Effectiveness of Psychotherapies and Psychotropic Drugs against Mental Illness/Psychotherapies for anxiety

Effectiveness of Psychotherapies and Psychotropic Drugs against Mental Illness Psychotherapies for anxiety Psychotherapies for Depression Psychotherapies for social anxiety Loading libraries library(dplyr) library(metafor) library(meta) Part 1: Data At https://docs.metapsy.org/databases/gad-psyctr/ you can download documents in PDF format and data in ZIP format related to a meta-analysis conducted by researchers entitled "Generalized Anxiety Disorder: Psychotherapy vs. Control." This analysis analyzed 126 clinical trials of psychotherapies for generalized anxiety disorder (GAD), comparing groups receiving psychotherapy and control groups. The CSV dataset contains the Hedges' effect size "g" with its corresponding standard deviation for each study, as well as the variable "condition_arm1," which contains the type of psychotherapy used in the study: CBT: Traditional Cognitive Behavioral Therapy. 3rd: "Third-wave" therapies (such as Mindfulness or ACT). AR: Applied Relaxation. BT: Behavioral Therapy. CR: Cognitive Restructuring. DYN: Psychodynamic Therapy. PE: Psychoeducation. SUP: Nondirective Supportive Therapy. PST/IPT/BAT: Problem-Solving, Interpersonal, or Behavioral Activation Therapy. Other psy: Other psychotherapies that do not fall into the previous categories. The variable "condition_arm2" contains the type of group to which the psychotherapy group is compared: (cau = Care-as-usual: The standard psychosocial or medical support a patient normally receives in a hospital or clinic, wl = Waiting List: Where patients receive no immediate treatment, pl = Placebo control condition, other = Other types of controls). The variable "time" = post expresses the effectiveness of post-treatment psychotherapy. Loading and viewing the first 5 studies: df <- read.csv("data.csv", sep = ";", dec = ",", stringsAsFactors = FALSE) df1<-df %>% select(study,.g,.g_se,condition_arm1,condition_arm2,time) %>% head() study .g .g_se condition_arm1 condition_arm2 time Alavi, 2020 -1.67646657594636 0.271084899400218 cbt cau post Andersson, 2012 -0.215274979445237 0.287103180731833 cbt wl post Andersson, 2012 -0.114524183406901 0.277584366334222 dyn wl post Andersson, 2012 0.0031254693247278 0.286251466873408 cbt wl post Andersson, 2012 -0.0505029090309542 0.277395670256741 dyn wl post Andersson, 2012 -0.488135014653391 0.290604741225905 cbt wl post Part 2: Meta-analysis Calculating Hedges' g We calculate Hedges' g in meta-analyses of studies with time = post and perform Egger's test to assess whether there is publication bias due to the fact that studies with positive results and high g are more likely to be published than those with modest or negative results. Since the p-value is <0.05, there is indeed publication bias in the test, so we use Duval and Tweedie's "trim and fill" procedure, which estimates the number of missing studies and recalculates g, obtaining g = -0.6 with a 95% confidence interval: [ -0.72 , -0.47 ], so in this case the effect of psychotherapy on anxiety is medium-high. # Filter for the primary outcome at post-treatment data_eff <- df %>% filter(time == "post" & !is.na(.g)) m_g <- metagen(TE = .g, seTE = .g_se, data = data_eff, studlab = study, sm = "SMD", random = TRUE) #summary(m_eff) # Egger's test for publication bias publication metabias(m_g, method.stat = "linreg") Linear regression test of funnel plot asymmetry Test result: t = -4.65, df = 120, p-value < 0.0001 Bias estimate: -1.7601 (SE = 0.3789) Details: - multiplicative residual heterogeneity variance (tau^2 = 2.9822) - predictor: standard error - weight: inverse variance - reference: Egger et al. (1997), BMJ m_g<- trimfill(m_g) print(paste("g =",round(m_g$TE.random,2),"; 95%CI: [",round(m_g$lower.random,2),",",round(m_g$upper.random,2),"]")) "g = -0.6; 95%CI: [ -0.72, -0.47]" Measuring g for the various psychotherapies immediately after treatment (time=post), we find that 3rd = "third-wave" therapies (such as mindfulness or ACT) have the highest g (g = -1.06), PST = Problem-Solving Therapy (g = -0.88), CBT = Cognitive Behavioral Therapy (g=-0.86) etc., so the effect of most psychotherapies on anxiety is high... for (p in unique(df$condition_arm1)) { df_post <- df %>% filter( time == "post", !is.na(.g), condition_arm1==p) m_pst<-metagen(TE = .g, seTE = .g_se, data = df_post, studlab = study, sm = "SMD", random = TRUE) print(paste(p,": g=",round(m_pst$TE.random,2),"; 95%CI: [",round(m_pst$lower.random,2),",",round(m_pst$upper.random,2),"]")) } [1] "cbt : g= -0.86 ; 95%CI: [ -0.99 , -0.72 ]" [1] "dyn : g= -0.18 ; 95%CI: [ -0.49 , 0.14 ]" [1] "ar : g= -0.81 ; 95%CI: [ -1.09 , -0.53 ]" [1] "other psy : g= -1.13 ; 95%CI: [ -2.16 , -0.09 ]" [1] "cr : g= -0.84 ; 95%CI: [ -1.71 , 0.02 ]" [1] "pst : g= -0.88 ; 95%CI: [ -1.38 , -0.39 ]" [1] "bt : g= -0.4 ; 95%CI: [ -0.85 , 0.05 ]" [1] "3rd : g= -1.06 ; 95%CI: [ -1.34 , -0.78 ]" [1] "sup : g= -0.49 ; 95%CI: [ -0.94 , -0.04 ]" [1] "pe : g= -0.62 ; 95%CI: [ -0.89 , -0.36 ]"