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PRISMA flow diagram: CCDANCTR update search June 2014
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Figure 1

PRISMA flow diagram: CCDANCTR update search June 2014

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 1 Remission by clinical interview (post‐intervention) ITT.
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Analysis 1.1

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 1 Remission by clinical interview (post‐intervention) ITT.

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 2 Remission by clinical interview (post‐intervention) OC.
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Analysis 1.2

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 2 Remission by clinical interview (post‐intervention) OC.

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 3 Remission by clinical interview (six to nine months follow‐up) ITT.
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Analysis 1.3

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 3 Remission by clinical interview (six to nine months follow‐up) ITT.

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 4 Remission by clinical interview (six to nine months follow‐up) OC.
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Analysis 1.4

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 4 Remission by clinical interview (six to nine months follow‐up) OC.

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 5 Dropouts (post‐intervention).
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Analysis 1.5

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 5 Dropouts (post‐intervention).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 6 Dropouts (six to nine months follow‐up).
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Analysis 1.6

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 6 Dropouts (six to nine months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 7 Suicidal ideation (post‐intervention).
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Analysis 1.7

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 7 Suicidal ideation (post‐intervention).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 8 Suicidal ideation (six to nine months follow‐up).
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Analysis 1.8

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 8 Suicidal ideation (six to nine months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 9 Suicidal ideation (post‐intervention).
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Analysis 1.9

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 9 Suicidal ideation (post‐intervention).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 10 Suicidal ideation (six to nine months follow‐up).
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Analysis 1.10

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 10 Suicidal ideation (six to nine months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 11 Suicidal ideation (12 months follow‐up).
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Analysis 1.11

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 11 Suicidal ideation (12 months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 12 Remission by cut‐off (post‐intervention).
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Analysis 1.12

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 12 Remission by cut‐off (post‐intervention).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 13 Remission by cut‐off (six to nine months follow‐up).
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Analysis 1.13

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 13 Remission by cut‐off (six to nine months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 14 Remission by cut‐off (12 months follow‐up).
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Analysis 1.14

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 14 Remission by cut‐off (12 months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 15 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).
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Analysis 1.15

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 15 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 16 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up).
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Analysis 1.16

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 16 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 17 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up).
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Analysis 1.17

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 17 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 18 Depression symptoms self rated (post‐intervention).
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Analysis 1.18

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 18 Depression symptoms self rated (post‐intervention).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 19 Depression symptoms self rated (six to nine months follow‐up).
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Analysis 1.19

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 19 Depression symptoms self rated (six to nine months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 20 Depression symptoms self rated (12 months follow‐up).
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Analysis 1.20

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 20 Depression symptoms self rated (12 months follow‐up).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 21 Functioning (post‐intervention).
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Analysis 1.21

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 21 Functioning (post‐intervention).

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 22 Functioning (six to nine months follow‐up).
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Analysis 1.22

Comparison 1 Psychological therapy versus antidepressant medication, Outcome 22 Functioning (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 1 Remission by clinical interview (post‐intervention) ITT.
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Analysis 2.1

Comparison 2 Combination therapy versus antidepressant medication, Outcome 1 Remission by clinical interview (post‐intervention) ITT.

Comparison 2 Combination therapy versus antidepressant medication, Outcome 2 Remission by clinical interview (post‐intervention) OC.
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Analysis 2.2

Comparison 2 Combination therapy versus antidepressant medication, Outcome 2 Remission by clinical interview (post‐intervention) OC.

Comparison 2 Combination therapy versus antidepressant medication, Outcome 3 Remission by clinical interview (six to nine months follow‐up) ITT.
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Analysis 2.3

Comparison 2 Combination therapy versus antidepressant medication, Outcome 3 Remission by clinical interview (six to nine months follow‐up) ITT.

Comparison 2 Combination therapy versus antidepressant medication, Outcome 4 Remission by clinical interview (six to nine months follow‐up) OC.
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Analysis 2.4

Comparison 2 Combination therapy versus antidepressant medication, Outcome 4 Remission by clinical interview (six to nine months follow‐up) OC.

Comparison 2 Combination therapy versus antidepressant medication, Outcome 5 Remission by clinical interview (12 months follow‐up).
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Analysis 2.5

Comparison 2 Combination therapy versus antidepressant medication, Outcome 5 Remission by clinical interview (12 months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 6 Dropouts (post‐intervention).
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Analysis 2.6

Comparison 2 Combination therapy versus antidepressant medication, Outcome 6 Dropouts (post‐intervention).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 7 Dropouts (six to nine months follow‐up).
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Analysis 2.7

Comparison 2 Combination therapy versus antidepressant medication, Outcome 7 Dropouts (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 8 Dropouts (12 months follow‐up).
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Analysis 2.8

Comparison 2 Combination therapy versus antidepressant medication, Outcome 8 Dropouts (12 months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 9 Suicidal ideation (post‐intervention).
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Analysis 2.9

Comparison 2 Combination therapy versus antidepressant medication, Outcome 9 Suicidal ideation (post‐intervention).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 10 Suicidal ideation (six to nine months follow‐up).
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Analysis 2.10

Comparison 2 Combination therapy versus antidepressant medication, Outcome 10 Suicidal ideation (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 11 Suicidal ideation (12 months follow‐up).
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Analysis 2.11

Comparison 2 Combination therapy versus antidepressant medication, Outcome 11 Suicidal ideation (12 months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 12 Suicidal ideation (post‐intervention).
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Analysis 2.12

Comparison 2 Combination therapy versus antidepressant medication, Outcome 12 Suicidal ideation (post‐intervention).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 13 Suicidal ideation (six to nine months follow‐up).
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Analysis 2.13

Comparison 2 Combination therapy versus antidepressant medication, Outcome 13 Suicidal ideation (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 14 Suicidal ideation (12 months follow‐up).
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Analysis 2.14

Comparison 2 Combination therapy versus antidepressant medication, Outcome 14 Suicidal ideation (12 months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 15 Remission by cut‐off (post‐intervention).
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Analysis 2.15

Comparison 2 Combination therapy versus antidepressant medication, Outcome 15 Remission by cut‐off (post‐intervention).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 16 Remission by cut‐off (six to nine months follow‐up).
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Analysis 2.16

Comparison 2 Combination therapy versus antidepressant medication, Outcome 16 Remission by cut‐off (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 17 Remission by cut‐off (12 months follow‐up).
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Analysis 2.17

Comparison 2 Combination therapy versus antidepressant medication, Outcome 17 Remission by cut‐off (12 months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 18 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).
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Analysis 2.18

Comparison 2 Combination therapy versus antidepressant medication, Outcome 18 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 19 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up).
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Analysis 2.19

Comparison 2 Combination therapy versus antidepressant medication, Outcome 19 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 20 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up).
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Analysis 2.20

Comparison 2 Combination therapy versus antidepressant medication, Outcome 20 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 21 Depression symptoms self rated (post‐intervention).
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Analysis 2.21

Comparison 2 Combination therapy versus antidepressant medication, Outcome 21 Depression symptoms self rated (post‐intervention).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 22 Depression symptoms self rated (six to nine months follow‐up).
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Analysis 2.22

Comparison 2 Combination therapy versus antidepressant medication, Outcome 22 Depression symptoms self rated (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 23 Depression symptoms self rated (12 months follow‐up).
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Analysis 2.23

Comparison 2 Combination therapy versus antidepressant medication, Outcome 23 Depression symptoms self rated (12 months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 24 Functioning (post‐intervention).
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Analysis 2.24

Comparison 2 Combination therapy versus antidepressant medication, Outcome 24 Functioning (post‐intervention).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 25 Functioning (six to nine months follow‐up).
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Analysis 2.25

Comparison 2 Combination therapy versus antidepressant medication, Outcome 25 Functioning (six to nine months follow‐up).

Comparison 2 Combination therapy versus antidepressant medication, Outcome 26 Functioning (12 months follow‐up).
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Analysis 2.26

Comparison 2 Combination therapy versus antidepressant medication, Outcome 26 Functioning (12 months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 1 Remission by clinical interview (post‐intervention) ITT.
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Analysis 3.1

Comparison 3 Combination therapy versus psychological therapy, Outcome 1 Remission by clinical interview (post‐intervention) ITT.

Comparison 3 Combination therapy versus psychological therapy, Outcome 2 Remission by clinical interview (post‐intervention) OC.
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Analysis 3.2

Comparison 3 Combination therapy versus psychological therapy, Outcome 2 Remission by clinical interview (post‐intervention) OC.

Comparison 3 Combination therapy versus psychological therapy, Outcome 3 Remission by clinical interview (six to nine months follow‐up) ITT.
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Analysis 3.3

Comparison 3 Combination therapy versus psychological therapy, Outcome 3 Remission by clinical interview (six to nine months follow‐up) ITT.

Comparison 3 Combination therapy versus psychological therapy, Outcome 4 Remission by clinical interview (six to nine months follow‐up) OC.
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Analysis 3.4

Comparison 3 Combination therapy versus psychological therapy, Outcome 4 Remission by clinical interview (six to nine months follow‐up) OC.

Comparison 3 Combination therapy versus psychological therapy, Outcome 5 Dropouts (post‐intervention).
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Analysis 3.5

Comparison 3 Combination therapy versus psychological therapy, Outcome 5 Dropouts (post‐intervention).

Comparison 3 Combination therapy versus psychological therapy, Outcome 6 Dropouts (six to nine months follow‐up).
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Analysis 3.6

Comparison 3 Combination therapy versus psychological therapy, Outcome 6 Dropouts (six to nine months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 7 Suicidal ideation (post‐intervention).
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Analysis 3.7

Comparison 3 Combination therapy versus psychological therapy, Outcome 7 Suicidal ideation (post‐intervention).

Comparison 3 Combination therapy versus psychological therapy, Outcome 8 Suicidal ideation (six to nine months follow‐up).
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Analysis 3.8

Comparison 3 Combination therapy versus psychological therapy, Outcome 8 Suicidal ideation (six to nine months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 9 Suicidal ideation (post‐intervention).
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Analysis 3.9

Comparison 3 Combination therapy versus psychological therapy, Outcome 9 Suicidal ideation (post‐intervention).

Comparison 3 Combination therapy versus psychological therapy, Outcome 10 Suicidal ideation (six to nine months follow‐up).
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Analysis 3.10

Comparison 3 Combination therapy versus psychological therapy, Outcome 10 Suicidal ideation (six to nine months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 11 Suicidal ideation (12 months follow‐up).
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Analysis 3.11

Comparison 3 Combination therapy versus psychological therapy, Outcome 11 Suicidal ideation (12 months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 12 Remission by cut‐off (post‐intervention).
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Analysis 3.12

Comparison 3 Combination therapy versus psychological therapy, Outcome 12 Remission by cut‐off (post‐intervention).

Comparison 3 Combination therapy versus psychological therapy, Outcome 13 Remission by cut‐off (six to nine months follow‐up).
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Analysis 3.13

Comparison 3 Combination therapy versus psychological therapy, Outcome 13 Remission by cut‐off (six to nine months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 14 Remission by cut‐off (12 months follow‐up).
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Analysis 3.14

Comparison 3 Combination therapy versus psychological therapy, Outcome 14 Remission by cut‐off (12 months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 15 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).
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Analysis 3.15

Comparison 3 Combination therapy versus psychological therapy, Outcome 15 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).

Comparison 3 Combination therapy versus psychological therapy, Outcome 16 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up).
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Analysis 3.16

Comparison 3 Combination therapy versus psychological therapy, Outcome 16 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 17 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up).
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Analysis 3.17

Comparison 3 Combination therapy versus psychological therapy, Outcome 17 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 18 Depression symptoms self rated (post‐intervention).
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Analysis 3.18

Comparison 3 Combination therapy versus psychological therapy, Outcome 18 Depression symptoms self rated (post‐intervention).

Comparison 3 Combination therapy versus psychological therapy, Outcome 19 Depression symptoms self rated (six to nine months follow‐up).
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Analysis 3.19

Comparison 3 Combination therapy versus psychological therapy, Outcome 19 Depression symptoms self rated (six to nine months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 20 Depression symptoms self rated (12 months follow‐up).
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Analysis 3.20

Comparison 3 Combination therapy versus psychological therapy, Outcome 20 Depression symptoms self rated (12 months follow‐up).

Comparison 3 Combination therapy versus psychological therapy, Outcome 21 Functioning (post‐intervention).
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Analysis 3.21

Comparison 3 Combination therapy versus psychological therapy, Outcome 21 Functioning (post‐intervention).

Comparison 3 Combination therapy versus psychological therapy, Outcome 22 Functioning (six to nine months follow‐up).
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Analysis 3.22

Comparison 3 Combination therapy versus psychological therapy, Outcome 22 Functioning (six to nine months follow‐up).

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 1 Dropouts (post‐intervention).
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Analysis 4.1

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 1 Dropouts (post‐intervention).

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 2 Suicidal ideation (post‐intervention).
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Analysis 4.2

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 2 Suicidal ideation (post‐intervention).

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 3 Remission by cut‐off (post‐intervention).
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Analysis 4.3

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 3 Remission by cut‐off (post‐intervention).

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 4 Remission by cut‐off (12 months follow‐up).
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Analysis 4.4

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 4 Remission by cut‐off (12 months follow‐up).

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 5 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).
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Analysis 4.5

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 5 Depression symptoms clinician rated (CDRS‐R) (post‐intervention).

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 6 Depression symptoms self rated (post‐intervention).
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Analysis 4.6

Comparison 4 Combination therapy versus psychological therapy plus placebo, Outcome 6 Depression symptoms self rated (post‐intervention).

Comparison 1. Psychological therapy versus antidepressant medication

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Remission by clinical interview (post‐intervention) ITT Show forest plot

2

268

Odds Ratio (M‐H, Random, 95% CI)

0.62 [0.28, 1.35]

2 Remission by clinical interview (post‐intervention) OC Show forest plot

2

220

Odds Ratio (M‐H, Random, 95% CI)

0.52 [0.27, 0.98]

3 Remission by clinical interview (six to nine months follow‐up) ITT Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Remission by clinical interview (six to nine months follow‐up) OC Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Dropouts (post‐intervention) Show forest plot

2

271

Odds Ratio (M‐H, Random, 95% CI)

0.61 [0.11, 3.28]

6 Dropouts (six to nine months follow‐up) Show forest plot

2

223

Odds Ratio (M‐H, Random, 95% CI)

1.17 [0.63, 2.19]

7 Suicidal ideation (post‐intervention) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Suicidal ideation (six to nine months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Suicidal ideation (post‐intervention) Show forest plot

2

268

Mean Difference (IV, Random, 95% CI)

‐3.12 [‐5.91, ‐0.33]

10 Suicidal ideation (six to nine months follow‐up) Show forest plot

2

268

Mean Difference (IV, Random, 95% CI)

‐2.89 [‐5.49, ‐0.28]

11 Suicidal ideation (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

12 Remission by cut‐off (post‐intervention) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Remission by cut‐off (six to nine months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

14 Remission by cut‐off (12 months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

15 Depression symptoms clinician rated (CDRS‐R) (post‐intervention) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

16 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

17 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

18 Depression symptoms self rated (post‐intervention) Show forest plot

2

255

Std. Mean Difference (IV, Random, 95% CI)

0.16 [‐0.69, 1.01]

19 Depression symptoms self rated (six to nine months follow‐up) Show forest plot

2

268

Std. Mean Difference (IV, Random, 95% CI)

‐0.04 [‐0.51, 0.42]

20 Depression symptoms self rated (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

21 Functioning (post‐intervention) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

22 Functioning (six to nine months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

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Comparison 1. Psychological therapy versus antidepressant medication
Comparison 2. Combination therapy versus antidepressant medication

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Remission by clinical interview (post‐intervention) ITT Show forest plot

3

419

Odds Ratio (M‐H, Random, 95% CI)

1.50 [0.99, 2.27]

2 Remission by clinical interview (post‐intervention) OC Show forest plot

3

378

Odds Ratio (M‐H, Random, 95% CI)

1.56 [0.98, 2.47]

3 Remission by clinical interview (six to nine months follow‐up) ITT Show forest plot

2

203

Odds Ratio (M‐H, Random, 95% CI)

1.93 [0.93, 4.00]

4 Remission by clinical interview (six to nine months follow‐up) OC Show forest plot

2

193

Odds Ratio (M‐H, Random, 95% CI)

1.94 [0.88, 4.27]

5 Remission by clinical interview (12 months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Dropouts (post‐intervention) Show forest plot

5

699

Odds Ratio (M‐H, Random, 95% CI)

0.84 [0.51, 1.39]

7 Dropouts (six to nine months follow‐up) Show forest plot

3

420

Odds Ratio (M‐H, Random, 95% CI)

0.94 [0.54, 1.64]

8 Dropouts (12 months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Suicidal ideation (post‐intervention) Show forest plot

2

388

Odds Ratio (M‐H, Random, 95% CI)

0.75 [0.26, 2.16]

10 Suicidal ideation (six to nine months follow‐up) Show forest plot

2

344

Odds Ratio (M‐H, Random, 95% CI)

0.53 [0.06, 4.58]

11 Suicidal ideation (12 months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

12 Suicidal ideation (post‐intervention) Show forest plot

2

267

Mean Difference (IV, Random, 95% CI)

‐2.57 [‐5.53, 0.40]

13 Suicidal ideation (six to nine months follow‐up) Show forest plot

2

267

Mean Difference (IV, Random, 95% CI)

‐1.89 [‐4.50, 0.72]

14 Suicidal ideation (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

15 Remission by cut‐off (post‐intervention) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

16 Remission by cut‐off (six to nine months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

17 Remission by cut‐off (12 months follow‐up) Show forest plot

2

319

Odds Ratio (M‐H, Random, 95% CI)

1.45 [0.60, 3.52]

18 Depression symptoms clinician rated (CDRS‐R) (post‐intervention) Show forest plot

2

415

Mean Difference (IV, Random, 95% CI)

‐0.27 [‐4.95, 4.41]

19 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up) Show forest plot

2

408

Mean Difference (IV, Random, 95% CI)

‐0.27 [‐2.26, 1.72]

20 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

21 Depression symptoms self rated (post‐intervention) Show forest plot

5

683

Std. Mean Difference (IV, Random, 95% CI)

‐0.14 [‐0.36, 0.09]

22 Depression symptoms self rated (six to nine months follow‐up) Show forest plot

4

610

Std. Mean Difference (IV, Random, 95% CI)

‐0.06 [‐0.28, 0.17]

23 Depression symptoms self rated (12 months follow‐up) Show forest plot

2

368

Std. Mean Difference (IV, Random, 95% CI)

‐0.26 [‐0.46, ‐0.05]

24 Functioning (post‐intervention) Show forest plot

3

396

Std. Mean Difference (IV, Random, 95% CI)

0.09 [‐0.11, 0.28]

25 Functioning (six to nine months follow‐up) Show forest plot

3

385

Std. Mean Difference (IV, Random, 95% CI)

0.08 [‐0.12, 0.28]

26 Functioning (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

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Comparison 2. Combination therapy versus antidepressant medication
Comparison 3. Combination therapy versus psychological therapy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Remission by clinical interview (post‐intervention) ITT Show forest plot

2

265

Odds Ratio (M‐H, Random, 95% CI)

1.61 [0.38, 6.90]

2 Remission by clinical interview (post‐intervention) OC Show forest plot

2

222

Odds Ratio (M‐H, Random, 95% CI)

1.82 [0.38, 8.68]

3 Remission by clinical interview (six to nine months follow‐up) ITT Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Remission by clinical interview (six to nine months follow‐up) OC Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Dropouts (post‐intervention) Show forest plot

2

265

Odds Ratio (M‐H, Random, 95% CI)

1.23 [0.12, 12.71]

6 Dropouts (six to nine months follow‐up) Show forest plot

2

231

Odds Ratio (M‐H, Random, 95% CI)

0.75 [0.40, 1.42]

7 Suicidal ideation (post‐intervention) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

8 Suicidal ideation (six to nine months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

9 Suicidal ideation (post‐intervention) Show forest plot

2

265

Mean Difference (IV, Random, 95% CI)

0.60 [‐2.25, 3.45]

10 Suicidal ideation (six to nine months follow‐up) Show forest plot

2

265

Mean Difference (IV, Random, 95% CI)

1.78 [‐2.29, 5.85]

11 Suicidal ideation (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

12 Remission by cut‐off (post‐intervention) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

13 Remission by cut‐off (six to nine months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

14 Remission by cut‐off (12 months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

15 Depression symptoms clinician rated (CDRS‐R) (post‐intervention) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

16 Depression symptoms clinician rated (CDRS‐R) (six to nine months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

17 Depression symptoms clinician rated (CDRS‐R) (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

18 Depression symptoms self rated (post‐intervention) Show forest plot

2

265

Std. Mean Difference (IV, Random, 95% CI)

‐0.28 [‐1.41, 0.84]

19 Depression symptoms self rated (six to nine months follow‐up) Show forest plot

2

265

Std. Mean Difference (IV, Random, 95% CI)

‐0.16 [‐0.63, 0.31]

20 Depression symptoms self rated (12 months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

21 Functioning (post‐intervention) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

22 Functioning (six to nine months follow‐up) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figures and Tables -
Comparison 3. Combination therapy versus psychological therapy
Comparison 4. Combination therapy versus psychological therapy plus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Dropouts (post‐intervention) Show forest plot

4

249

Odds Ratio (M‐H, Random, 95% CI)

0.98 [0.42, 2.28]

2 Suicidal ideation (post‐intervention) Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Remission by cut‐off (post‐intervention) Show forest plot

2

173

Odds Ratio (M‐H, Random, 95% CI)

2.15 [1.15, 4.02]

4 Remission by cut‐off (12 months follow‐up) Show forest plot

1

Odds Ratio (M‐H, Random, 95% CI)

Totals not selected

5 Depression symptoms clinician rated (CDRS‐R) (post‐intervention) Show forest plot

3

239

Std. Mean Difference (IV, Random, 95% CI)

‐0.52 [‐0.78, ‐0.26]

6 Depression symptoms self rated (post‐intervention) Show forest plot

3

123

Std. Mean Difference (IV, Random, 95% CI)

‐0.34 [‐0.70, 0.02]

Figures and Tables -
Comparison 4. Combination therapy versus psychological therapy plus placebo