TY - JOUR
T1 - Psychotherapy for comorbid depression and somatic disorders
T2 - A systematic review and meta-analysis
AU - Miguel, Clara
AU - Karyotaki, Eirini
AU - Ciharova, Marketa
AU - Cristea, Ioana A.
AU - Penninx, Brenda W. J. H.
AU - Cuijpers, Pim
N1 - Funding Information: BWJHP has received research funding from Jansen Research and Boehringer Ingelheim, for work outside the scope of this paper. All other authors declare no competing interests. Publisher Copyright: Copyright © The Author(s), 2021. Published by Cambridge University Press.
PY - 2023/4/18
Y1 - 2023/4/18
N2 - Background The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological, cardiometabolic, and neurological disorders. Methods We conducted a meta-analysis of 75 randomized trials (8209 participants) of psychotherapy for adults with somatic disorders and a diagnosis or elevated symptoms of depression. Outcomes included depression, QoL, somatic health-related outcomes, and mortality. Results Psychotherapy significantly reduced the severity of depression at post-treatment across all categories of somatic disorders (Hedges'g = 0.65; 95% CI 0.52-0.79), with sustained effects at 6-11 months (g = 0.38; 95% CI 0.22-0.53) and at 12 months follow-up or longer (g = 0.13; 95% CI 0.04-0.21). Psychotherapy also showed significant effects on QoL (g = 0.26; 95% CI 0.17-0.35), maintained up to 11 months follow-up (g = 0.25; 95% CI 0.16-0.34). No significant effects were observed on the most frequently reported somatic health-related outcomes (glycemic control, pain), and neither on mortality. Heterogeneity in most analyses was very high, and only 29 (38%) trials were rated at low risk of bias (RoB). Conclusions Psychotherapy may be an effective treatment option for patients with depression and somatic disorders, with long-term effects on depression severity and QoL. However, these results should be interpreted with caution due to heterogeneity and RoB.
AB - Background The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological, cardiometabolic, and neurological disorders. Methods We conducted a meta-analysis of 75 randomized trials (8209 participants) of psychotherapy for adults with somatic disorders and a diagnosis or elevated symptoms of depression. Outcomes included depression, QoL, somatic health-related outcomes, and mortality. Results Psychotherapy significantly reduced the severity of depression at post-treatment across all categories of somatic disorders (Hedges'g = 0.65; 95% CI 0.52-0.79), with sustained effects at 6-11 months (g = 0.38; 95% CI 0.22-0.53) and at 12 months follow-up or longer (g = 0.13; 95% CI 0.04-0.21). Psychotherapy also showed significant effects on QoL (g = 0.26; 95% CI 0.17-0.35), maintained up to 11 months follow-up (g = 0.25; 95% CI 0.16-0.34). No significant effects were observed on the most frequently reported somatic health-related outcomes (glycemic control, pain), and neither on mortality. Heterogeneity in most analyses was very high, and only 29 (38%) trials were rated at low risk of bias (RoB). Conclusions Psychotherapy may be an effective treatment option for patients with depression and somatic disorders, with long-term effects on depression severity and QoL. However, these results should be interpreted with caution due to heterogeneity and RoB.
KW - Depression
KW - meta-analysis
KW - psychological interventions
KW - psychotherapy
KW - quality of life
KW - somatic disorders
KW - somatic health
UR - http://www.scopus.com/inward/record.url?scp=85120059143&partnerID=8YFLogxK
UR - https://doi.org/10.1017/S0033291721004414
U2 - https://doi.org/10.1017/S0033291721004414
DO - https://doi.org/10.1017/S0033291721004414
M3 - Article
C2 - 34792017
SN - 0033-2917
VL - 53
SP - 2503
EP - 2513
JO - Psychological Medicine
JF - Psychological Medicine
IS - 6
ER -