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Review: cognitive behavioural therapy is an effective treatment for depression, panic disorder, and generalised anxiety disorder, but may be less effective in severe cases

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 Q Is cognitive behavioural therapy effective for the treatment of depression, panic disorder, and generalised anxiety disorder, and what factors affect outcome?

METHODS

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Systematic review with meta-analysis and meta-regression.

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Existing meta-analyses of cognitive behavioural therapy (CBT) for depression, panic disorder, and generalised anxiety disorder (GAD), and searches of MEDLINE and the Cochrane Collaboration Trials Register up to November 2002.

Embedded ImageStudy selection and analysis:

The review included randomised controlled trials of (RCTs) of CBT, behavioural therapy, or cognitive therapy with a wait list, no treatment, attention placebo, or pill placebo control group. Participants were aged 18 or over with DSM-III or DSM-III-R major depression or dysthymia (excluding psychotic disorder and bipolar disorder), panic disorder or DSM-III-R or DSM-IV generalised anxiety disorder. RCTs were only included if means and standard deviations were reported for continuous outcome measures, to enable the calculation of effect sizes. Effect sizes for each study were calculated using Hedges’ adjusted g, by averaging across the relevant …

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