Background: Background: Major depressive disorder (MDD) and anxiety disorders are significant contributors to global impairment. While both psychosocial and pharmaceutical therapies are well-established, an updated synthesis evaluating their efficacy is necessary to inform clinical decision-making. Objective: To assess the relative efficacy of organized psychosocial therapy compared to first-line antidepressant medicines in enhancing outcomes for people with Major Depressive Disorder or anxiety disorders. Methods: A systematic review guided by PRISMA was conducted using PubMed, Scopus, Web of Science, PsycINFO, and Cochrane to find randomized controlled trials (2014–2024) that compare a structured psychosocial intervention with a first-line antidepressant in individuals diagnosed with major depressive disorder or an anxiety disorder. Two reviewers independently performed research selection, data extraction, and risk-of-bias evaluation. Results: Eight randomized controlled trials with 2,143 individuals satisfied the inclusion criteria. Cognitive-behavioral treatment in major depressive disorder showed therapeutic equivalence to antidepressant drugs for main outcome metrics. In generalized anxiety disorder, findings were varied, with two studies demonstrating a slight benefit for medication. Under various situations, psychosocial therapies consistently showed enhanced tolerability, with a reduced incidence of adverse events compared to medicine. Conclusion: All techniques are beneficial; however, the recommended starting therapy may differ depending on the diagnosis. In Major Depressive Disorder, comparable efficacy endorses preference-sensitive choices that prioritize acceptability, but in some anxiety disorders, medication may provide marginally superior symptom alleviation. Shared decision-making is advised, and more study should ascertain drivers of varied responses.
Alvi et al. (Sat,) studied this question.