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Review ArticleSystematic Reviews

Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis

Klaus Linde, Kirsten Sigterman, Levente Kriston, Gerta Rücker, Susanne Jamil, Karin Meissner and Antonius Schneider
The Annals of Family Medicine January 2015, 13 (1) 56-68; DOI: https://doi.org/10.1370/afm.1719
Klaus Linde
1Institute of General Practice, Technische Universität München, Munich, Germany
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  • For correspondence: Klaus.Linde@tum.de
Kirsten Sigterman
1Institute of General Practice, Technische Universität München, Munich, Germany
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Levente Kriston
2Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Gerta Rücker
3Institute of Medical Biometry and Statistics, University Medical Center Freiburg, Freiburg, Germany
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Susanne Jamil
1Institute of General Practice, Technische Universität München, Munich, Germany
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Karin Meissner
1Institute of General Practice, Technische Universität München, Munich, Germany
4Institute of Medical Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
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Antonius Schneider
1Institute of General Practice, Technische Universität München, Munich, Germany
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Abstract

PURPOSE We performed a systematic review of the currently available evidence on whether psychological treatments are effective for treating depressed primary care patients in comparison with usual care or placebo, taking the type of therapy and its delivery mode into account.

METHODS Randomized controlled trials comparing a psychological treatment with a usual care or a placebo control in adult, depressed, primary care patients were identified by searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO up to December 2013. At least 2 reviewers extracted information from included studies and assessed the risk of bias. Random effects meta-analyses were performed using posttreatment depression scores as outcome.

RESULTS A total of 30 studies with 5,159 patients met the inclusion criteria. Compared with control, the effect (standardized mean difference) at completion of treatment was −0.30 (95% CI, −0.48 to −0.13) for face-to-face cognitive behavioral therapy (CBT), −0.14 (−0.40 to 0.12) for face-to-face problem-solving therapy, −0.24 (−0.47 to −0.02) for face-to-face interpersonal psychotherapy, −0.28 (−0.44 to −0.12) for other face-to-face psychological interventions, −0.43 (−0.62 to −0.24) for remote therapist-led CBT, −0.56 (−1.57 to 0.45) for remote therapist-led problem-solving therapy, −0.40 (−0.69 to −0.11) for guided self-help CBT, and −0.27 (−0.44 to −0.10) for no or minimal contact CBT.

CONCLUSIONS There is evidence that psychological treatments are effective in depressed primary care patients. For CBT approaches, substantial evidence suggests that interventions that are less resource intensive might have effects similar to more intense treatments.

  • depression
  • depressive disorders
  • psychotherapy
  • cognitive therapy
  • therapeutics
  • primary health care
  • review, systematic
  • Received for publication July 24, 2014.
  • Revision received September 12, 2014.
  • Accepted for publication September 17, 2014.
  • © 2015 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 13 (1)
The Annals of Family Medicine
Vol. 13, Issue 1
January/February 2015
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Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis
Klaus Linde, Kirsten Sigterman, Levente Kriston, Gerta Rücker, Susanne Jamil, Karin Meissner, Antonius Schneider
The Annals of Family Medicine Jan 2015, 13 (1) 56-68; DOI: 10.1370/afm.1719

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Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis
Klaus Linde, Kirsten Sigterman, Levente Kriston, Gerta Rücker, Susanne Jamil, Karin Meissner, Antonius Schneider
The Annals of Family Medicine Jan 2015, 13 (1) 56-68; DOI: 10.1370/afm.1719
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Subjects

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