PMID- 24030613
OWN - NLM
STAT- MEDLINE
DCOM- 20131101
LR  - 20191210
IS  - 1535-7228 (Electronic)
IS  - 0002-953X (Linking)
VI  - 170
IP  - 9
DP  - 2013 Sep
TI  - The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the 
      outpatient treatment of major depression: a randomized clinical trial.
PG  - 1041-50
LID - 10.1176/appi.ajp.2013.12070899 [doi]
AB  - OBJECTIVE: The efficacy of psychodynamic therapies for depression remains open to 
      debate because of a paucity of high-quality studies. The authors compared the 
      efficacy of psychodynamic therapy with that of cognitive-behavioral therapy 
      (CBT), hypothesizing nonsignificant differences and the noninferiority of 
      psychodynamic therapy relative to CBT. METHOD: A total of 341 adults who met 
      DSM-IV criteria for a major depressive episode and had Hamilton Depression Rating 
      Scale (HAM-D) scores >/=14 were randomly assigned to 16 sessions of individual 
      manualized CBT or short-term psychodynamic supportive therapy. Severely depressed 
      patients (HAM-D score >24) also received antidepressant medication according to 
      protocol. The primary outcome measure was posttreatment remission rate (HAM-D 
      score </=7). Secondary outcome measures included mean posttreatment HAM-D score and 
      patient-rated depression score and 1-year follow-up outcomes. Data were analyzed 
      with generalized estimating equations and mixed-model analyses using 
      intent-to-treat samples. Noninferiority margins were prespecified as an odds 
      ratio of 0.49 for remission rates and a Cohen's d value of 0.30 for continuous 
      outcome measures. RESULTS: No statistically significant treatment differences 
      were found for any of the outcome measures. The average posttreatment remission 
      rate was 22.7%. Noninferiority was shown for posttreatment HAM-D and 
      patient-rated depression scores but could not be demonstrated for posttreatment 
      remission rates or any of the follow-up measures. CONCLUSIONS: The findings 
      extend the evidence base of psychodynamic therapy for depression but also 
      indicate that time-limited treatment is insufficient for a substantial number of 
      patients encountered in psychiatric outpatient clinics.
FAU - Driessen, Ellen
AU  - Driessen E
FAU - Van, Henricus L
AU  - Van HL
FAU - Don, Frank J
AU  - Don FJ
FAU - Peen, Jaap
AU  - Peen J
FAU - Kool, Simone
AU  - Kool S
FAU - Westra, Dieuwertje
AU  - Westra D
FAU - Hendriksen, Marielle
AU  - Hendriksen M
FAU - Schoevers, Robert A
AU  - Schoevers RA
FAU - Cuijpers, Pim
AU  - Cuijpers P
FAU - Twisk, Jos W R
AU  - Twisk JW
FAU - Dekker, Jack J M
AU  - Dekker JJ
LA  - eng
SI  - ISRCTN/ISRCTN31263312
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Psychiatry
JT  - The American journal of psychiatry
JID - 0370512
RN  - 0 (Antidepressive Agents)
SB  - IM
CIN - Am J Psychiatry. 2013 Sep;170(9):953-6. PMID: 24030607
CIN - J Am Psychoanal Assoc. 2014 Feb;62(1):116-8. PMID: 24610763
CIN - Evid Based Ment Health. 2014 Nov;17(4):118. PMID: 25326494
CIN - JAMA Psychiatry. 2016 Sep 1;73(9):893-4. PMID: 27487423
MH  - Adult
MH  - Ambulatory Care/*methods
MH  - Antidepressive Agents/*therapeutic use
MH  - Cognitive Behavioral Therapy/*methods
MH  - Depressive Disorder, Major/diagnosis/psychology/*therapy
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Female
MH  - Humans
MH  - Male
MH  - *Mental Health Services
MH  - Middle Aged
MH  - Odds Ratio
MH  - Outcome Assessment, Health Care
MH  - Outpatients
MH  - Psychiatric Status Rating Scales
MH  - Psychotherapy, Brief/*methods
MH  - Remission Induction
MH  - Treatment Outcome
EDAT- 2013/09/14 06:00
MHDA- 2013/11/02 06:00
CRDT- 2013/09/14 06:00
PHST- 2013/09/14 06:00 [entrez]
PHST- 2013/09/14 06:00 [pubmed]
PHST- 2013/11/02 06:00 [medline]
AID - 1734470 [pii]
AID - 10.1176/appi.ajp.2013.12070899 [doi]
PST - ppublish
SO  - Am J Psychiatry. 2013 Sep;170(9):1041-50. doi: 10.1176/appi.ajp.2013.12070899.