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- Shafran, R., et al.
(författare)
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Mind the gap : Improving the dissemination of CBT
- 2009
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 47:11, s. 902-909
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Tidskriftsartikel (refereegranskat)abstract
- Empirically supported psychological treatments have been developed for a range of psychiatric disorders but there is evidence that patients are not receiving them in routine clinical care. Furthermore, even when patients do receive these treatments there is evidence that they are often not well delivered. The aim of this paper is to identify the barriers to the dissemination of evidence-based psychological treatments and then propose ways of overcoming them, hence potentially bridging the gap between research findings and clinical practice.
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- Cuijpers, P, et al.
(författare)
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The effects of psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size
- 2010
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Ingår i: PSYCHOLOGICAL MEDICINE. - 0033-2917 .- 1469-8978. ; 40:2, s. 211-223
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Tidskriftsartikel (refereegranskat)abstract
- Background. No meta-analytical study has examined whether the quality of the Studies examining psychotherapy for adult depression is associated with the effect sizes found. This study assesses this association. Method. We used a database of 115 randomized controlled trials in which 178 psychotherapies for adult depression were compared to a control condition. Eight quality criteria were assessed by two independent coders: participants met diagnostic criteria for a depressive disorder, a treatment manual was used, the therapists were trained, treatment integrity was checked, intention-to-treat analyses were used, N andgt;= 50, randomization was Conducted by an independent party, and assessors of outcome were blinded. Results. Only 11 studies (16 comparisons) met the eight quality criteria. The standardized mean effect size found for the high-quality studies (d=0.22) was significantly smaller than in the other Studies (d=0.74, pandlt;0.001), even after restricting the sample to the Subset of other studies that used the kind of care-as-usual or non-specific controls that tended to be used in the high-quality studies. Heterogeneity was zero in the group of high-quality studies. The numbers needed to be treated in the high-quality studies was 8, while it was 2 in the lower-quality Studies. Conclusions. We found strong evidence that the effects of psychotherapy for adult depression have been overestimated in meta-analytical studies. Although the effects of psychotherapy are significant, the), are Much smaller than was assumed until now, even after controlling for the type of control condition used.
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- Furukawa, Toshi A., et al.
(författare)
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Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials
- 2017
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Ingår i: British Journal of Psychiatry. - : ROYAL COLLEGE OF PSYCHIATRISTS. - 0007-1250 .- 1472-1465. ; 210:3, s. 190-196
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Forskningsöversikt (refereegranskat)abstract
- Background The influence of baseline severity has been examined for antidepressant medications but has not been studied properly for cognitive behavioural therapy (CBT) in comparison with pill placebo. Aims To synthesise evidence regarding the influence of initial severity on efficacy of CBT from all randomised controlled trials (RCTs) in which CBT, in face-to-face individual or group format, was compared with pill-placebo control in adults with major depression. Method A systematic review and an individual-participant data meta-analysis using mixed models that included trial effects as random effects. We used multiple imputation to handle missing data. Results We identified five RCTs, and we were given access to individual-level data (n=509) for all five. The analyses revealed that the difference in changes in Hamilton Rating Scale for Depression between CBT and pill placebo was not influenced by baseline severity (interaction P=0.43). Removing the non-significant interaction term from the model, the difference between CBT and pill placebo was a standardised mean difference of 0.22 (95% CI 0.42 to 0.02, P=0.03, l(2)=0%). Conclusions Patients suffering from major depression can expect as much benefit from CBT across the wide range of baseline severity. This finding can help inform individualised treatment decisions by patients and their clinicians.
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