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Quantified superiority of cognitive behaviour therapy to antidepressant drugs: a challenge to an earlier meta-analysis

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Abstract:

Parker GB, Crawford J, Hadzi-Pavlovic D. Quantified superiority of cognitive behaviour therapy to antidepressant drugs: a challenge to an earlier meta-analysis. Objective: 

The study aimed to review the conclusion of a previously published meta-analysis which quantified distinct superiority of cognitive therapy to antidepressant drug-therapy (P < 0.0001). Method: 

We sought to include all studies used in the original meta-analysis. Adopting both that study’s inclusion criteria and additional criteria resulted in a reduced set of studies. We analysed both ‘completer’ and ‘intention to treat’ data, using effect size and odds ratio quantification. Results: 

There was an overall trend for cognitive therapy to be superior to antidepressant drug-therapy, but this was significant for only one of the four meta-analyses (an intention to treat analysis). We demonstrated considerable heterogeneity between studies, and a significantly higher drop-out rate in the antidepressant groups. Conclusion: 

The previous interpretation – cognitive therapy being distinctly superior to antidepressant medication – cannot be sustained from the currently analysed data set.

Keywords: antidepressive agents; cognitive therapy; depression; meta-analysis

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1600-0447.2008.01196.x

Affiliations: School of Psychiatry, University of New South Wales

Publication date: August 1, 2008

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