Search Here

Major depressive disorder or MDD is a pervasive mental health condition that not only affects the emotional well-being of individuals but also poses significant risks such as suicide attempts and other serious psychiatric adverse events or SAEs. 

To address these challenges, researchers conducted a comprehensive meta-analysis to evaluate the efficacy of different treatment options and their impact on mitigating the risk of SAEs in individuals with MDD.

The meta-analysis included data from 34 randomized controlled trials encompassing various treatment modalities, including antidepressant medication or ADM-only, psychotherapy-only, and combined treatment. The study focused on evaluating the comparative effectiveness of these treatments in reducing the likelihood of suicide attempts and other SAEs, such as psychiatric emergency department visits, psychiatric hospitalizations and suicide deaths.

Psychotherapy, antidepressants, or combined treatment?

Key findings from the meta-analysis revealed that psychotherapy-only exhibited a notable superiority over combined treatment and ADM-only in reducing the probability of SAEs among individuals with MDD. Specifically, psychotherapy-only demonstrated efficacy in decreasing the likelihood of SAEs, including suicide attempts, psychiatric emergency department visits, psychiatric hospitalizations and suicide deaths. 

However, the combined treatment showed a significant advantage over ADM-only in mitigating the risk of SAEs, particularly among adult populations with MDD.

Subgroup analyses further showed the differential benefits of treatment modalities based on age groups, with psychotherapy-only emerging as particularly beneficial for reducing SAE risk among children and adolescents. In contrast, combined treatment showed advantages in reducing SAEs among adults with MDD. 

The study also identified potential effect modifiers such as gender and psychiatric comorbidities, underscoring the importance of considering these factors in treatment selection and intervention strategies.

These findings provide valuable insights into the comparative effectiveness of different treatment options for MDD, informing clinicians and policymakers in developing personalized and targeted approaches to address the complex challenges associated with MDD and its associated risks, including suicide attempts and other SAEs.