Psychotherapy for comorbid depression and somatic disorders: A systematic review and meta-analysis

Clara Miguel, Eirini Karyotaki, Marketa Ciharova, Ioana A. Cristea, Brenda W. J. H. Penninx, Pim Cuijpers

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6 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)2503-2513
Number of pages11
JournalPsychological Medicine
Volume53
Issue number6
Early online date2021
DOIs
Publication statusPublished - 18 Apr 2023

Keywords

  • Depression
  • meta-analysis
  • psychological interventions
  • psychotherapy
  • quality of life
  • somatic disorders
  • somatic health

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