TY - JOUR
T1 - Biological markers evaluated in randomized trials of psychological treatments for depression
T2 - a systematic review and meta-analysis
AU - Cristea, Ioana A.
AU - Karyotaki, Eirini
AU - Hollon, Steven D.
AU - Cuijpers, Pim
AU - Gentili, Claudio
PY - 2019/6
Y1 - 2019/6
N2 -
Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding. We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression. Fifty-one trials (5123 participants) and a pooled analysis were included. Biological markers were outcomes in 43 studies and predictors of treatment response in 9. At post-treatment, psychotherapy could not be distinguished from control conditions for glycaemic control (Hb1AC), 7 trials, Hedges’ g= -.01, 95% CI -0.30 to 0.29, I
2
= 65% and cortisol concentration after-wake, 5 trials, Hedges’ g= -.19, 95% CI -0.45 to 0.06, I
2
= 0%. Follow-up results were similar. For the other biological domains (immunological, neurobiological, inflammatory, weight, blood pressure), overall findings were mixed and often inconsistent. Few trials investigated prediction of response, with only neuroimaging markers showing promise. Across domains, we found limited evidence that benefits of psychological treatments for depression translate to biological outcomes.
AB -
Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding. We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression. Fifty-one trials (5123 participants) and a pooled analysis were included. Biological markers were outcomes in 43 studies and predictors of treatment response in 9. At post-treatment, psychotherapy could not be distinguished from control conditions for glycaemic control (Hb1AC), 7 trials, Hedges’ g= -.01, 95% CI -0.30 to 0.29, I
2
= 65% and cortisol concentration after-wake, 5 trials, Hedges’ g= -.19, 95% CI -0.45 to 0.06, I
2
= 0%. Follow-up results were similar. For the other biological domains (immunological, neurobiological, inflammatory, weight, blood pressure), overall findings were mixed and often inconsistent. Few trials investigated prediction of response, with only neuroimaging markers showing promise. Across domains, we found limited evidence that benefits of psychological treatments for depression translate to biological outcomes.
KW - Biomarkers
KW - Depression
KW - Meta-analysis
KW - Psychotherapy
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85063762934&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063762934&partnerID=8YFLogxK
U2 - 10.1016/j.neubiorev.2019.03.022
DO - 10.1016/j.neubiorev.2019.03.022
M3 - Review article
C2 - 30922979
AN - SCOPUS:85063762934
VL - 101
SP - 32
EP - 44
JO - Neuroscience and Biobehavioral Reviews
JF - Neuroscience and Biobehavioral Reviews
SN - 0149-7634
ER -
