Clara Miguel

Cognitive behavioral therapy skills via a smartphone app for subthreshold depression among adults in the community: the RESiLIENT randomized controlled trial - Nature Medicine A trial that used a master randomized design found that the skills commonly found in smartphone-based cognitive behavioral therapy, when tested alone or in combination with behavioral activation, were...

Published today in Nature Medicine. In one of the world’s largest RCTs of its kind (n=3,936), a smartphone app teaching 5 key cognitive-behavioral therapy skills improved subthreshold depression—and the effects lasted 6 months.

www.nature.com/articles/s41...

Cognitive Behavior Therapy for Mental Disorders in Adults This unified series of meta-analyses examines the effect sizes of cognitive behavior therapy for many mental and eating disorders on symptoms of the respective disorders using uniform methodologies fo...

Pim Cuijpers and the team has published a comprehensive meta-analysis of CBT for 12 mental disorders, from psychosis to depression to specific phobia. jamanetwork.com/journals/jam...
@pimcuijpers.bsky.social @mathiasharrer.bsky.social @claramiguel.bsky.social

Cognitive Behavior Therapy for Mental Disorders in Adults This unified series of meta-analyses examines the effect sizes of cognitive behavior therapy for many mental and eating disorders on symptoms of the respective disorders using uniform methodologies fo...

Today our new unified series of meta-analyses of CBT for 11 mental disorders was published in JAMA Psychiatry. Another nice example of a 'next level' meta-analysis of the Metapsy initiative. With @mathiasharrer.bsky.social, @claramiguel.bsky.social, and many others
jamanetwork.com/journals/jam...

Couldn’t resist it eh 😆

we couldn't disentangle this in our analyses. We used a sophisticated method to find trial-level predictors of the difference between self-reports and clinician ratings, but this doesn't work for the rating and instrument type. And of course, this is all observational data subject to confounding.

Thanks a lot Eiko! I am looking forward to your thoughts. We tried to look for trials where the same version of the instrument was employed as self-rated and observer-rated. e.g., MADRS, QIDS, IDS offer this possibility. But we did not find any eligible trials with such possibility, so unfortunately

Special thanks to @mathiasharrer.bsky.social for sharing this journey, and many thanks to our co-authors Eirini Karyotaki, @cyplessen.bsky.social, Marketa Ciharova, @toshi-frkw.bsky.social, @ioanaacristea.bsky.social, and @pimcuijpers.bsky.social for their continuous guidance and support!

5/ Self-report instruments do not overestimate the effects of psychotherapy for depression and might be more conservative than clinician assessments. Our findings support the validity of patient perspectives in evaluating treatment outcomes.

4/ Across 91 RCTs (283 effect sizes from multiple measurements), self-reports produced smaller effect size estimates compared to clinician-rated instruments (Δg = 0.12; 95% CI: 0.03–0.21). This difference was more pronounced for unmasked clinician ratings (Δg = 0.20; 95% CI: −0.03 to 0.43)

3/ We included trials measuring depression at post-treatment using both self-reports (e.g., BDI) and clinician ratings (e.g., HRDS). We ran a multilevel hierarchical meta-analysis, resulting in a pooled differential effect size (Δg) between self-reports and clinician ratings.

2/ pose a validity threat when masking of participants is not possible. We conducted the largest study to date examining systematic differences in effect estimates between self-reports and clinician assessments across RCTs on psychotherapy for depression.

1/ The comparability between self-reports and clinician-rated scales for measuring depression after treatment has been debated for years. Studies show mixed results, and while self-reports are common in psychotherapy trials, it is often assumed that these tools

Our new paper on self-reports vs clinician ratings of efficacies of psychotherapies for depression can be read open-access in Epidemiology and Psychiatric Sciences!

Here is a short summary of our findings🧵
www.cambridge.org/core/journal...

Very nice! @mathiasharrer.bsky.social et al.'s metapsy now has a data base of PTSD studies: www.metapsy.org/database/ptsd