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Does the placebo effect inflate the effectiveness of psychotherapy?
Sarah Knowles.
The Mental Elf.
23rd March 2016
http://www.nationalelfservice.net/t...t-inflate-the-effectiveness-of-psychotherapy/
A review of this 2015 paper...
Cuijpers P, Karyotaki E, Andersson G, Li J, Mergl R, Hegerl U.
The effects of blinding on the outcomes of psychotherapy and pharmacotherapy for adult depression: A meta-analysis.
Eur Psychiatry. 2015; 30:685-93.
http://www.europsy-journal.com/article/S0924-9338(15)00131-5/abstract
http://www.sciencedirect.com/science/article/pii/S0924933815001315
Sarah Knowles.
The Mental Elf.
23rd March 2016
http://www.nationalelfservice.net/t...t-inflate-the-effectiveness-of-psychotherapy/
A review of this 2015 paper...
Cuijpers P, Karyotaki E, Andersson G, Li J, Mergl R, Hegerl U.
The effects of blinding on the outcomes of psychotherapy and pharmacotherapy for adult depression: A meta-analysis.
Eur Psychiatry. 2015; 30:685-93.
http://www.europsy-journal.com/article/S0924-9338(15)00131-5/abstract
http://www.sciencedirect.com/science/article/pii/S0924933815001315
Background
Randomized trials with antidepressants are often run under double blind placebo-controlled conditions, whereas those with psychotherapies are mostly unblinded. This can introduce bias in favor of psychotherapy when the treatments are directly compared. In this meta-analysis, we examine this potential source of bias.
Methods
We searched Pubmed, PsycInfo, Embase and the Cochrane database (1966 to January 2014) by combining terms indicative of psychological treatment and depression, and limited to randomized trials. We included 35 trials (with 3721 patients) in which psychotherapy and pharmacotherapy for adult depression were directly compared with each other. We calculated effect sizes for each study indicating the difference between psychotherapy and pharmacotherapy at post-test. Then, we examined the difference between studies with a placebo condition and those without in moderator analyses.
Results
We did not find a significant difference between the studies with and those without a placebo condition. The studies in which a placebo condition was included indicated no significant difference between psychotherapy and pharmacotherapy (g = −0.07; NNT = 25). Studies in which no placebo condition was included (and patients and clinicians in both conditions were not blinded), resulted in a small, but significant difference between psychotherapy and pharmacotherapy in favor of pharmacotherapy (g = −0.13; NNT = 14).
Conclusions
Studies comparing psychotherapy and pharmacotherapy in which both groups of patients (and therapists) are not blinded (no placebo condition is included) result in a very small, but significantly higher effect for pharmacotherapy.