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Cognitive-behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled
Matthijs W Beltman1, Richard C Oude Voshaar, Anne E Speckens
1Radboud University Nijmegen Medical Centre, Department of Psychiatry, Nijmegen, The Netherlands. mw.beltman@psy.umcn.nl
Background:
Meta-analyses on psychological treatment for depression in individuals with a somatic disease are limited to specific underlying somatic diseases, thereby neglecting the generalisability of the interventions.
Aims:
To examine the effectiveness of cognitive-behavioural therapy (CBT) for depression in people with a diversity of somatic diseases.
Method:
Meta-analysis of randomised controlled trials evaluating CBT for depression in people with a somatic disease. Severity of depressive symptoms was pooled using the standardised mean difference (SMD).
Results:
Twenty-nine papers met inclusion criteria. Cognitive-behavioural therapy was superior to control conditions with larger effects in studies restricted to participants with depressive disorder (SMD = -0.83, 95% CI -1.36 to -0.31, P<0.001) than in studies of participants with depressive symptoms (SMD = -0.16, 95% CI -0.27 to -0.06, P = 0.001). Subgroup analyses showed that CBT was not superior to other psychotherapies.
Conclusions:
Cognitive-behavioural therapy significantly reduces depressive symptoms in people with a somatic disease, especially in those who meet the criteria for a depressive disorder.
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