No difference was found among seven forms of talk therapy used to treat depression, with all of them helping patients to one degree or another, Swiss researchers say.

The psychotherapeutic interventions were all found to have moderate to strong effects on depressed patients, who were receiving treatment without psychoactive medications, an international team reported Tuesday. The findings suggest that people with depression consider any one of the non-drug talk therapies available, including interpersonal psychotherapy, behavioral activation, cognitive behavioral therapy, problem solving therapy, psychodynamic therapy, social skills training, and supportive counseling.

"We found evidence that most of the seven psychotherapeutic interventions under investigation have comparable effects on depressive symptoms and achieve moderate to large effects vis-à-vis waitlist," a control group comprised of patients who were not receiving any therapy for their depression, the researchers wrote.

Led by Jürgen Barth from the University of Bern in Switzerland, the international team of researchers reviewed 198 studies involving more than 15,000 patients receiving one of the seven psychotherapies, to which they compared patients receiving either customary therapy — talk therapy in combination with antidepressant medication — or those on waiting lists for therapy.

All seven therapies more effectively eased symptoms of depression with no differences among them, for patients young and old, as well as for mothers who had just given birth. Furthermore, the researchers found no difference in effectiveness between modes of delivery, including group versus individual therapy or face-to-face versus Internet-based interaction.

"All seven psychotherapeutic interventions achieved a small to moderate effect compared to usual care," the authors wrote. "Overall, we found that different psychotherapeutic interventions for depression have comparable, moderate-to-large effects."

The seven psychotherapies include "interpersonal psychotherapy," a short and highly structured form of talk therapy using a manual to focus on issues in depression; "behavioral activation," which seeks to emphasize the pleasure of life to patients and to increase positive interactions between the patient and his or her environment; "cognitive behavioral therapy," also known commonly as "CBT," which focuses on a patient's negative thoughts in an attempt to restructure beliefs and change outlook; "problem solving therapy," which aims to define a patient's problems and to propose practical solutions; "psychodynamic therapy, which focuses on past unresolved conflicts and relationships that impact present life; and "social skills therapy," which teaches certain skills to patients to help them build and maintain healthier interpersonal relationships.

Published Tuesday in the open-access journal PLOS Medicine, the research was funded by the Swiss National Science Foundation.

Source: Barth J, Munder T, Gerger H, et al. Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis. PLoS Med. 2013.