Research Assistant University of Oregon Eugene, Oregon
Background: Different response rates of psychotherapy approaches were examined in the same type of psychological problems/disorders. Limited studies have investigated specific factors that would play a decisive role in determining which treatment was more favorable for individual patients. Differential results have been revealed in previous research examining such predictors of psychotherapy responses for depression.
Purpose: The goal of the current systematic review was to identify predictors of differential responses to psychotherapy for depression, which could influence the effectiveness of psychotherapy treatments for depression.
Method: Research studies investigating predictors of treatment response to psychotherapy for depression were searched in PsycINFO, PubMed, Web of Science, and Google Scholar databases. Specific inclusion and exclusion criteria were provided. Due to the heterogeneity of study designs, outcome measures, criteria of responses, and statistical analysis methods, this systematic review used a narrative technique instead of a meta-analysis.
Results: 11 studies met inclusion criteria. A total of 2340 patients (M=34.8 years) with the major depressive disorder as their primary diagnosis. Psychotherapy approaches used in the included papers were cognitive behavior therapy, group cognitive behavior therapy, schema therapy, interpersonal therapy, solution-focused therapy, short- and long-term psychodynamic therapy. Results were analyzed based on predictor types, i.e. personality/interpersonal functioning, clinical/diagnostic characteristics, sociodemographic characteristics, therapy process factors, psychological suitability, and quality of life, with subcategories under each predictor type. Some consistent results were examined given the different criteria used in those studies. The clinical/diagnostic domain (e.g., age of onset of first depressive episode, chronic depression, early symptom trajectories) has the most amount of predictors, revealing the important effect on psychotherapy outcome.
Limitations: Due to the heterogeneity in criteria of response to psychotherapy used in the included papers (e.g., change in scores on different types of assessment), it might be difficult for readers to compare the findings without the same set of criteria of treatment response.
Conclusions: There is evidence that many factors could predict the responses to psychotherapy for depression in adults. Cross-cultural differences and future directions were discussed.
