BACKGROUND: A variety of psychological interventions to treat @entity308 have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mode for @entity308 @entity1 in this setting. METHODS: Randomized trials comparing a psychological treatment with usual care, placebo, another psychological treatment, pharmacotherapy, or a combination treatment in adult @entity308 primary care @entity1 were identified by database searches up to December 2013. We performed both conventional pairwise meta-analysis and network meta-analysis combining direct and indirect evidence. Outcome measures were response to treatment (primary outcome), remission of symptoms, post-treatment @entity308 scores and study discontinuation. RESULTS: A total of 37 studies with 7,024 @entity1 met the inclusion criteria. Among the psychological treatments investigated in at least 150 @entity1 face-to-face cognitive behavioral therapy (CBT; OR 1.80; 95  % credible interval 1.35-2.39), face-to-face counselling and psychoeducation (1.65; 1.27-2.13), remote therapist lead CBT (1.87; 1.38-2.53), guided self-help CBT (1.68; 1.22-2.30) and no/minimal contact CBT (1.53; 1.07-2.17) were superior to usual care or placebo, but not face-to-face problem-solving therapy and face-to-face interpersonal therapy. There were no statistical differences between psychological treatments apart from face-to-face interpersonal psychotherapy being inferior to remote therapist-lead CBT (0.60; 0.37-0.95). Remote therapist-led (0.86; 0.21-3.67), guided self-help (0.93; 0.62-1.41) and no/minimal contact CBT (0.85; 0.54-1.36) had similar effects as face-to-face CBT. CONCLUSIONS: The limited available evidence precludes a sufficiently reliable assessment of the comparative effectiveness of psychological treatments in @entity308 primary care @entity1 . Findings suggest that psychological interventions with a cognitive behavioral approach are promising, and primarily indirect evidence indicates that it applies also when they are delivered with a reduced number of therapist contacts or remotely. SYSTEMATIC REVIEW REGISTRATION: 01KG1012 at http://www.gesundheitsforschung-bmbf.de/de/2852.php.

Comparative effectiveness of psychological treatments for XXXX in primary care: network meta-analysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depressed', 'depression', 'depressive disorders']
@entity308 :: (MESH:D003866,Disease) :: ['depressive disorders']
