[The effects of shared decision making in depression: systematic review and meta-analysis]

Shared decision making (SDM) is advised in the treatment guideline for depressive disorders. However, it’s unclear if SDM contributes to the optimization of care.

To provide an overview of the effects of SDM within the treatment of depression on treatment outcome, patient satisfaction and adherence through a meta-analysis and systematic review.

In a literature search (PubMed, PsycINFO, Embase), randomised controlled studies with patients who suffer from depression or depressive symptoms were selected. The effect of a SDM intervention previous to treatment was compared to no SDM intervention on the outcome measures. Effect sizes were computed with random effects models and risk of bias was assessed.

Five studies were included (N = 850). SDM did not result in superior treatment outcome (Cohen’s d = 0.02;
95%-BI:-0.12-0,16; p = 0.773) and adherence (Cohen’s d = 0.29; 95%-BI:-0.01-0.58; p = 0.056). SDM did lead to higher patient satisfaction with a medium-large effect size (Cohen’s d = 0.53; 95%-BI:0,17-0.90; p = .004).

SDM resulted in higher patient satisfaction, no effects were found regarding treatment outcome and adherence. However, operationalisation of SDM in the studies were variable. SDM appears to be a versatile construct in clinical practice.