Table 1.

Characteristics of included studies

Study	Conditions	Psychotherapy	Therapy quality	Pharmacotherapy	Adequate therapy	Risk of bias
Ahmadpanah et al33	Combined vs. pharmacotherapy	MBCT	– – –	SSRI	Yes	+ + + +
	Combined vs. pharmacotherapy	Stress management	– – –	SSRI	Yes	+ + + +
Altamura et al34	Psychotherapy vs. pharmacotherapy	IPT	+ + –	SSRI	Yes	+ – + –
Appleby et al35	Combined vs. pharmacotherapy vs. placebo vs. psychotherapy + placebo	CBT	– + –	SSRI	No	+ – + +
Ashouri et al36	Combined vs. pharmacotherapy	CBT	– – –	Other	No	– – sr –
	Combined vs. pharmacotherapy	MBCT	– – –	Other	No	– – sr –
Barber et al37	Psychotherapy vs. pharmacotherapy vs. placebo	DYN	+ + –	Other	Yes	+ – + +
Barrett et al38	Psychotherapy vs. pharmacotherapy vs. placebo	PST	+ + –	SSRI	Yes	+ – + –
Beck et al39	Combined vs. psychotherapy	CBT	+ + –	TCA	Yes	– – – –
Bedi et al40	Psychotherapy vs. pharmacotherapy	Not specified	– + –	Other	No	– + sr –
Bellack et al41	Combined vs. pharmacotherapy vs. psychotherapy + placebo	Social skills	+ + –	TCA	Yes	– – + –
Bellino et al42	Combined vs. pharmacotherapy	IPT	+ + –	SSRI	Yes	– – + –
Blackburn et al43	Combined vs. psychotherapy vs. pharmacotherapy	CBT	– – –	TCA	Yes	– – – –
Blackburn & Moore44	Psychotherapy vs. pharmacotherapy	CBT	– + –	Other	No	– – + –
Bloch et al45	Combined vs. psychotherapy + placebo	DYN	– + +	SSRI	Yes	+ + + +
Blom et al46	Combined vs. psychotherapy vs. pharmacotherapy vs. psychotherapy + placebo	IPT	+ + +	Other	Yes	– – + +
Browne et al47	Combined vs. psychotherapy vs. pharmacotherapy	IPT	+ + +	SSRI	Yes	+ + + –
Burnand et al48	Combined vs. pharmacotherapy	DYN	– + +	Other	Yes	– – + –
Chibanda et al49	Psychotherapy vs. pharmacotherapy	PST	+ + +	TCA	No	+ – sr –
Corruble et al50	Combined vs. pharmacotherapy	Social rhythms	+ + +	Other	No	+ + + –
Covi & Lipman51	Combined vs. psychotherapy	CBT	+ + +	TCA	Yes	– – sr –
David et al52	Psychotherapy vs. pharmacotherapy	CT	+ + +	SSRI	Yes	– – + +
	Psychotherapy vs. pharmacotherapy	REBT	+ + +	SSRI	Yes	– – + +
De Jonghe et al53	Combined vs. pharmacotherapy	DYN	+ + +	Other	No	– – + +
De Jonghe et al54	Combined vs. psychotherapy	DYN	+ + +	Other	No	– – + –
de Mello et al55	Combined vs. pharmacotherapy	IPT	+ + –	Other	Yes	– – + –
Dekker et al56	Psychotherapy vs. pharmacotherapy	DYN	+ + +	Other	No	– – + –
Denton et al57	Combined vs. pharmacotherapy	EFT	+ + +	Other	No	+ + + +
DeRubeis et al58	Psychotherapy vs. pharmacotherapy	CBT	+ + +	SSRI	Yes	– – + +
Dimidjian et al59	Psychotherapy vs. pharmacotherapy	BAT	+ + +	SSRI	Yes	+ – + +
	Psychotherapy vs. pharmacotherapy	CBT	+ + +	SSRI	Yes	+ – + +
Dozois et al60	Combined vs. pharmacotherapy	CBT	+ + +	Other	No	– + – –
Dunlop et al61	Psychotherapy vs. pharmacotherapy	CBT	+ – –	SSRI	Yes	– + + –
Dunlop et al62	Psychotherapy vs. pharmacotherapy	CBT	+ + +	Other	Yes	+ + + +
	Psychotherapy vs. pharmacotherapy	CBT	+ + +	SSRI	Yes	+ + + +
Dunn63	Combined vs. pharmacotherapy	CBT	– – –	Other	No	– – sr –
Dunner et al64	Psychotherapy vs. pharmacotherapy	CBT	+ + +	SSRI	Yes	– – + –
Eisendrath et al65	Combined vs. pharmacotherapy	MBCT	+ + +	Other	No	+ + + +
Elkin et al66	Psychotherapy vs. pharmacotherapy vs. placebo	CBT	+ + +	TCA	Yes	+ + + +
	Psychotherapy vs. pharmacotherapy vs. placebo	IPT	+ + +	TCA	Yes	+ + + +
Faramarzi et al67	Psychotherapy vs. pharmacotherapy	CBT	+ – –	SSRI	Yes	– – sr –
Finkenzeller et al68	Combined vs. psychotherapy vs. pharmacotherapy	IPT	+ – –	SSRI	Yes	+ – + +
Frank et al69	Psychotherapy vs. pharmacotherapy	IPT	+ + +	SSRI	Yes	– – + +
Gater et al70	Combined vs. psychotherapy vs. pharmacotherapy	Social group	+ + +	Other	No	+ + + +
Gaudiano et al71	Combined vs. pharmacotherapy	ABT	+ + +	Other	No	– – + +
Hautzinger et al72	Combined vs. psychotherapy vs. pharmacotherapy	CBT	– – –	TCA	Yes	– – + +
Hegerl et al73	Psychotherapy vs. pharmacotherapy vs. placebo	CBT	+ – +	SSRI	Yes	+ + + +
Hellerstein et al74	Combined vs. pharmacotherapy	Cognitive‐interpersonal	+ + +	SSRI	Yes	– – – +
Hollon et al75	Combined vs. psychotherapy vs. pharmacotherapy	CBT	+ + +	TCA	Yes	– – + +
Hollon et al76	Combined vs. pharmacotherapy	CBT	+ + +	Other	No	+ + + +
Hsiao et al77	Combined vs. pharmacotherapy	BMS	+ + –	Other	No	+ – sr +
Husain et al78	Psychotherapy vs. pharmacotherapy	CBT	+ – –	Other	No	+ + + +
Jarrett et al79	Psychotherapy vs. pharmacotherapy vs. placebo	CBT	+ + +	Other	Yes	– + + +
Keller et al80	Combined vs. psychotherapy vs. pharmacotherapy	CBASP	+ + +	Other	Yes	+ + + +
Kennedy et al81	Psychotherapy vs. pharmacotherapy	CBT	+ + +	Other	Yes	– – – –
Lam et al82	Combined vs. pharmacotherapy	CBT	+ + +	SSRI	Yes	+ + + +
Lesperance et al83	Combined vs. pharmacotherapy vs. placebo vs. psychotherapy + placebo	IPT	+ + +	SSRI	Yes	+ + + +
Lynch et al84	Combined vs. pharmacotherapy	DBT	– + +	Other	No	– – – –
Macaskill & Macaskill85	Combined vs. pharmacotherapy	CBT	+ – –	TCA	Yes	– – – –
Maina et al86	Combined vs. pharmacotherapy	DYN	– + +	SSRI	Yes	+ + + +
Maldonado López87	Psychotherapy vs. pharmacotherapy	CBT	– – –	Other	No	– – + –
	Psychotherapy vs. pharmacotherapy	BAT	– – –	Other	No	– – + –
Maldonado López 88	Combined vs. pharmacotherapy	CBT	– – –	Other	No	– – + –
	Combined vs. pharmacotherapy	BAT	– – –	Other	No	– – + –
Markowitz et al89	Combined vs. psychotherapy	SUP	+ + +	TCA	Yes	+ + + +
Markowitz et al90	Combined vs. psychotherapy vs. pharmacotherapy	IPT	+ + +	SSRI	Yes	+ + + +
	Psychotherapy vs. pharmacotherapy	SUP	+ + +	SSRI	Yes	+ + + +
Marshall et al91	Psychotherapy vs. pharmacotherapy	CBT	+ + +	Other	No	– – – –
	Psychotherapy vs. pharmacotherapy	IPT	+ + +	Other	No	– – – –
Martin et al92	Psychotherapy vs. pharmacotherapy	IPT	+ + –	Other	Yes	– – – +
McKnight et al93	Psychotherapy vs. pharmacotherapy	CBT	+ + –	TCA	No	– – sr –
McLean & Hakstian94	Psychotherapy vs. pharmacotherapy	CBT	+ + +	TCA	Yes	– – sr –
	Psychotherapy vs. pharmacotherapy	DYN	+ + +	TCA	Yes	– – sr –
Menchetti et al95	Psychotherapy vs. pharmacotherapy	IPT	+ – –	SSRI	No	+ + – +
Milgrom et al96	Combined vs. psychotherapy vs. pharmacotherapy	CBT	+ – +	SSRI	Yes	+ + sr +
Miranda et al97	Psychotherapy vs. pharmacotherapy	CBT	+ + +	Other	No	+ + + +
Misri et al98	Combined vs. pharmacotherapy	CBT	+ + –	SSRI	No	+ – + +
Mitchell et al99	Combined vs. pharmacotherapy	PST	+ – +	Other	No	+ + + +
Mohr et al100	Psychotherapy vs. pharmacotherapy	CBT	+ – +	SSRI	Yes	– – – +
	Psychotherapy vs. pharmacotherapy	SEG	+ – +	SSRI	Yes	– – – +
Moradveisi et al101	Psychotherapy vs. pharmacotherapy	BAT	+ + +	SSRI	Yes	+ + + +
Murphy et al102	Combined vs. psychotherapy vs. pharmacotherapy vs. psychotherapy + placebo	CBT	+ + +	TCA	Yes	+ + – +
Murphy et al103	Psychotherapy vs. pharmacotherapy	CBT	+ + +	TCA	Yes	+ – – –
Mynors‐Wallis et al104	Psychotherapy vs. pharmacotherapy vs. placebo	PST	+ + –	TCA	Yes	– + + –
Mynors‐Wallis et al105	Psychotherapy vs. pharmacotherapy	PST	+ – +	SSRI	Yes	+ + + +
	Combined vs. psychotherapy vs. pharmacotherapy	PST	+ – +	SSRI	Yes	+ + + +
Naeem et al106	Combined vs. pharmacotherapy	CBT	+ + +	SSRI	Yes	+ + sr +
Parker et al107	Psychotherapy vs. pharmacotherapy	CBT	+ + –	Other	Yes	+ + + –
Petrak et al108	Psychotherapy vs. pharmacotherapy	CBT	+ + –	SSRI	Yes	+ + + +
Quilty et al109	Psychotherapy vs. pharmacotherapy	CBT	+ + +	Other	No	– – – +
Ravindran et al110	Combined vs. pharmacotherapy vs. placebo vs. psychotherapy + placebo	CBT	+ + –	SSRI	Yes	+ + + –
Reynolds et al111	Combined vs. pharmacotherapy vs. placebo vs. psychotherapy + placebo	IPT	+ + +	TCA	Yes	– – + +
Rodriguez Vega et al112	Combined vs. pharmacotherapy	Narrative	+ + +	SSRI	Yes	+ + sr +
Roth et al113	Combined vs. psychotherapy	Self‐control	+ + +	TCA	Yes	– – – –
Rush et al114	Psychotherapy vs. pharmacotherapy	CBT	+ – +	TCA	Yes	– – + +
Rush & Watkins115	Combined vs. psychotherapy	CBT	+ – +	Other	No	– – sr +
Salminen et al116	Psychotherapy vs. pharmacotherapy	DYN	– + –	SSRI	Yes	– – – +
Schiffer & Wineman117	Combined vs. psychotherapy + placebo	Three types	– – –	TCA	Yes	– – – –
Schramm et al118	Psychotherapy vs. pharmacotherapy	CBASP	+ + +	SSRI	Yes	+ – + +
Schulberg et al119	Psychotherapy vs. pharmacotherapy	IPT	+ + +	TCA	Yes	– – + +
Scott & Freeman120	Psychotherapy vs. pharmacotherapy	CBT	+ + –	TCA	Yes	– + + –
	Psychotherapy vs. pharmacotherapy	SUP	– – –	TCA	Yes	– + + –
Shamsaei et al121	Combined vs. psychotherapy vs. pharmacotherapy	CBT	– – –	SSRI	Yes	+ – sr –
Sharp et al122	Psychotherapy vs. pharmacotherapy	SUP	– + +	Other	No	+ + sr +
Souza et al123	Combined vs. pharmacotherapy	IPT	+ + +	Other	No	+ + + +
Stravynski et al124	Combined vs. psychotherapy	CBT	– – –	TCA	Yes	– – + –
Targ et al125	Combined vs. psychotherapy + placebo	PST	– – +	SSRI	Yes	– – + –
Thompson et al126	Combined vs. psychotherapy vs. pharmacotherapy	CBT	+ – –	TCA	No	– – – +
Weissman et al127	Combined vs. psychotherapy vs. pharmacotherapy	IPT	+ – –	TCA	Yes	– – + –
Wiles et al128	Combined vs. pharmacotherapy	CBT	+ – +	Other	No	+ + sr +
Wiles et al129	Combined vs. pharmacotherapy	CBT	+ + +	Other	No	+ + sr +
Williams et al130	Psychotherapy vs. pharmacotherapy vs. placebo	PST	+ + –	SSRI	Yes	+ + + +
Wilson131	Combined vs. pharmacotherapy vs. placebo vs. psychotherapy + placebo	BAT	+ – –	TCA	Yes	– – + –
Zisook et al132	Combined vs. psychotherapy + placebo	SUP	– – –	SSRI	Yes	– – + +
Zu et al133	Combined vs. psychotherapy vs. pharmacotherapy	CBT	– + +	SSRI	Yes	+ – + –

Risk of bias: + means low risk, – means high or unclear risk, “sr” means that only a self‐report instrument was used

ABT – acceptance‐based behavior therapy, BAT – behavioral activation therapy, BMS – body‐mind‐spirit therapy, CBASP – cognitive behavioral analysis system of psychotherapy, CBT – cognitive behavior therapy, CT – cognitive therapy, DBT – dialectical behavioral therapy, DYN – psychodynamic therapy, EFT – emotion‐focused therapy, IPT – interpersonal psychotherapy, MBCT – mindfulness‐based cognitive therapy, PST – problem‐solving therapy, REBT – rational‐emotive behavior therapy, SEG – supportive‐expressive group psychotherapy, SUP – supportive therapy, SSRI – selective serotonin reuptake inhibitor, TCA – tricyclic antidepressant