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It remains unclear, however, whether the effects persist over the long term. We conducted a comprehensive meta\u2010analysis examining the long\u2010term effects of psychotherapies for depression compared with control conditions. We included randomized controlled trials (RCTs) comparing psychotherapies for adult depression with control conditions (care\u2010as\u2010usual, waitlist, or other) that reported outcomes at six months after randomization or later. The standardized mean difference (SMD) was the main outcome, but we also examined response rates in the treatment and control groups and the relevant risk ratio (RR). We evaluated the effectiveness of psychotherapies over time using a multivariate pooling model with cubic regression splines to allow for potentially non\u2010linear interactions. Dependencies in the true effects were modeled using continuous\u2010time autoregressive variance\u2010covariance matrices. We included 191 RCTs with 209 comparisons between treatment and control groups, involving 33,691 participants (17,715 in the treatment, 15,976 in the control conditions). The trials encompassed 534 follow\u2010up measurements, of which 52 (9.7%) occurred more than 12 months after randomization. The best fitting restricted cubic spline model for long\u2010term SMDs (5 basis functions) indicated that the SMD increased from baseline to 0.55 at 12 weeks, then gradually decreased to 0.39 at around one\u2010year follow\u2010up, and remained largely stable thereafter. The SMD remained statistically significant up to 8.3 years (431 months) after randomization. The RR for response went up to 1.68 after 3 months and slowly decreased over time to 1.14 at 5\u2010year follow\u2010up. The RR remained significant up to 4.5 years (236 weeks). We conclude that psychotherapies have moderate to large effects at 3 months after randomization, which slowly decrease during the next 9 months to a moderate level, and remain stably moderate for several years.<\/jats:p>","DOI":"10.1002\/wps.70065","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T07:48:21Z","timestamp":1778831301000},"page":"287-294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term effects of psychotherapies for depression: an advanced meta\u2010analysis"],"prefix":"10.1002","volume":"25","author":[{"given":"Pim","family":"Cuijpers","sequence":"first","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"International Institute for Psychotherapy Babes,\u2010Bolyai University  Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Miguel","sequence":"additional","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Kaya Aglio","sequence":"additional","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemieke","family":"van Straten","sequence":"additional","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirini","family":"Karyotaki","sequence":"additional","affiliation":[{"name":"Programme on Clinical Psychology, Faculty of Social and Behavioural Sciences University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Harrer","sequence":"additional","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20860"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20701"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20906"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22491"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.01.036"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2024.102518"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2196\/46925"},{"key":"e_1_2_6_9_1","unstructured":"CuijpersP KaryotakiE.A meta\u2010analytic database of randomised trials on psychotherapies for depression.https:\/\/doi.org\/10.17605\/OSF.IO\/825C6."},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2023.05.011"},{"key":"e_1_2_6_11_1","unstructured":"CuijpersP HarrerM.Long\u2010term effects of psychotherapies for adult depression: a meta\u2010analysis.https:\/\/osf.io\/xckwa."},{"key":"e_1_2_6_12_1","unstructured":"CuijpersP HarrerM.Long\u2010term effects of psychotherapies for adult depression: a meta\u2010analysis.www.metapsy.org\/registrations#rec7A2Q6LBdVgc9tZ."},{"key":"e_1_2_6_13_1","unstructured":"HallS MoskovitzC PembertonM;Text Recycling Research Project. 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