Are pills or psychology best for treating mental illness?

JAMA, a major medical journal, has just published a review of reviews which tries to answer that question.  They found a slight edge in favour of psychology, somewhat surprisingly.  Excerpt of results  below:

Efficacy of Pharmacotherapy and Psychotherapy for Adult Psychiatric Disorders:  A Systematic Overview of Meta-analyses

By Maximilian Huhn et al

Findings

The search yielded 45 233 results. We included 61 meta-analyses on 21 psychiatric disorders, which contained 852 individual trials and 137 126 participants. The mean effect size of the meta-analyses was medium (mean, 0.50; 95% CI, 0.41-0.59). Effect sizes of psychotherapies vs placebo tended to be higher than those of medication, but direct comparisons, albeit usually based on few trials, did not reveal consistent differences. Individual pharmacotherapy trials were more likely to have large sample sizes, blinding, control groups, and intention-to-treat analyses. In contrast, psychotherapy trials had lower dropout rates and provided follow-up data. In psychotherapy studies, wait-list designs showed larger effects than did comparisons with placebo.

JAMA Psychiatry. Published online April 30, 2014.

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