A meta-analysis of the effects of cognitive therapy in depressed patients

J Affect Disord. 1998 Apr;49(1):59-72. doi: 10.1016/s0165-0327(97)00199-7.


Background: Cognitive therapy (CT) has been studied in 78 controlled clinical trials from 1977 to 1996.

Method: The meta-analysis used Hedges and Olkin d+ and included 48 high-quality controlled trials. The 2765 patients presented non-psychotic and non-bipolar major depression, or dysthymia of mild to moderate severity.

Results: At post-test CT appeared significantly better than waiting-list, antidepressants (P < 0.0001) and a group of miscellaneous therapies (P < 0.01). But, CT was equal to behaviour therapy. As between-trial homogeneity was not met, the comparisons of CT with waiting-list or placebo, and other therapies should be taken cautiously. In contrast, between-trial homogeneity was high for the comparisons of CT with behaviour therapy and antidepressants. A review of eight follow-up studies comparing CT with antidepressants suggested that CT may prevent relapses in the long-term, while relapse rate is high with antidepressants in naturalistic studies.

Conclusion: CT is effective in patients with mild or moderate depression.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Chi-Square Distribution
  • Cognitive Behavioral Therapy / standards*
  • Confidence Intervals
  • Depression / therapy*
  • Female
  • Humans
  • Linear Models
  • Male
  • Multivariate Analysis
  • Psychotherapy / classification
  • Psychotherapy / standards
  • Randomized Controlled Trials as Topic / statistics & numerical data


  • Antidepressive Agents