Absolute and relative outcomes of psychotherapies for eight mental disorders: a systematic review and meta‐analysis

Summary & key facts

This large review combined 441 randomized trials with 33,881 patients to measure how many people show a clear response to psychotherapy across eight mental disorders. Response was defined as at least a 50% reduction in symptoms from before to after treatment. Pooled response rates were modest (for example, about 42% for major depression and 24% for borderline personality disorder). Psychotherapies were more effective than control groups for most disorders, but many people did not reach a 50% symptom reduction. The authors say better or additional treatments are needed for people who do not respond to first-line psychotherapy.

Key facts:

• The review included 441 randomized controlled trials with a total of 33,881 patients.
• Response was defined as at least a 50% symptom reduction between baseline and post-test.
• Pooled response rate for major depressive disorder (MDD) was 42% (95% CI: 39%–45%).
• Pooled response rate for post-traumatic stress disorder (PTSD) was 38% (95% CI: 33%–43%).
• Pooled response rate for obsessive-compulsive disorder (OCD) was 38% (95% CI: 30%–47%).
• Pooled response rate for panic disorder was 38% (95% CI: 33%–43%), and for generalized anxiety disorder (GAD) it was 36% (95% CI: 30%–42%).
• Pooled response rates were 32% (95% CI: 29%–37%) for social anxiety disorder, 32% (95% CI: 23%–42%) for specific phobia, and 24% (95% CI: 15%–36%) for borderline personality disorder (BPD).
• Relative risks comparing psychotherapy to control were statistically significant for all disorders except borderline personality disorder, and sensitivity analyses broadly supported the main findings.
• The literature search covered major databases up to January 1, 2023, and included trials that compared psychotherapies to control groups such as waitlist, care-as-usual, or pill placebo.

Abstract

Psychotherapies are first‐line treatments for most mental disorders, but their absolute outcomes (i.e., response and remission rates) are not well studied, despite the relevance of such information for health care users, providers and policy makers. ...

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Psychosomatic Disorders and Their Treatments Treatment of Major Depression

Categories

Health Sciences Medicine Pharmacology

Tags

Agoraphobia Anxiety Borderline personality disorder Clinical psychology Confidence interval Internal medicine Law Major depressive disorder Medicine MEDLINE Mental health Meta-analysis Mood Number needed to treat Panic disorder Political science Psychiatry Psychology PsycINFO Randomized controlled trial Relative risk Systematic review

Conditions & symptoms

Anxiety Depression Obsessive-Compulsive Disorder Panic disorder and phobias PTSD Anxiety or worry Panic Sadness or low mood