Nineteen RCTs and one systematic review. Numbers of participants were not clear.
Individual cognitive behavioural therapy versus pharmacotherapy (3 studies): both treatments were found to be effective in reducing BDI scores (n=155; WMD 1.3 favouring pharmacotherapy (95% CI: -1.3, 4.0)) and HRSD scores (n=138; WMD -0.6 favouring cognitive therapy (95% CI: -2.5, 1.2)). The authors note that the included studies predate selective serotonin reuptake inhibitors (SSRIs).
Individual cognitive therapy versus individual cognitive therapy combined with pharmacotherapy (2 studies): neither ICT nor combined therapy was found to be significantly more effective than the other in either trial. Due to the nature of the reporting of data, meta-analysis was not possible.
Individual cognitive therapy versus waiting list with medication support (1 study): ICT significantly reduced BDI scores over the period of treatment and at 6 month follow up compared to the control (p<0.05).
Cognitive individual and group therapy versus waiting list with support (treatment as usual) (2 studies): One study found significant reductions in BDI scores for group cognitive therapy compared to control at post treatment but the groups were not compared at follow-up. The other study found significant reductions in BDI scores for individual therapy compared to control at post treatment but not at 3 months follow-up. The two studies could not be combined in a meta-analysis.
Cognitive individual or group therapy versus waiting list (no other treatment) (2 studies): In one study group therapy generated significantly lower BDI and HRSD scores than control. In the other study, individual therapy was significantly more effective than control in reducing BDI and HRSD scores at post-treatment and at 2 month follow-up. Meta-analysis of these two studies could not be performed.
Cognitive group therapy versus individual cognitive therapy (4 studies): BDI scores post treatment (n=124) WMD 0.2 (95% CI: -2.1, 2.6) and HRSD scores (2 studies, n=42)) WMD -0.3 (95% CI: -3.6, 3.0). Follow up BDI scores were not significantly different between groups at 2 and 3 months, but at 6 months CGT was favoured (n=62; WMD -6.9, 95% CI -11.6, -2.2). One study using ITT analysis claimed a significant advantage of ICT over CGT in BDI scores at post treatment and follow-up (p<0.02) and two did not.
Individual psychotherapy versus individual cognitive therapy (1 study): no significant difference between treatments was shown.
Cognitive group therapy versus computer assisted therapy (therapeutic learning programme or TLP) (2 studies): both studies reported no significant difference in the effectiveness of treatments in reducing depression scores; meta-analysis could not be performed.
Coping with depression: a course, comparison of group or class therapy and individual therapy (2 studies): Meta-analysis showed individual treatment was significantly more effective at reducing BDI scores than was the class method (n=104; WMD 3.0, 95% CI 1.0, 5.0), however the effect did not persist at follow up at 1 and 6 months.
Individual cognitive therapy versus waiting list control (1 systematic review): Remission from depressive disorder was higher in the ICT group compared to control OR 2.2 (95% CI: 1.4, 3.5).
Cognitive group therapy versus waiting list control (2 studies): CGT was significantly better than control in reducing BDI scores post-treatment (n=56; WMD -11.2, 95% CI -16, -6.5). One study found this difference persisted at follow-up. CGT was also significantly better than control for producing participants with normal BDI scores post-treatment (n=46; Peto OR 11.8, 95% CI 3.3, 42.3).