Cognitive Behavioral Analysis System of Psychotherapy versus Antidepressants: a Systematic Review
DOI: 10.3238/zfa.2017.0017-0023german translation / full article
Background: Depression is classified as the most socially onerous common illness in Germany, outranking even diabetes mellitus and coronary heart disease. It is particularly prone to chronification. Depression is identified as chronic when it persists for a period of at least two years. In comparison with patients experiencing episodic depression, chronically depressed patients show younger age of onset, more frequent suicide attempts, and a poorer response to antidepressants. Only 12 % of chronically depressed patients receive psychotherapeutic treatment alongside antidepressants. Cognitive behavioral analysis system of psychotherapy (CBASP) is the only form of psychotherapy specially developed for the treatment of chronic depression. This study’s aim was to contrast psychotherapy/CBASP with pharmacotherapy/antidepressants with respect to their effectiveness in patients with chronic depression.
Methods: A systematic literature search was carried out to identify all studies directly comparing CBASP with antidepressants (PubMed, Embase and Cochrane Library).
Results: Only two randomized controlled trials (RCTs) about CBASP could be found which included a direct comparison with pharmacotherapy. In addition, a reanalysis could be identified which reevaluated the data of one of the above RCTs with respect to whether there was childhood trauma. The results in the above mentioned studies showed that CBASP is an equally good option to pharmacotherapy with respect to response and remission rates.
Conclusions: As the studies on this topic are limited, meta-analytical statistical decisions are difficult. There is, however, indication that adding CBASP to pharmacotherapy could be a good combination for patients with early trauma episodes.