The effects of blinding on the outcomes of psychotherapy and pharmacotherapy for adult depression: A meta-analysis.
Eur Psychiatry
; 30(6): 685-93, 2015 Sep.
Article
en En
| MEDLINE
| ID: mdl-26169475
ABSTRACT
BACKGROUND:
Randomized 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.METHODS:
We 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.RESULTS:
We 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).CONCLUSIONS:
Studies 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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Psicoterapia
/
Ensayos Clínicos Controlados Aleatorios como Asunto
/
Depresión
/
Antidepresivos
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Adult
/
Humans
Idioma:
En
Revista:
Eur Psychiatry
Asunto de la revista:
PSIQUIATRIA
Año:
2015
Tipo del documento:
Article
Pais de publicación:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM