Biological markers evaluated in randomized trials of psychological treatments for depression: a systematic review & meta-analysis (2019) Cristea et al

J

JohnTheJack

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Staff member
I haven't looked at this, but it sounds interesting and relevant.

It is accepted by the CBT-GET promoters that there are biological changes in patients with ME. A key part of their argument has always been that psychotherapy can bring about or reverse biological changes.

Here is a study that finds no support that biomarkers are related to psychotherapy outcome across 51 trials. And in an area where it is generally accepted that psychotherapy is helpful.

https://www.sciencedirect.com/science/article/pii/S0149763419300247

Abstract
Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding.

We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression.

Fifty-one trials (5123 participants) and a pooled analysis were included. Biological markers were outcomes in 43 studies and predictors of treatment response in 9.

At post-treatment, psychotherapy could not be distinguished from control conditions for glycaemic control (Hb1AC), 7 trials, Hedges’ g= -.01, 95% CI -0.30 to 0.29, I2 = 65% and cortisol concentration after-wake, 5 trials, Hedges’ g= -.19, 95% CI -0.45 to 0.06, I2 = 0%. Follow-up results were similar.

For the other biological domains (immunological, neurobiological, inflammatory, weight, blood pressure), overall findings were mixed and often inconsistent. Few trials investigated prediction of response, with only neuroimaging markers showing promise.

Across domains, we found limited evidence that benefits of psychological treatments for depression translate to biological outcomes.
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Though it is widely believed that psychotherapy changes biology
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Really? Widely believed? Why would people believe such a thing? This is in the same realm as believing in fairies or astrology. It's not as if this were something that would merit some, I don't know, testing?! You know, show your work, extraordinary claims require extraordinary evidence and all that.

I get it, being nervous can make your heart go faster, your hands sweaty, but this is on a whole other level.

Ugh. :sick::banghead:
 
Thank you to these researchers. Not at all intending to disparage them, but believing that "psychotherapy changes biology", is total bunk. I understand, this does not appear to be the position these authors are taking. If I read the abstract correctly, these investigators found little evidence that psychotherapy changes biology. If one believes in the magic of therapy changing physiology, might as well believe in the magic of fairy dust.
 
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is it possible that the belief in psychotherapy’s capacity to alter biological functions in our bodies is nothing more than the product of marketing and hype?
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Say it ain't so. Who knew relying on a dogmatic belief was a bad idea?

This is seriously embarrassing. This whole field is uselessly inept.
 
JohnTheJack said:
A recent blog on this paper.
https://digest.bps.org.uk/2019/05/1...therapy-changes-the-body-as-well-as-the-mind/
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Thanks. For those not wanting to read the blog, this is probably a handy summary:

The authors believe their failure to uncover evidence for psychotherapy having biological effects is most likely due primarily to methodological inconsistencies between studies (there was large variability across the biological domains and markers explored and overall findings were mixed), or to the confounding factors, such as placebo effects, that are so characteristic of studies on the biology of psychological illness. If they are correct, then in time, once researchers solidify their methodology, this will deliver new results that confirm the general belief in the beneficial effect of psychotherapy on disruptions to human biological functioning. However, if the researchers’ explanation is untrue, then the results of their new meta-analysis give rise to very fundamental doubts and questions: Is the dogma of psychophysical unity, presently accepted in contemporary psychology and medicine, correct? Is it possible that any associations which occur are of a solely unidirectional nature (biology modifies our mental states, but not the reverse)? And finally, perhaps the most banal question that would render the others meaningless: is it possible that the belief in psychotherapy’s capacity to alter biological functions in our bodies is nothing more than the product of marketing and hype?
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