A meta-analysis of Prozac and three psychotherapies in the treatment of unipolar major depression

Abstract

Seventeen years have passed since Smith and Glass’s paper "Meta-analysis of Psychotherapy Outcome Studies" (1977) influenced how researchers integrated cumulative knowledge. The problem is that no meta-analyses have been found which compare psychotherapeutic methods to the use of Prozac in the treatment of unipolar major depression. Prozac was chosen, specifically, due to its reputation as a new, very effective anti-depressant.

This study used a meta-analysis to compare three psychotherapies with medication: 1) cognitive therapy, 2) behavioral therapy, 3) cognitive-behavioral therapy, and 4) the prescription of Prozac. New methods of meta-analysis advocated by Rosenthal (1984) and Wolf (1986) were integrated with Smith and Glass’s (1977) Original approach to analyze the outcome research.

The results indicate that Prozac is more effective than psychotherapy in the treatment of unipolar major depression. Psychotherapy results were statistically significant (p=.05) for the subjects as own control condition, but not for the control condition. In the subjects as own control group, cognitive and cognitive-behavior therapy were statistically significant (p < .05). The effectiveness of Prozac may have been caused in part by a selection bias of subjects or other factors outlined in the discussion.