Psychosomatic Medicine

Skip Navigation LinksHome > May 2013 - Volume 75 - Issue 4 > How Many Meta-Analyses Does it Take to Settle a Question?
Psychosomatic Medicine:
doi: 10.1097/PSY.0b013e318295e046
Editorial Comment

How Many Meta-Analyses Does it Take to Settle a Question?

Linden, Wolfgang PhD

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Abstract: Psychological treatments (PTs) are used as adjuncts to cardiac care. This issue of Psychosomatic Medicine provides a meta-analysis by Rutledge et al. (3) on the effects of PT and cardiac rehabilitation on depression and cardiac outcomes, and the journal recently published a systematic review and meta-regression on a similar topic by Dickens et al. (4). This editorial compares the results from these two meta-analyses and discusses the problems associated with combining different types of PT and other treatments, dose-response effects, floor effects, collapsing across outcomes, and therapist qualifications. PTs have mixed but generally positive effects on reducing mortality and cardiac outcomes, but it remains a challenge explaining how such beneficial outcomes can be achieved by relatively small effects on well-being (typical effect sizes: d = 0.2–0.3). Randomized controlled trials are needed on timing of PT, patients with cardiac problems who will benefit most from PT, and the mechanisms by which PT improves cardiac outcomes.

Copyright © 2013 by American Psychosomatic Society

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