Problem-solving therapy for adult depression: An updated meta-analysis

Pim Cuijpers, Leonore de Wit, Annet Kleiboer, Eirini Karyotaki, David D. Ebert

Research output: Contribution to journalShort surveypeer-review

87 Scopus citations

Abstract

Background Problem-solving therapy (PST) is one of the best examined types of psychotherapy for adult depression. No recent meta-analysis has examined the effects of PST compared to control groups or to other treatments. We wanted to verify whether PST is effective, whether effects are comparable to those of other treatments, and whether we could identify the possible sources of high heterogeneity that was found in earlier meta-analyses. Methods We conducted systematic searches in bibliographical databases, including PubMed, PsycInfo, Embase and the Cochrane database of randomized trials. Results We included 30 randomized controlled trials on PST (with 3530 patients), in which PST was compared to control conditions, with other therapies, and with pharmacotherapy. We could compare these 30 trials on PST also with 259 trials on other psychotherapies for adult depression. The effect size of PST versus control groups was g = 0.79 (0.57–1.01) with very high heterogeneity (I2 = 84; 95% CI: 77–88). The effect size from the 9 studies with low risk of bias was g = 0.34 (95% CI: 0.22–0.46) with low heterogeneity (I2 = 32; 95% CI: 0–68), which is comparable to the effects of other psychotherapies. PST was a little more effective than other therapies in direct comparisons, but that may be explained by the considerable number of studies with researcher allegiance towards PST. In meta-regression analyses of all controlled studies, no significant difference between PST and other therapies was found. Conclusion PST is probably an effective treatment for depression, with effect sizes that are small, but comparable to those found for other psychological treatments of depression.

Original languageEnglish
Pages (from-to)27-37
Number of pages11
JournalEuropean Psychiatry
Volume48
DOIs
StatePublished - Feb 2018
Externally publishedYes

Keywords

  • Comparative outcomes
  • Depression
  • Meta-analysis
  • Problem-solving therapy

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