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Care-as-usual control groups across different settings in randomized trials on psychotherapy for adult depression: a meta-analysis

Published online by Cambridge University Press:  17 December 2019

Pim Cuijpers Open the ORCID record for Pim Cuijpers [Opens in a new window] ,
Soledad Quero ,
Davide Papola ,
Ioana A. Cristea  and
Eirini Karyotaki
Pim Cuijpers*
Affiliation:
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
Soledad Quero
Affiliation:
Department of Basic, Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
Davide Papola
Affiliation:
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands Department of Neuroscience, Biomedicine and Movement Science, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
Ioana A. Cristea
Affiliation:
Department of Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
Eirini Karyotaki
Affiliation:
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
*
Author for correspondence: Pim Cuijpers, E-mail: p.cuijpers@vu.nl
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Abstract

Background

Care-as-usual (CAU) is often used as a control condition in psychotherapy research, but it may vary considerably what that entails, ranging from no treatment, to routine treatment in primary care, general medical care, perinatal care, and specialized mental health care.

Methods

We conducted a meta-analysis of trials comparing psychotherapy for depression to CAU, with a focus on the different categories of CAU and countries where the studies were conducted. We used an existing database of randomized trials on psychotherapy for depression that is updated every year.

Results

A total of 140 studies with 15 419 patients were included. We found no significant differences in effects between categories of CAU (effect sizes ranging from g = 0.43 for CAU in primary care to g = 0.73 for no treatment), but heterogeneity was high in all CAU categories. After stratifying effects across specific countries (within CAU categories) we found that heterogeneity was considerably lower and there were several significant differences between countries. Overall, effects were larger in non-Western countries (g = 0.84 to 1.28) compared to those in Western countries (g = 0.52; p for difference = 0.002). Effects were smaller in studies with risk of bias (p = 0.01).

Conclusions

There are no significant differences between major categories of CAU when compared to psychotherapy conditions in randomized trials. However, effects of psychotherapy differ considerably across CAU conditions in specific countries. CAU therefore is a heterogeneous control condition in psychotherapy research.

Keywords

Care-as-usualcontrol conditionsdepressionmajor depressionmeta-analysispsychotherapy
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 4 , March 2021 , pp. 634 - 644
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Copyright
Copyright © Cambridge University Press 2019

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References

Barth, J., Munder, T., Gerger, H., Nuesch, E., Trelle, S., Znoj, H., … Cuijpers, P. (2013). Comparative efficacy of seven psychotherapeutic interventions for depressed patients: A network meta-analysis. Plos Medicine, 10, e1001454.CrossRefGoogle Scholar
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II. Beck depression inventory second edition. Manual. San Antonio: Psychological Corporation.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Beeber, L. S., Holditch-Davis, D., Perreira, K., Schwartz, T. A., Lewis, V., Blanchard, H., & Goldman, B. D. (2010). Short-term in-home intervention reduces depressive symptoms in Early Head Start Latina mothers of infants and toddlers. Research on Nursing and Health, 33, 60–76.CrossRefGoogle ScholarPubMed
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. Chichester, UK: Wiley.CrossRefGoogle Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Erlbaum.Google Scholar
Cristea, I. A. (2017). The waiting list is an inadequate benchmark for estimating the effectiveness of psychotherapy for depression. Epidemiology and Psychiatric Science, 28, 278–279.CrossRefGoogle Scholar
Cuijpers, P. (2017). Four decades of outcome research on psychotherapies for adult depression: An overview of a series of meta-analyses. Canadian Psychology, 58, 7–19.CrossRefGoogle Scholar
Cuijpers, P., Driessen, E., Hollon, S. D., van Oppen, P., Barth, J., & Andersson, G. (2012). The efficacy of non-directive supportive therapy for adult depression: A meta-analysis. Clinical Psychology Review, 32, 280–291.CrossRefGoogle ScholarPubMed
Cuijpers, P., Karyotaki, E., & Ciharova, M. (2019a). A meta-analytic database of randomised trials on psychotherapies for depression. Open Science Foundation. https://doi.org/10.17605/OSF.IO/825C6.Google Scholar
Cuijpers, P., Karyotaki, E., de Wit, L., & Ebert, D. D. (2019b). The effects of fifteen evidence-supported therapies for adult depression: A meta-analytic review. Psychotherapy Research. epub ahead of print.Google Scholar
Cuijpers, P., Karyotaki, E., Reijnders, M., & Ebert, D. D. (2019c). Was Eysenck right after all? A reassessment of the effects of psychotherapy for adult depression. Epidemiology and Psychiatric Sciences, 28, 21–30.CrossRefGoogle Scholar
Cuijpers, P., Karyotaki, E., Reijnders, M., Purgato, M., & Barbui, C. (2018). Psychotherapies for depression in low- and middle-income countries: A meta-analysis. World Psychiatry, 17, 90–101.CrossRefGoogle ScholarPubMed
Cuijpers, P., Noma, H., Karyotaki, E., Cipriani, A., & Furukawa, T. (2019d). Individual, group, telephone, self-help and internet-based cognitive behavior therapy for adult depression: A network meta-analysis of delivery methods. JAMA Psychiatry, 76, 700–707.CrossRefGoogle Scholar
Cuijpers, P., Noma, H., Karyotaki, E., Vinkers, C. H., Cipriani, A., & Furukawa, T. A. (2020). A network meta-analysis of the effects of psychotherapies, pharmacotherapies and their combination in the treatment of adult depression. World Psychiatry, in press.CrossRefGoogle ScholarPubMed
Cuijpers, P., van Straten, A., Andersson, G., & van Oppen, P. (2008). Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 76, 909–922.CrossRefGoogle ScholarPubMed
Cuijpers, P., Weitz, E., Cristea, I., & Twisk, J. (2017). Pre-post effect sizes should be avoided in meta-analyses. Epidemiology and Psychiatric Sciences, 26, 364–368.CrossRefGoogle ScholarPubMed
Driessen, E., Hollon, S. D., Bockting, C. L. H., Cuijpers, P., & Turner, E. H. (2015). Does publication bias inflate the apparent efficacy of psychological treatment for major depressive disorder? A systematic review and meta-analysis of us national institutes of health-funded trials. Plos One, 10, e0137864.CrossRefGoogle ScholarPubMed
Duval, S., & Tweedie, R. (2000). Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56, 455–463.CrossRefGoogle ScholarPubMed
Eseadi, C., Obidoa, M. A., Ogbuabor, S. E., & Ikechukwu-Ilomuanya, A. B. (2018). Effects of group-focused cognitive-behavioral coaching program on depressive symptoms in a sample of inmates in a Nigerian prison. International Journal of Offender Therapy and Comparative Criminology, 62, 1589–1602.CrossRefGoogle Scholar
Furukawa, T. A. (1999). From effect size into number needed to treat. Lancet, 353(9165), 1680.CrossRefGoogle ScholarPubMed
Furukawa, T. A., Noma, H., Caldwell, D. M., Honyashiki, M., Shinohara, K., Imai, H., … Churchill, R. (2014). Waiting list may be a nocebo condition in psychotherapy trials: A contribution from network meta-analysis. Acta Psychiatrica Scandinavica, 130, 181–192.CrossRefGoogle ScholarPubMed
Gold, S. M., Enck, P., Hasselmann, H., Friede, T., Hegerl, U., Mohr, D. C., & Otte, C. (2017). Control conditions for randomised trials of behavioural interventions in psychiatry: A decision framework. The Lancet. Psychiatry, 4, 725–732.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis. Orlando, FL: Academic Press.Google Scholar
Higgins, J. P. T., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., … Sterne, J. A. C. (2011). The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. British Medical Journal, 343, d5928.CrossRefGoogle ScholarPubMed
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327(7414), 557–560.CrossRefGoogle ScholarPubMed
Karyotaki, E., Smit, Y., Holdt Henningsen, K., Huibers, M. J. H., Robayse, J., de Beurs, D., & Cuijpers, P. (2016). Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects. Journal of Affective Disorders, 194, 144–152.CrossRefGoogle ScholarPubMed
Kolovos, S., van Tulder, M. W., Cuijpers, P., Prigent, A., Chevreul, K., Riper, H., & Bosmans, J. E. (2017). The effect of treatment as usual on major depressive disorder: A meta-analysis. Journal of Affective Disorders, 210, 72–81.CrossRefGoogle ScholarPubMed
Mohr, D. C., Ho, J., Hart, S. L., Baron, K. G., Berendsen, M., Beckner, V., … Duffecy, J. (2014). Control condition design and implementation features in controlled trials: A meta-analysis of trials evaluating psychotherapy for depression. Translational Behavioral Medicine: Practice, Policy and Research, 4, 407–423.CrossRefGoogle ScholarPubMed
Mohr, D. C., Spring, B., Freedland, K. E., Beckner, V., Arean, P., Hollon, S. D., … Kaplan, R. (2009). The selection and design of control conditions for randomized controlled trials of psychological interventions. Psychotherapy and Psychosomatics, 78, 275–284.CrossRefGoogle ScholarPubMed
Watts, S. E., Turnell, A., Kladnitski, N., Newby, J. M., & Andrews, G. (2015). Treatment-as-usual (TAU) is anything but usual: A meta-analysis of CBT versus TAU for anxiety and depression. Journal of Affective Disorders, 175, 152–167.CrossRefGoogle ScholarPubMed
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