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Efficacy of inpatient psychotherapy for major depressive disorder: a meta‐analysis of controlled trials
Author(s) -
Schefft C.,
Guhn A.,
Brakemeier E.L.,
Sterzer P.,
Köhler S.
Publication year - 2019
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12995
Subject(s) - meta analysis , strictly standardized mean difference , psychological intervention , depression (economics) , placebo , major depressive disorder , psychology , subgroup analysis , randomized controlled trial , clinical psychology , psychiatry , medicine , alternative medicine , cognition , pathology , economics , macroeconomics
Objective This meta‐analysis investigates the efficacy of inpatient psychotherapy in major depressive disorders compared to control conditions. Methods In total, 14 studies were entered into the meta‐analysis with a total of 1.080 patients. Primary outcome was the standardized mean differences in self‐rated depression outcomes. A priori planned subgroup analyses included the influence of different control conditions: (a) no psychiatric inpatient treatment (e.g., waitlist control), (b) treatment as usual ( TAU ; e.g., non‐manualized clinical management), (c) TAU determined by study design (manualized/’placebo’ control condition), as well as number of sessions and influence of self‐ vs. clinician ratings. Results The meta‐analysis of 19 available comparisons resulted in a moderate pooled effect size showing a small and statistically significant benefit of the psychotherapeutic intervention over control conditions ( g = 0.24, P < 0.001, I 2 = 0%). This corresponds to a number needed to treat of 7.4. The effects of the interventions were stable over 12‐month follow‐up ( g = 0.21, P < 0.01, I 2 = 30%). Comparisons with waitlist or non‐standardized control treatments tended to be associated with larger effect sizes than standardized control treatments. Conclusions Despite some limitations (small number of studies), this meta‐analysis provides evidence for a small but sustained effect of inpatient psychotherapy in patients with major depressive disorders.