Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis.
<h4>Objectives</h4>To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits.<h4>Data s...
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0050202 |
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| author | Shanil Ebrahim Luis Montoya Wanda Truong Sandy Hsu Mostafa Kamal El Din Alonso Carrasco-Labra Jason W Busse Stephen D Walter Diane Heels-Ansdell Rachel Couban Irene Patelis-Siotis Marg Bellman L Esther de Graaf David J A Dozois Peter J Bieling Gordon H Guyatt |
| author_facet | Shanil Ebrahim Luis Montoya Wanda Truong Sandy Hsu Mostafa Kamal El Din Alonso Carrasco-Labra Jason W Busse Stephen D Walter Diane Heels-Ansdell Rachel Couban Irene Patelis-Siotis Marg Bellman L Esther de Graaf David J A Dozois Peter J Bieling Gordon H Guyatt |
| author_sort | Shanil Ebrahim |
| collection | DOAJ |
| description | <h4>Objectives</h4>To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits.<h4>Data sources</h4>All relevant RCTs from a database of randomized controlled and comparative studies examining the effects of psychotherapy for adult depression (http://www.evidencebasedpsychotherapies.org), electronic databases (MEDLINE, EMBASE, PSYCINFO, AMED, CINAHL and CENTRAL) to June 2011, and bibliographies of all relevant articles. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTION: Adult patients with major depression, randomly assigned to CBT versus minimal/no treatment or care-as-usual.<h4>Study appraisal and synthesis methods</h4>Three teams of reviewers, independently and in duplicate, completed title and abstract screening, full text review and data extraction. We performed an individual patient data meta-analysis to summarize data.<h4>Results</h4>Of 92 eligible trials, 70 provided author contact information; of these 56 (80%) were successfully contacted to establish if they captured receipt of benefits as a baseline characteristic; 8 recorded benefit status, and 3 enrolled some patients in receipt of benefits, of which 2 provided individual patient data. Including both patients receiving and not receiving disability benefits, 2 trials (227 patients) suggested a possible reduction in depression with CBT, as measured by the Beck Depression Inventory, mean difference [MD] (95% confidence interval [CI]) = -2.61 (-5.28, 0.07), p = 0.06; minimally important difference of 5. The effect appeared larger, though not significantly, in those in receipt of benefits (34 patients) versus not receiving benefits (193 patients); MD (95% CI) = -4.46 (-12.21, 3.30), p = 0.26.<h4>Conclusions</h4>Our data does not support the hypothesis that CBT has smaller effects in depressed patients receiving disability benefits versus other patients. Given that the confidence interval is wide, a decreased effect is still possible, though if the difference exists, it is likely to be small. |
| format | Article |
| id | doaj-art-3da719a66e944adf963d4c3b879e34d4 |
| institution | Matheson Library |
| issn | 1932-6203 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-3da719a66e944adf963d4c3b879e34d42025-06-28T05:31:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01711e5020210.1371/journal.pone.0050202Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis.Shanil EbrahimLuis MontoyaWanda TruongSandy HsuMostafa Kamal El DinAlonso Carrasco-LabraJason W BusseStephen D WalterDiane Heels-AnsdellRachel CoubanIrene Patelis-SiotisMarg BellmanL Esther de GraafDavid J A DozoisPeter J BielingGordon H Guyatt<h4>Objectives</h4>To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits.<h4>Data sources</h4>All relevant RCTs from a database of randomized controlled and comparative studies examining the effects of psychotherapy for adult depression (http://www.evidencebasedpsychotherapies.org), electronic databases (MEDLINE, EMBASE, PSYCINFO, AMED, CINAHL and CENTRAL) to June 2011, and bibliographies of all relevant articles. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTION: Adult patients with major depression, randomly assigned to CBT versus minimal/no treatment or care-as-usual.<h4>Study appraisal and synthesis methods</h4>Three teams of reviewers, independently and in duplicate, completed title and abstract screening, full text review and data extraction. We performed an individual patient data meta-analysis to summarize data.<h4>Results</h4>Of 92 eligible trials, 70 provided author contact information; of these 56 (80%) were successfully contacted to establish if they captured receipt of benefits as a baseline characteristic; 8 recorded benefit status, and 3 enrolled some patients in receipt of benefits, of which 2 provided individual patient data. Including both patients receiving and not receiving disability benefits, 2 trials (227 patients) suggested a possible reduction in depression with CBT, as measured by the Beck Depression Inventory, mean difference [MD] (95% confidence interval [CI]) = -2.61 (-5.28, 0.07), p = 0.06; minimally important difference of 5. The effect appeared larger, though not significantly, in those in receipt of benefits (34 patients) versus not receiving benefits (193 patients); MD (95% CI) = -4.46 (-12.21, 3.30), p = 0.26.<h4>Conclusions</h4>Our data does not support the hypothesis that CBT has smaller effects in depressed patients receiving disability benefits versus other patients. Given that the confidence interval is wide, a decreased effect is still possible, though if the difference exists, it is likely to be small.https://doi.org/10.1371/journal.pone.0050202 |
| spellingShingle | Shanil Ebrahim Luis Montoya Wanda Truong Sandy Hsu Mostafa Kamal El Din Alonso Carrasco-Labra Jason W Busse Stephen D Walter Diane Heels-Ansdell Rachel Couban Irene Patelis-Siotis Marg Bellman L Esther de Graaf David J A Dozois Peter J Bieling Gordon H Guyatt Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. PLoS ONE |
| title | Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. |
| title_full | Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. |
| title_fullStr | Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. |
| title_full_unstemmed | Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. |
| title_short | Effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits: a systematic review and individual patient data meta-analysis. |
| title_sort | effectiveness of cognitive behavioral therapy for depression in patients receiving disability benefits a systematic review and individual patient data meta analysis |
| url | https://doi.org/10.1371/journal.pone.0050202 |
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