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The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis

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The process and delivery of CBT for depression in adults : a systematic review and network meta-analysis. / Lopez-Lopez, Jose; Davies, Sarah; Caldwell, Deborah; Churchill, Rachel; Peters, TJ; Tallon, Debbie; Dawson, Sarah; Wu, Qi; Li, Jinshuo; Taylor, Abigail; Lewis, Glyn H; Kessler, David; Wiles, Nicola; Welton, Nicky.

In: Psychological Medicine, 10.06.2019.

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Lopez-Lopez, Jose ; Davies, Sarah ; Caldwell, Deborah ; Churchill, Rachel ; Peters, TJ ; Tallon, Debbie ; Dawson, Sarah ; Wu, Qi ; Li, Jinshuo ; Taylor, Abigail ; Lewis, Glyn H ; Kessler, David ; Wiles, Nicola ; Welton, Nicky. / The process and delivery of CBT for depression in adults : a systematic review and network meta-analysis. In: Psychological Medicine. 2019.

Bibtex

@article{07cf2279345a4ea8bb6315f91a18607b,
title = "The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis",
abstract = "Cognitive-behavioural therapy (CBT) is an effective treatment for depressed adults. CBT interventions are complex, as they include multiple content components and can be delivered in different ways. We compared the effectiveness of different types of therapy, different components and combinations of components and aspects of delivery used in CBT interventions for adult depression. We conducted a systematic review of randomised controlled trials in adults with a primary diagnosis of depression, which included a CBT intervention. Outcomes were pooled using a component-level network meta-analysis. Our primary analysis classified interventions according to the type of therapy and delivery mode. We also fitted more advanced models to examine the effectiveness of each content component or combination of components. We included 91 studies and found strong evidence that CBT interventions yielded a larger short-term decrease in depression scores compared to treatment-as-usual, with a standardised difference in mean change of -1.11 (95{\%} credible interval -1.62 to -0.60) for face-to-face CBT, -1.06 (-2.05 to -0.08) for hybrid CBT, and -0.59 (-1.20 to 0.02) for multimedia CBT, whereas wait list control showed a detrimental effect of 0.72 (0.09 to 1.35). We found no evidence of specific effects of any content components or combinations of components. Technology is increasingly used in the context of CBT interventions for depression. Multimedia and hybrid CBT might be as effective as face-to-face CBT, although results need to be interpreted cautiously. The effectiveness of specific combinations of content components and delivery formats remain unclear. Wait list controls should be avoided if possible.",
keywords = "Cognitive-behavioural therapy, depression, multimedia, network meta-analysis, systematic review",
author = "Jose Lopez-Lopez and Sarah Davies and Deborah Caldwell and Rachel Churchill and TJ Peters and Debbie Tallon and Sarah Dawson and Qi Wu and Jinshuo Li and Abigail Taylor and Lewis, {Glyn H} and David Kessler and Nicola Wiles and Nicky Welton",
year = "2019",
month = "6",
day = "10",
doi = "10.1017/S003329171900120X",
language = "English",
journal = "Psychological Medicine",
issn = "0033-2917",
publisher = "Cambridge University Press",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - The process and delivery of CBT for depression in adults

T2 - a systematic review and network meta-analysis

AU - Lopez-Lopez, Jose

AU - Davies, Sarah

AU - Caldwell, Deborah

AU - Churchill, Rachel

AU - Peters, TJ

AU - Tallon, Debbie

AU - Dawson, Sarah

AU - Wu, Qi

AU - Li, Jinshuo

AU - Taylor, Abigail

AU - Lewis, Glyn H

AU - Kessler, David

AU - Wiles, Nicola

AU - Welton, Nicky

PY - 2019/6/10

Y1 - 2019/6/10

N2 - Cognitive-behavioural therapy (CBT) is an effective treatment for depressed adults. CBT interventions are complex, as they include multiple content components and can be delivered in different ways. We compared the effectiveness of different types of therapy, different components and combinations of components and aspects of delivery used in CBT interventions for adult depression. We conducted a systematic review of randomised controlled trials in adults with a primary diagnosis of depression, which included a CBT intervention. Outcomes were pooled using a component-level network meta-analysis. Our primary analysis classified interventions according to the type of therapy and delivery mode. We also fitted more advanced models to examine the effectiveness of each content component or combination of components. We included 91 studies and found strong evidence that CBT interventions yielded a larger short-term decrease in depression scores compared to treatment-as-usual, with a standardised difference in mean change of -1.11 (95% credible interval -1.62 to -0.60) for face-to-face CBT, -1.06 (-2.05 to -0.08) for hybrid CBT, and -0.59 (-1.20 to 0.02) for multimedia CBT, whereas wait list control showed a detrimental effect of 0.72 (0.09 to 1.35). We found no evidence of specific effects of any content components or combinations of components. Technology is increasingly used in the context of CBT interventions for depression. Multimedia and hybrid CBT might be as effective as face-to-face CBT, although results need to be interpreted cautiously. The effectiveness of specific combinations of content components and delivery formats remain unclear. Wait list controls should be avoided if possible.

AB - Cognitive-behavioural therapy (CBT) is an effective treatment for depressed adults. CBT interventions are complex, as they include multiple content components and can be delivered in different ways. We compared the effectiveness of different types of therapy, different components and combinations of components and aspects of delivery used in CBT interventions for adult depression. We conducted a systematic review of randomised controlled trials in adults with a primary diagnosis of depression, which included a CBT intervention. Outcomes were pooled using a component-level network meta-analysis. Our primary analysis classified interventions according to the type of therapy and delivery mode. We also fitted more advanced models to examine the effectiveness of each content component or combination of components. We included 91 studies and found strong evidence that CBT interventions yielded a larger short-term decrease in depression scores compared to treatment-as-usual, with a standardised difference in mean change of -1.11 (95% credible interval -1.62 to -0.60) for face-to-face CBT, -1.06 (-2.05 to -0.08) for hybrid CBT, and -0.59 (-1.20 to 0.02) for multimedia CBT, whereas wait list control showed a detrimental effect of 0.72 (0.09 to 1.35). We found no evidence of specific effects of any content components or combinations of components. Technology is increasingly used in the context of CBT interventions for depression. Multimedia and hybrid CBT might be as effective as face-to-face CBT, although results need to be interpreted cautiously. The effectiveness of specific combinations of content components and delivery formats remain unclear. Wait list controls should be avoided if possible.

KW - Cognitive-behavioural therapy

KW - depression

KW - multimedia

KW - network meta-analysis

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85067174455&partnerID=8YFLogxK

U2 - 10.1017/S003329171900120X

DO - 10.1017/S003329171900120X

M3 - Article

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

ER -