A meta-analysis/literature review comparing the effectiveness of SSRI antidepressants, cognitive behavioral therapy, and placebo for the treatment of depression

An on going debate exists pertaining to the effectiveness of SSRIs, CBT, and placebo for the treatment of depression in adults. A meta-analysis/literature review was conducted to determine what treatment is superior, how the study's effectiveness correlated with their strength, and to determine what may cause reported inconsistencies. One hundred and eight sources, including 93 journal articles were reviewed for the literature review, which resulted in evidence suggesting both the effectiveness and ineffectiveness of the three treatments. Fourteen experiments and 5 meta-analyses were analyzed to determine both effectiveness superiority and the correlation between study strength and effectiveness. The average percentage of decrease in outcomes sores for SSRIs was 61.2%, for CBT was 48.6% and for placebo, was 10.9%. The average percentage of subjects who responded to treatment for SSRIs was 47.9%, for CBT was 55.5%, and placebo was 32.5%. The correlation between percentage of change in outcome scores and study's strength resulted in a Pearson's r of .739 for CBT and .29 for antidepressants. The correlation between percentage that responded to treatment and study's strength resulted in a Pearson's r of -.61 for CBT and .49 for antidepressants. Both SSRIs and CBT proved effective treatments for depression, with both proving superior to placebo. Antidepressants had a higher correlation between their study's strength and the degree of effectiveness. Possible reasons for the effectiveness inconsistencies in the literature review and this meta-analysis are the low number of active placebo's used, the file drawer phenomenon, rater bias, placebo wash-out phases, and, non-representative subjects.