Cognitive–behavioural therapy for depression in people with a somatic disease: meta-analysis of randomised controlled trials

Abstract

BackgroundMeta-analyses on psychological treatment for depression in individuals with a somatic disease are limited to specific underlying somatic diseases, thereby neglecting the generalisability of the interventions.AimsTo examine the effectiveness of cognitive–behavioural therapy (CBT) for depression in people with a diversity of somatic diseases.MethodMeta-analysis of randomised controlled trials evaluating CBT for depression in people with a somatic disease. Severity of depressive symptoms was pooled using the standardised mean difference (SMD).ResultsTwenty-nine papers met inclusion criteria. Cognitive–behavioural therapy was superior to control conditions with larger effects in studies restricted to participants with depressive disorder (SMD =–0.83, 95% CI –1.36 to –0.31, P<0.001) than in studies of participants with depressive symptoms (SMD =–0.16, 95% CI –0.27 to –0.06, P = 0.001). Subgroup analyses showed that CBT was not superior to other psychotherapies.ConclusionsCognitive–behavioural therapy significantly reduces depressive symptoms in people with a somatic disease, especially in those who meet the criteria for a depressive disorder.