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Articles by P Cuijpers
Total Records ( 3 ) for P Cuijpers
  F. S Luppino , L. M de Wit , P. F Bouvy , T Stijnen , P Cuijpers , B. W. J. H Penninx and F. G. Zitman

Context  Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction.

Objective  To conduct a systematic review and meta-analysis on the longitudinal relationship between depression, overweight, and obesity and to identify possible influencing factors.

Data Sources  Studies were found using PubMed, PsycINFO, and EMBASE databases and selected on several criteria.

Study Selection  Studies examining the longitudinal bidirectional relation between depression and overweight (body mass index 25-29.99) or obesity (body mass index ≥30) were selected.

Data Extraction  Unadjusted and adjusted odds ratios (ORs) were extracted or provided by the authors.

Data Synthesis  Overall, unadjusted ORs were calculated and subgroup analyses were performed for the 15 included studies (N = 58 745) to estimate the effect of possible moderators (sex, age, depression severity). Obesity at baseline increased the risk of onset of depression at follow-up (unadjusted OR, 1.55; 95% confidence interval [CI], 1.22-1.98; P < .001). This association was more pronounced among Americans than among Europeans (P = .05) and for depressive disorder than for depressive symptoms (P = .05). Overweight increased the risk of onset of depression at follow-up (unadjusted OR, 1.27; 95% CI, 1.07-1.51; P < .01). This association was statistically significant among adults (aged 20-59 years and ≥60 years) but not among younger persons (aged <20 years). Baseline depression (symptoms and disorder) was not predictive of overweight over time. However, depression increased the odds for developing obesity (OR, 1.58; 95% CI, 1.33-1.87; P < .001). Subgroup analyses did not reveal specific moderators of the association.

Conclusions  This meta-analysis confirms a reciprocal link between depression and obesity. Obesity was found to increase the risk of depression, most pronounced among Americans and for clinically diagnosed depression. In addition, depression was found to be predictive of developing obesity.

  P Cuijpers , F Smit , B. W. J. H Penninx , R de Graaf , M ten Have and A. T. F. Beekman

Context  The importance of neuroticism for mental health care use and public health is well established. However, most research has focused on the association between neuroticism and a single specific disorder or health outcome, and the overall effect of neuroticism on use of somatic and mental health care and on society is not clear.

Objective  To examine the economic costs of neuroticism to get an impression of the overall effect of neuroticism on mental health care and on society in general.

Design  Cross-sectional population-based study.

Setting  General population.

Participants  A large representative sample (N = 5504) of the Dutch general population.

Main Outcome Measures  The costs (health service uptake in primary and secondary mental health care, out-of-pocket costs, and production losses) associated with neuroticism.

Results  The total per capita excess costs were $12 362 per year for the reference year 2007 in the 5% highest scorers of neuroticism, $8243 in the 10% highest scorers, and $5572 in the 25% highest scorers. The per capita excess costs of neuroticism are considerably higher than those of mental disorders. The total excess costs of neuroticism per 1 million inhabitants resulting from the 25% highest scorers ($1.393 billion) were approximately 2.5 times as high as the excess costs of common mental disorders ($585 million).

Conclusions  The economic costs of neuroticism are enormous and exceed those of common mental disorders. We should start thinking about interventions that focus not on each of the specific negative outcomes of neuroticism but rather on the starting point itself.

  P Cuijpers , F Smit , E Bohlmeijer , S. D Hollon and G. Andersson


It is not clear whether the effects of cognitive–behavioural therapy and other psychotherapies have been overestimated because of publication bias.


To examine indicators of publication bias in randomised controlled trials of psychotherapy for adult depression.


We examined effect sizes of 117 trials with 175 comparisons between psychotherapy and control conditions. As indicators of publication bias we examined funnel plots, calculated adjusted effect sizes after publication had been taken into account using Duval & Tweedie’s procedure, and tested the symmetry of the funnel plots using the Begg & Mazumdar rank correlation test and Egger’s test.


The mean effect size was 0.67, which was reduced after adjustment for publication bias to 0.42 (51 imputed studies). Both Begg & Mazumbar’s test and Egger’s test were highly significant (P<0.001).


The effects of psychotherapy for adult depression seem to be overestimated considerably because of publication bias.

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