Comment: The quality of evidence is downgraded by study quality (lack of blinding, high drop-out rate) and imprecise results (few small studies for comparisons).
A Cochrane review [Abstract] 1 included 6 studies with a total of 334 adults.Three studies compared a psychological intervention (either cognitive behaviour therapy or mindfulness-based cognitive therapy) with a control intervention. Data regarding depression symptom outcome measures were combined in a meta-analysis, but did not find an effect in favour of treatment (SMD -0.14; 95% CI -0.47 to 0.19; 3 trials, n=146). The other comparisons comprised of single studies of depression symptoms without clear benefits and compared cognitive behaviour therapy vs. supportive psychotherapy (SMD -0.09; 95% CI -0.65 to 0.48; one trial, n=48); repetitive transcranial magnetic stimulation plus tricyclic antidepressant (rTMS + TCA) vs. TCA alone (SMD -0.84; 95% CI -1.36 to -0.32; one trial, n=63); and a supervised exercise program vs. exercise as usual (SMD -0.43; 95% CI -0.88 to 0.03; one trial, n=76). Only one study mentioned minor, transient adverse events from rTMS.
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