Treatment of Atypical Depression With Cognitive Therapy or Phenelzine

Jarrett, Robin B.; Schäffer, Michael; McIntire, Donald D.; Witt-Browder, Amy; Kraft, Dolores

doi:10.1001/archpsyc.56.5.431

Cited by 154 publications

(141 citation statements)

References 29 publications

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“…For depression studies, 21 studies were included [7,[48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] with 1,095 patients randomized to medication and 932 patients randomized to therapy. Forest plots of posttreatment CBT minus medication effect sizes are shown in Figures 2 and 3 for anxiety and depression, respectively.…”

Section: Resultsmentioning

confidence: 99%

Relative effects of CBT and pharmacotherapy in depression versus anxiety: is medication somewhat better for depression, and CBT somewhat better for anxiety?

et al. 2011

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Background: Little is known about whether cognitive behavioral therapy (CBT) or pharmacotherapy is relatively more advantageous for depressive versus anxiety disorders. Methods: We conducted a meta-analysis wherein we searched electronic databases and references to select randomized controlled studies comparing CBT and pharmacotherapy, with or without placebo, in adults with major depressive or anxiety disorders. The primary effect size was calculated from disorder-specific outcome measures as the difference between CBT and pharmacotherapy outcomes (i.e., positive effect size favors CBT; negative effect size favors pharmacotherapy). Results: Twenty-one anxiety (N 5 1,266) and twenty-one depression (N 5 2,027) studies comparing medication to CBT were included. Including all anxiety disorders, the overall effect size was .25 (95% CI: À0.02, 0.55, P 5.07). Effects for panic disorder significantly favored CBT over medications (.50, 95% CI: 0.02, 0.98). Obsessive-compulsive disorder showed similar effects-sizes, though not statistically significant (.49, 95% CI: À0.11, 1.09). Medications showed a nonsignificant advantage for social anxiety disorder (À.22, 95% CI: À0.50, 0.06). The overall effect size for depression studies was .05 (95% CI: À0.09, 0.19), with no advantage for medications or CBT. Pooling anxiety disorder and depression studies, the omnibus comparison of the relative difference between anxiety and depression in effectiveness for CBT versus pharmacotherapy pointed to a nonsignificant advantage for CBT in anxiety versus depression (B 5 .14, 95% CI: À0.14, 0.43). Conclusions: On balance, the evidence presented here indicates that there are at most very modest differences in effects of CBT versus pharmacotherapy in the treatment of anxiety versus depressive disorders. There seems to be larger differences between the anxiety disorders in terms of their relative responsiveness to pharmacotherapy versus CBT. Depression and Anxiety 28:560-567, 2011.

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Section: Resultsmentioning

confidence: 99%

Relative effects of CBT and pharmacotherapy in depression versus anxiety: is medication somewhat better for depression, and CBT somewhat better for anxiety?

et al. 2011

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“…Published articles by the same research group that focused on the same study group were pooled to ensure the independence of studies included in our review. Our inclusion criteria were met by six main articles (21)(22)(23)(24)(25)(26) presenting efficacy data and seven companion articles (27)(28)(29)(30)(31)(32)(33) with additional relevant data.…”

Section: Methodsmentioning

confidence: 99%

Remission in Major Depressive Disorder: A Comparison of Pharmacotherapy, Psychotherapy, and Control Conditions

Casacalenda¹,

Perry²,

Looper³

2002

AJP

214

112

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“…1. Thirty-five studies met inclusion criteria [2][3][4]5,6,8,[15][16][17][18]20,21,24,27,31,33,34,[40][41][42][43]45,46,[50][51][52][53][56][57][58][60][61][62]65,66]. Fig.…”

Section: Selection and Inclusion Of Studiesmentioning

confidence: 99%

The Effects of Blinding on the Outcomes of Psychotherapy and Pharmacotherapy for Adult Depression: a Meta-Analysis

et al. 2015

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BackgroundRandomized trials with antidepressants are often run under double blind placebo-controlled conditions, whereas those with psychotherapies are mostly unblinded. This can introduce bias in favor of psychotherapy when the treatments are directly compared. In this meta-analysis, we examine this potential source of bias.MethodsWe searched Pubmed, PsycInfo, Embase and the Cochrane database (1966 to January 2014) by combining terms indicative of psychological treatment and depression, and limited to randomized trials. We included 35 trials (with 3721 patients) in which psychotherapy and pharmacotherapy for adult depression were directly compared with each other. We calculated effect sizes for each study indicating the difference between psychotherapy and pharmacotherapy at post-test. Then, we examined the difference between studies with a placebo condition and those without in moderator analyses.ResultsWe did not find a significant difference between the studies with and those without a placebo condition. The studies in which a placebo condition was included indicated no significant difference between psychotherapy and pharmacotherapy (g = −0.07; NNT = 25). Studies in which no placebo condition was included (and patients and clinicians in both conditions were not blinded), resulted in a small, but significant difference between psychotherapy and pharmacotherapy in favor of pharmacotherapy (g = −0.13; NNT = 14).ConclusionsStudies comparing psychotherapy and pharmacotherapy in which both groups of patients (and therapists) are not blinded (no placebo condition is included) result in a very small, but significantly higher effect for pharmacotherapy.

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Treatment of Atypical Depression With Cognitive Therapy or Phenelzine

Abstract: Cognitive therapy may offer an effective alternative to standard acute-phase treatment with a monoamine oxidase inhibitor for outpatients with major depressive disorder and atypical features.

Cited by 154 publications

References 29 publications

Relative effects of CBT and pharmacotherapy in depression versus anxiety: is medication somewhat better for depression, and CBT somewhat better for anxiety?

Relative effects of CBT and pharmacotherapy in depression versus anxiety: is medication somewhat better for depression, and CBT somewhat better for anxiety?

Remission in Major Depressive Disorder: A Comparison of Pharmacotherapy, Psychotherapy, and Control Conditions

The Effects of Blinding on the Outcomes of Psychotherapy and Pharmacotherapy for Adult Depression: a Meta-Analysis

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