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No evidence that CBT is less effective than antidepressants in moderate to severe depression
  1. Gemma Lewis,
  2. Glyn Lewis
  1. University College London, London, UK
  1. Correspondence to Dr Gemma Lewis, Division of Psychiatry, University College London (UCL), Wing B, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK; Gemma.Lewis{at}

Statistics from

ABSTRACT FROM: Weitz ES, Hollon SD, Twisk J, et al. Baseline depression severity as moderator of depression outcomes between cognitive behavioral therapy vs pharmacotherapy: an individual patient data meta-analysis. JAMA Psychiatry 2015;72:1102–9.

What is already known on this topic

Some guidelines for the treatment of severe depression recommend that antidepressant medication be used instead of cognitive–behavioural therapy (CBT). This is inconsistent with evidence collating individual patient data (IPD) from multiple randomised controlled trials (RCTs).1 IPD meta analyses are one way of increasing statistical power and analysing depressive symptoms of varying severity. A previous IPD meta analysis included only four studies, so may still have lacked statistical power.

Methods of the study

Weitz and colleagues requested IPD from previous RCTs comparing psychotherapy and antidepressants. RCTs were identified via database searches (PubMed, PsycINFO, EMBASE and Cochrane Registry of Controlled Trials). The authors selected studies that had compared CBT alone with antidepressants alone, in adults diagnosed with depression. Relapse prevention or maintenance treatment studies and …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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