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We conducted a meta\u2010analysis of studies in which psychotherapy and antidepressant medication were directly compared in the treatment of depressive and anxiety disorders. Systematic searches in bibliographical databases resulted in 67 randomized trials, including 5,993 patients that met inclusion criteria, 40 studies focusing on depressive disorders and 27 focusing on anxiety disorders. The overall effect size indicating the difference between psychotherapy and pharmacotherapy after treatment in all disorders was g=0.02 (95% CI: \u22120.07 to 0.10), which was not statistically significant. Pharmacotherapy was significantly more efficacious than psychotherapy in dysthymia (g=0.30), and psychotherapy was significantly more efficacious than pharmacotherapy in obsessive\u2010compulsive disorder (g=0.64). Furthermore, pharmacotherapy was significantly more efficacious than non\u2010directive counseling (g=0.33), and psychotherapy was significantly more efficacious than pharmacotherapy with tricyclic antidepressants (g=0.21). These results remained significant when we controlled for other characteristics of the studies in multivariate meta\u2010regression analysis, except for the differential effects in dysthymia, which were no longer statistically significant.<\/jats:p>","DOI":"10.1002\/wps.20038","type":"journal-article","created":{"date-parts":[[2013,6,4]],"date-time":"2013-06-04T11:52:38Z","timestamp":1370346758000},"page":"137-148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":450,"title":["The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta\u2010analysis of direct comparisons"],"prefix":"10.1002","volume":"12","author":[{"given":"Pim","family":"Cuijpers","sequence":"first","affiliation":[{"name":"Department of Clinical Psychology VU University Amsterdam Van der Boechorststraat 1 1081 BT Amsterdam The Netherlands"},{"name":"EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam The Netherlands"},{"name":"Leuphana University L\u00fcnebrug Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit","family":"Sijbrandij","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology VU University Amsterdam Van der Boechorststraat 1 1081 BT Amsterdam The Netherlands"},{"name":"EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander L.","family":"Koole","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology VU University Amsterdam Van der Boechorststraat 1 1081 BT Amsterdam The Netherlands"},{"name":"EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Behavioural Sciences and Learning Swedish Institute for Disability Research, University of Link\u00f6ping  Sweden"},{"name":"Department of Clinical Neuroscience, Psychiatry Section Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aartjan T.","family":"Beekman","sequence":"additional","affiliation":[{"name":"EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam The Netherlands"},{"name":"Department of Psychiatry VU University Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Charles F.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.23.3095"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.593"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030442"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/1099-176X(200003)3:1<3::AID-MHP68>3.0.CO;2-H"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.6.3.369"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.5.669"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.184.5.386"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.106.025106"},{"key":"e_1_2_5_10_1","volume-title":"Depression; the treatment and management of depression in adults","author":"National Institute for Health and Clinical Excellence (NICE)","year":"2009"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/15622970701227829"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/13651501.2012.667114"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n1102"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.131.5.785"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e31820caefb"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0013075"},{"key":"e_1_2_5_17_1","unstructured":"BarthJ MunderT GergerHet al.Comparative efficacy of seven psychotherapeutic interventions for depressed patients: results of a network meta\u2010analysis. 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