Effectiveness of Psychotherapies and Psychotropic Drugs against Mental Illness/Psychotherapies for panic disorder

Effectiveness of Psychotherapies and Psychotropic Drugs against Mental Illness Psychotherapies for panic disorder Psychotherapies for social anxiety Psychotherapies for psychosis Loading libraries library(dplyr) library(meta) Part 1: Data At https://docs.metapsy.org/databases/panic-psyctr/ you can download documents in PDF format and data in ZIP format related to a meta-analysis conducted by researchers entitled "Panic Disorder: Psychotherapy vs. Control." This analysis analyzed 82 clinical trials of psychotherapies for panic attacks, comparing groups undergoing 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. CT: Cognitive therapy. PT: Physiological therapies (e.g., relaxation, breathing) BT: Behavioral therapy. IPT: Interpersonal therapy. PD: Psychodynamic therapy. EMDR: Eye Movement Desensitization and Reprocessing. 3W: Third-wave therapies. The variable condition_arm2 contains the type of group to which the psychotherapy group is compared: (TAU/NT = Treatment as Usual / No Treatment, WL = Waiting List: Where patients receive no immediate treatment, PL (Placebo) = Placebo control condition, etc.). Loading and displaying the first 6 studies: df <- read.csv("data.csv", sep = ";", dec = ",", stringsAsFactors = FALSE) df %>% select(study, .g, .g_se, condition_arm1, condition_arm2) %>% head() study .g .g_se condition_arm1 condition_arm2 Addis, 2004 0.0161750627495288 0.223890554729454 CBT TAU/NT Allen, 2016 -0.972512153444725 0.324292277601381 CBT WL Bakker, 1999 -0.141202426916712 0.244895341518145 CT PL Barlow, 1989 -0.43330687233944 0.317863739274094 CBT WL Barlow, 1989 -0.556280081810442 0.416274889821373 PT WL Barlow, 2000 -0.483415186554789 0.236280209040239 CBT PL Part 2: Meta-analysis Calculating Hedges' g We calculate Hedges' g in meta-analyses of studies with time = post and perform the Egger 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 = -0.49 with a 95% confidence interval: [ -0.65 , -0.34 ], so in this case the effect in reducing panic attacks is medium: df_eff <- df %>% filter(!is.na(.g), !is.na(.g_se)) meta_eff <- metagen( TE = .g, seTE = .g_se, studlab = study, data = df_eff, sm = "SMD", method.tau = "REML", # random effects method.random.ci = "HK" # Hartung-Knapp ) # Egger test for publication bias metabias(meta_eff, method.stat = "linreg") Linear regression test of funnel plot asymmetry Test result: t = -4.37, df = 76, p-value < 0.0001 Bias estimate: -2.0106 (SE = 0.4605) Details: - multiplicative residual heterogeneity variance (tau^2 = 2.9623) - predictor: standard error - weight: inverse variance - reference: Egger et al. (1997), BMJ m_g<- trimfill(meta_eff) print(paste("g =",round(m_g$TE.random,2),"; 95%CI: [",round(m_g$lower.random,2),",",round(m_g$upper.random,2),"]")) "g = -0.49; 95%CI: [ -0.65, -0.34]" Measuring g for the various psychotherapies immediately after treatment (time=post), we find that BT = Behavioral Therapy has the highest g (g=-0.97), PT = Physiological Therapies (e.g., relaxation, breathing) (g=-0.87), CBT = Cognitive Behavioral Therapy (g=-0.83), etc. , so the effect of most psychotherapies on panic attacks, barring publication bias, is high, although some have low g: for (p in unique(df_eff$condition_arm1)) { df_post <- df_eff %>% filter( condition_arm1==p) m_pst<-metagen(TE = .g, seTE = .g_se, data = df_post, studlab = study, sm = "SMD", random = TRUE, method.random.ci = "HK" ) 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= -0.83 ; 95%CI: [ -0.98 , -0.68 ]" [1] "CT : g= -0.31 ; 95%CI: [ -0.58 , -0.03 ]" [1] "PT : g= -0.87 ; 95%CI: [ -1.79 , 0.05 ]" [1] "BT : g= -0.97 ; 95%CI: [ -1.47 , -0.47 ]" [1] "EMDR : g= -0.57 ; 95%CI: [ -2.23 , 1.08 ]" [1] "3W : g= -0.3 ; 95%CI: [ -1.11 , 0.51 ]" [1] "PD : g= -0.48 ; 95%CI: [ -11.11 , 10.16 ]"