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AimsThe aim of this study was to reanalyse the data from Cuijpers et al.'s (2018) meta-analysis, to examine Eysenck's claim that psychotherapy is not effective. Cuijpers et al., after correcting for bias, concluded that the effect of psychotherapy for depression was small (standardised mean difference, SMD, between 0.20 and 0.30), providing evidence that psychotherapy is not as effective as generally accepted. METHODS: The data for this study were the effect sizes included in Cuijpers et al. (2018). We removed outliers from the data set of effects, corrected for publication bias and segregated psychotherapy from other interventions. In our study, we considered wait-list (WL) controls as the most appropriate estimate of the natural history of depression without intervention. RESULTS: The SMD for all interventions and for psychotherapy compared to WL controls was approximately 0.70, a value consistent with past estimates of the effectiveness of psychotherapy. Psychotherapy was also more effective than care-as-usual (SMD = 0.31) and other control groups (SMD = 0.43). CONCLUSIONS: The re-analysis reveals that psychotherapy for adult patients diagnosed with depression is effective.

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Replicability of findings is an essential prerequisite of research. For both basic and clinical research, however, low replicability of findings has recently been reported. Replicability may be affected by research biases not sufficiently controlled for by the existing research standards. Several biases such as researcher allegiance or selective reporting are well-known for affecting results. For psychotherapy and pharmacotherapy research, specific additional biases may affect outcome (e.g. therapist allegiance, therapist effects or impairments in treatment implementation). For meta-analyses further specific biases are relevant. In psychotherapy and pharmacotherapy research these biases have not yet been systematically discussed in the context of replicability. Using a list of 13 biases as a starting point, we discuss each bias's impact on replicability. We illustrate each bias by selective findings of recent research, showing that (1) several biases are not yet sufficiently controlled for by the presently applied research standards, (2) these biases have a pernicious effect on replicability of findings. For the sake of research credibility, it is critical to avoid these biases in future research. To control for biases and to improve replicability, we propose to systematically implement several measures in psychotherapy and pharmacotherapy research, such as adversarial collaboration (inviting academic rivals to collaborate), reviewing study design prior to knowing the results, triple-blind data analysis (including subjects, investigators and data managers/statisticians), data analysis by other research teams (crowdsourcing), and, last not least, updating reporting standards such as CONSORT or the Template for Intervention Description and Replication (TIDieR).

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Rief and Hofmann (Nervenarzt 80:593-597) criticize in a very detailed comment our meta-analysis of long-term psychodynamic psychotherapy (JAMA 300:1551-1565). Although our article clearly included information that our meta-analysis addressed long-term psychodynamic psychotherapy of at least 50 sessions or at least 1 year duration, Rief and Hofmann allege that we studied "psychoanalysis" or "long-term psychoanalysis". Then they "show" for some of the studies we included that these studies did not address "psychoanalysis" or "long-term psychoanalysis" - which they did indeed not, but had never been claimed by us. For all other points of criticism put forward by the authors we show that they are not tenable as well. In addition, we show that Rief and Hofmann use omissions and allegations that give the impression that we deliberately violated principles of good scientific practice. This is reputation-damaging behaviour that clearly goes beyond a scientific discussion among researchers and constitutes a special act which itself violates the principles of good scientific practice.

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OBJECTIVE: Quality of life is a major criterion of the outcome of psychotherapeutic interventions. The concept of quality of life emphasizes patient self-ratings. However, they can be burdensome or inappropriate in some cases. Therefore we have compared self-ratings and clinician-ratings of quality of life. METHODS: Self- and clinician-ratings of the SF-8 (1-week recall version) were measured from consecutive samples of 1 812 inpatients from eleven psychotherapeutic clinics at admission and at discharge six weeks later. A physical summary score (PSS) and a mental summary score (MSS) were calculated. Pearson product-moment correlations were used. RESULTS: Self- and clinician-ratings of the PSS correlate r=0.48 at admission and r=0.58 at discharge, of the MSS r=0.46 and r=0.51, respectively. Concerning single items we find the highest correlation for item 4 (bodily pain: r=0.53 and r=0.55), the lowest for item 6 (social functioning: r=0.26 and r=0.30). Change scores of the PSS correlate r=0.20, of the MSS r=0.32. Correlations differ between diagnostic groups: Correlations are low for patients with either schizophrenia (F2), depressive episode (F32) or personality disorder (F60-62), comparatively higher for patients with dysthymia. Comparing correlations across the 11 clinics reveals substantial differences, for the MSS ranging from r=0.38 to r=0.58 at admission and r=0.27 to r=0.68 at discharge. CONCLUSION: Patient self-ratings of quality of life as a psychotherapeutic outcome measure using the SF-8 Health Survey could not be substituted by clinician-ratings, they should be used as complements.

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