Table 2.
Trial and outcome characteristics of the six studies investigating the efficacy of CBASP in chronically depressed individuals
| Study | Participants | Intervention type (N/Attrition‐N) | Comparison group (N/Attrition‐N) | Primary outcome | Remission rates | Main results | Effect sizea CI95 |
|---|---|---|---|---|---|---|---|
| Keller et al. (2000) | Chronic MDD | CBASP+ (226/47) | ADM [nefazodone] (220/53) CBASP (216/43) | HAM‐D |
CBASP + ADM: 48% CBASP: 33% ADM: 29% |
Both of the monotherapies (CBASP; ADM) yielded results of similar efficacy, whereas the combined treatment (CBASP + ADM) revealed improved efficacy | g = 0.55 [0.37–0.74] g = 0.64 [0.35–0.73] |
| Kocsis et al. (2009) | Chronic MDD | CBASP (200/25) |
BSP (195/27) ADM (96/16) |
HAM‐D QIDS‐CR |
CBASP: 43% BSP: 37.9% ADM: 40.6% |
None of the therapies (CBASP; BSP) as adjunction to ADM improved the outcome effects over ADM alone. There were no significant differences between CBASP and BSP | g = 0.16 [0.01–0.31] g = 0.28 [0.10–0.48] |
| Schramm et al. (2011a) | Chronic MDD | CBASP (14/1) | IPT (15/2) |
HAM‐D BDI |
CBASP: 57.1% IPT: 20% |
CBASP and IPT turned out to be equally effective in reducing observer‐rated depression. However, CBASP was significantly superior to IPT in decreasing self‐reported depressive symptoms | g = 0.62 [−0.05 to 1.28] |
| Wiersma et al. (2014) | Chronic MDD | CBASP (67/16) | CAU (72/19) | IDS‐SR |
CBASP: 19.4% CAU: 9.9% |
Compared to CAU, patients receiving CBASP revealed greater reductions in depressive symptoms at posttreatment (week 52). No significant differences were found during treatment phase (weeks 8, 16, 32) | g = 0.34 [0.01–0.67] |
| Schramm et al. (2015) | Chronic MDD | CBASP+ (20/3) |
ADM [escitalopram] (16/2) CBASP (17/0) |
MADRS IDS‐SR |
CBASP: 36.8% ADM: 50% Combined (CBASP + ADM) after nonresponse: 30% |
Compared to ADM, individuals assigned to CBASP improved in a similar extent. There were no significant differences. For nonimprovers (after 8 weeks of treatment), the augmentation of the other treatment (ADM, CBASP), respectively, proved to be efficacious | g = 0.59 [0.01–1.16] g = 0.49 [−0.09 to 1.07] |
| Michalak et al. (2015) | Chronic MDD | CBASP (35/8) |
TAU (35/3) MBCT (36/10) |
HAM‐D BDI |
CBASP: 25.7% MBCT: 16.7% TAU: 5.7% |
CBASP was significantly more effective than TAU in reducing depressive symptoms. MBCT failed to reveal clear advantages over TAU across treatment sites. There was no significant difference between CBASP and MBCT | g = 0.71 [0.27–1.15] g = 0.23 [−0.15 to 0.70] |
+: specific antidepressant; MDD, major depressive disorder; CBASP, cognitive behavioral analysis system of psychotherapy; MBCT, mindfulness‐based cognitive therapy; IPT, interpersonal psychotherapy; CAU, care‐as‐usual (evidence‐based psychological treatments); BSP, brief supportive psychotherapy; ADM, antidepressant medication; TAU, treatment‐as‐usual; HAM‐D, Hamilton Rating Scale for Depression; BDI, Beck Depression Inventory; IDS‐SR, Inventory of Depressive Symptomatology – Self Rating; QIDS‐CR, Quick Inventory of Depressive Symptomatology – Clinical Rating; MADRS, Montgomery Asperg Depression Rating Scale.
Effect size (CI95): Calculated from mean change scores divided by a pooled standard deviation, comparing CBASP to the control conditions.