibbon, ML, Cella, DF, Sweeney, JA (1988). Redundancy in measures of depression. Journal of Clinical Psychology 44, 372374.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Gallagher, TD, Steffen, AM (1994). Comparative effects of cognitive-behavioral and brief psychodynamic psychotherapies for depressed family caregivers. Journal of Consulting and Clinical Psychology 62, 543549.CrossRefGoogle Scholar
Geddes, JR, Carney, SM, Davies, C, Furukawa, TA, Kupfer, DJ, Frank, E, Goodwin, GM (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 361, 653661.CrossRefGoogle ScholarPubMed
Gluud, C (2006 a). The culture of designing hepato-biliary randomised trials. Journal of Hepatology 44, 607615.CrossRefGoogle ScholarPubMed
Gluud, LL (2006 b). Bias in clinical intervention research. American Journal of Epidemiology 163, 493501.CrossRefGoogle ScholarPubMed
Greenberg, P, Stiglin, LE, Finkelstein, SN, Berndt, ER (1993). The economic burden of depression in 1990. Journal of Clinical Psychiatry 54, 405418.Google ScholarPubMed
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5661.CrossRefGoogle ScholarPubMed
Hardy, GE, Barkham, M, Shapiro, DA, Stiles, WB, Rees, A, Reynolds, S (1995). Impact of cluster C personality disorders on outcomes of contrasting brief psychotherapies for depression. Journal of Consulting and Clinical Psychology 63, 9971004.CrossRefGoogle ScholarPubMed
Heo, M, Murphy, CF, Meyers, BS (2007). Relationship between the Hamilton Depression Rating Scale and the Montgomery–Asberg Depression Rating Scale in depressed elderly: a meta-analysis. American Journal of Geritric Psychiatry 15, 899905.CrossRefGoogle ScholarPubMed
Higgins, J, Green, S (2008). Cochrane Handbook for Systematic Reviews of Interventions, Version 5.0.0. The Cochrane Collaboration, 2008 (http://www.cochrane-handbook.org). Accessed 29 May 2011.CrossRefGoogle Scholar
Higginson, IJ, Carr, AJ (2001). Measuring quality of life: using quality of life measures in the clinical setting. BMJ 322, 12971300.CrossRefGoogle ScholarPubMed
Hogg, JA, Deffenbacher, JL (1988). A comparison of cognitive and interpersonal-process group therapies in the treatment of depression among college students. Journal of Counseling Psychology 35, 304310.CrossRefGoogle Scholar
Hopewell, S, Wolfenden, L, Clarke, M (2008). Reporting of adverse events in systematic reviews can be improved: survey results. Journal of Clinical Epidemiology 61, 597602.CrossRefGoogle ScholarPubMed
Howard, M, Battle, CL, Pearlstein, T, Rosene-Montella, K (2006). A psychiatric mother–baby day hospital for pregnant and postpartum women. Archives of Woman's Mental Health 9, 213218.CrossRefGoogle ScholarPubMed
Imber, SD, Pilkonis, PA, Sotsky, SM, Elkin, I, Watkins, JT, Collins, JF, Shea, MT, Leber, WR, Glass, DR (1990). Mode-specific effects among three treatments for depression. Journal of Consulting and Clinical Psychology 58, 352359.CrossRefGoogle ScholarPubMed
International Conference on Harmonisation E9 Expert Working Group (1997). Code of Federal Regulations and Guidelines, vol. 1. Barnett International/PAREXEL: Philadelphia, PA.Google Scholar
Jakobsen, J, Lindschou Hansen, J, Simonsen, S, Simonsen, E (2010). The effect of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder. A systematic review of randomised clinical trials with meta-analyses and trial sequential analyses (http://www.ctu.dk). Accessed February 2010.Google Scholar
Joyce, PR, McKenzie, JM, Carter, JD, Rae, AM, Luty, SE, Frampton, CMA, Mulder, RT (2007). Temperament, character and personality disorders as predictors of response to interpersonal psychotherapy and cognitive-behavioural therapy for depression. British Journal of Psychiatry 190, 503508.CrossRefGoogle Scholar
Kellet, S, Clarke, S, Matthews, L (2007). Delivering group psychoeducational CBT in primary care: comparing outcomes with individual CBT and individual psychodynamic-interpersonal psychotherapy. British Journal of Clinical Psychology 46, 211222.CrossRefGoogle Scholar
Kessler, RC, McGnagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, H-U, Kendler, KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 819.CrossRefGoogle ScholarPubMed
Keus, F, Wetterslev, J, Gluud, C, van Laarhoven, CJ (2010). Evidence at a glance: error matrix approach for overviewing available evidence. BMC Medical Research Methodology 10, 90.CrossRefGoogle Scholar
Kirsch, I, Deacon, BJ, Huedo-Medina, TB, Scoboria, A, Moore, TJ, Johnson, BT (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine 5, e45.CrossRefGoogle ScholarPubMed
Kjaergaard, L, Villumsen, J, Gluud, C (2001). Reported methodologic quality and discrepancies between large and small randomized trials in meta-analysis. Annals of Internal Medicine 135, 982989.CrossRefGoogle Scholar
Levav, I, Rutz, W (2002). The WHO World Health Report 2001. New understanding – new hope. Israel Journal of Psychiatry and Related Sciences 39, 5056.Google ScholarPubMed
Levenson, H, Butler, SF, Powers, TA, Beitman, BD (2002). Concise Guide to Brief Dynamic and Interpersonal Therapy. American Psychiatric Publishing Inc.: Washington, DC.Google Scholar
Luty, SE, Carter, JD, McKenzie, JM, Rae, AM, Frampton, CMA, Mulder, RT, Joyce, PR (2007). Randomised controlled trial of interpersonal psychotherapy and cognitive-behavioural therapy for depression. British Journal of Psychiatry 190, 496502.CrossRefGoogle ScholarPubMed
Majani, G, Pierobon, A, Giardini, A, Callegari, S (2000). Satisfaction profile (SAT-P) in 732 patients: focus on subjectivity in HRQoL assessment. Psychology and Health 15, 409422.CrossRefGoogle Scholar
Marshall, MB, Zuroff, DC, McBride, C, Bagby, RM (2008). Self-criticism predicts differential response to treatment for major depression. Journal of Clinical Psychology 64, 231244.CrossRefGoogle ScholarPubMed
McBride, C, Atkinson, L, Quilty, LC, Bagby, RM (2006). Attachment as moderator of treatment outcome in major depression: a randomized control trial of interpersonal psychotherapy versus cognitive behavior therapy. Journal of Consulting and Clinical Psychology 74, 10411054.CrossRefGoogle ScholarPubMed
Neimeyer, RA, Feixas, G (1990). The role of homework and skill acquisition in the outcome of group cognitive therapy for depression. Behavior Therapy 21, 281292.CrossRefGoogle Scholar
Neimeyer, RA, Weiss, ME (1990). Cognitive and symptomatic predictors of outcome of group therapies for depression. Journal of Cognitive Psychotherapy: An International Quarterly 4, 2332.Google Scholar
Quilty, LC, McBride, C, Bagby, RM (2008). Evidence for the cognitive mediational model of cognitive behavioural therapy for depression. Psychological Medicine 38, 15311541.CrossRefGoogle ScholarPubMed
Rose, SC, Bisson, J, Churchill, R, Wessely, S (2002). Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, issue 2, art. no.: CD000560. doi:10.1002/14651858.CD000560.CrossRefGoogle ScholarPubMed
Shapiro, DA, Barkham, M, Hardy, GE, Morrison, LA (1990). The second Sheffield psychotherapy project: rationale, design and preliminary outcome data. British Journal of Medical Psychology 63, 97108.CrossRefGoogle ScholarPubMed
Shapiro, DA, Barkham, M, Rees, A, Hardy, GE, Reynolds, S, Startup, M (1994). Effects of treatment duration and severity of depression on the effectiveness of cognitive-behavioral and psychodynamic-interpersonal psychotherapy. Journal of Consulting and Clinical Psychology 62, 522534.CrossRefGoogle ScholarPubMed
Shapiro, DA, Rees, A, Barkham, M, Hardy, G (1995). Effects of treatment duration and severity of depression on the maintenance of gains after cognitive-behavioral and psychodynamic-interpersonal psychotherapy. Journal of Consulting and Clinical Psychology 63, 378387.CrossRefGoogle ScholarPubMed
Shea, MT, Elkin, I, Imber, SD, Sotsky, SM (1992). Course of depressive symptoms over follow-up: findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Archives of General Psychiatry 49, 782787.CrossRefGoogle ScholarPubMed
Shea, MT, Pilkonis, PA, Beckham, E, Collins, JF (1990). Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program. American Journal of Psychiatry 147, 711718.Google ScholarPubMed
Sofuoglu, M, Sugarman, DE, Carroll, KM (2010). Cognitive function as an emerging treatment target for marijuana addiction. Experimental and Clinical Psychopharmacology 18, 109119.CrossRefGoogle ScholarPubMed
Sotsky, SM, Glass, DR, Shea, MT, Pilkonis, PA (1991). Patient predictors of response to psychotherapy and pharmacotherapy: findings in the NIMH Treatment of Depression Collaborative Research Program. American Journal of Psychiatry 148, 9971008.Google ScholarPubMed
Spijker, J, de Graaf, R, Bijl, RV, Beekman, AT, Ormel, J, Nolen, WA (2002). Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS). British Journal of Psychiatry 181, 208213.CrossRefGoogle ScholarPubMed
Stewart, JW, Garfinkel, R, Nunes, EV, Donovan, S, Klein, DF (1998). Atypical features and treatment response in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Clinical Psychopharmacology 18, 429434.CrossRefGoogle ScholarPubMed
Thorlund, K, Devereaux, PJ, Wetterslev, J, Guyatt, G, Ioannidis, JP, Thabane, L, Gluud, LL, Als-Nielsen, B, Gluud, C (2009). Can trial sequential monitoring boundaries reduce spurious inferences from meta-analyses? International Journal of Epidemiology 38, 276286.CrossRefGoogle ScholarPubMed
Turner, EH, Matthews, AM, Linardatos, E, Tell, RA, Rosenthal, R (2008). Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine 358, 252260.CrossRefGoogle ScholarPubMed
Walwyn, R, Roberts, C (2010). Therapist variation within randomised trials of psychotherapy: implications for precision, internal and external validity. Statistical Methods in Medical Research 19, 291315.CrossRefGoogle ScholarPubMed
Weissman, M, Markowitz, J, Klerman, G (2000). Comprehensive Guide to Interpersonal Psychotherapy. Basic Books: New York.Google Scholar
Wetterslev, J, Thorlund, K, Brok, J, Gluud, C (2008). Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis. Journal of Clinical Epidemiology 61, 6475.CrossRefGoogle ScholarPubMed
WHO (1992). International Statistical Classification of Diseases and Related Health Problems (ICD-10), 10th revision. World Health Organization: Geneva.Google Scholar
Wilkins, CH, Mathews, J, Sheline, YI (2009). Late life depression with cognitive impairment: evaluation and treatment. Journal of Clinical Interventions in Aging 4, 5157.Google ScholarPubMed
Wiser, S, Goldfried, MR (1998). Therapist interventions and client emotional experiencing in expert psychodynamic-interpersonal and cognitive-behavioral therapies. Journal of Consulting and Clinical Psychology 66, 634640.CrossRefGoogle ScholarPubMed
Wood, L, Egger, M, Gluud, LL, Schulz, KF, Juni, P, Altman, DG, Gluud, C, Martin, RM, Wood, AJ, Sterne, JA (2008). Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. British Medical Journal 336, 601605.CrossRefGoogle ScholarPubMed