New research shows that there is little difference between the use of drugs versus a placebo for most mental health conditions.
Mental health problems are a growing problem in Australia and worldwide, with current estimates suggesting that about 45% of all Australians will experience at least one mental health condition during their lifetime.
Psychotherapies and pharmacotherapies are the first-line treatments for these problems, yet the evidence backing their efficacy is not clear. Now, a massive new review study found that the efficacy of drugs and treatments prescribed for mental disorders may be overestimated.
The study summarised the results of over 100 previous research reports evaluating the efficacy of drugs or treatments against a placebo. According to the authors of this study, both statistics are small, and suggest that both psychotherapies and drugs only offered a “limited additional gain”, compared to placebo.
Effect size is a statistical calculation commonly used to compare the efficacy of different treatments. In this case, the effect size of 0.34, for example, compared the efficacy of psychotherapies against a placebo, and showed that only a small percentage of patients experienced benefit from the treatments.
About the study
This new study consisted of an umbrella review of recent meta-analyses of randomised controlled trials. In practice this mean that the study scrutinised the findings of over a hundred previous research reports involving 3,782 clinical trials and over 650,000 patients.
The clinical trials analysed involved a wide range of mental health issues, including depression, anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, eating disorders, attention-deficit/hyperactivity disorder, and insomnia, among others.
The study found that most of the effect size for target symptoms reported in clinical trials were small. Their analyses compared effect sizes of psychotherapies across mental conditions, which resulted in a standardised mean difference (SMD) of 0.34, whereas medication had an effect size SMD of 0.36. According to the authors their findings hint at the low efficacy of current treatments for mental disorders.
“After more than half a century of research, thousands of RCTs and millions of invested funds, the effect sizes of psychotherapies and pharmacotherapies for mental disorders are limited.”