抑郁症心理治疗中突然获益发生率的meta分析

A meta-analysis of the incidence of sudden gains during psychotherapy of depressive disorder

目的:系统评价抑郁症心理治疗过程中突然获益发生率的水平。方法:检索PubMed、Embase、Cochrane Library、中国知网数据库(CNKI)、万方数据库,同时手工检索纳入文献的参考文献列表。文献检索时间均为建库至2019年9月份,纳入抑郁症心理治疗过程中突然获益发生率的随机与非随机对照试验进行meta分析。结果:11个随机对照试验与10个非随机对照试验共2475例抑郁症患者符合纳入标准,meta分析结果显示抑郁症心理治疗过程中突然获益发生率为40%(95%CI:37~43)。亚组分析结果显示认知行为治疗、认知治疗、行为激活的突然获益发生率分别为43%(95%CI:37~48)、43%(95%CI:38~47)、39%(95%CI:33~46)。结论:本研究提示抑郁症心理治疗过程中突然获益的发生是跨人群与心理治疗流派的,是一种比较稳定与普遍的现象,但结果仍需要增加非认知行为治疗与大样本量的试验加以验证。

Objective:To systematically review the incidence of sudden gains during psychotherapy of depressive disorder.Methods:The databases of PubMed,Embase,Cochrane Library,CNKI,Wanfang were retrieved from the beginning of the databases to September 2019,and the reference lists of the included article was searched manually.The relevant randomized and non-randomized controlled trials of the incidence of sudden gains during psychotherapy of depressive disorder were included for meta-analysis.Results:Eleven randomized controlled trials and 10non-randomized controlled trials involving 2475patients with depressive disorder were included.The incidence of sudden gains during psychotherapy of depressive disorder was estimated at 40%(95%CI:37-43).Subgroup analysis showed the incidence of sudden gains in cognitive behavior therapy(CBT)was 43%(95%CI:37-48),43%(95%CI:38-47)in cognitive therapy and 39%(95%CI:33-46)in behavioral activation,respectively.Conclusion:The occurrence of sudden gains during psychotherapy of depressive disorder is across diverse populations and approaches of psychotherapy,which is a kind of relatively stable and common phenomenon.Nonetheless,more non-cognitive behavior therapy and large sample trails are needed to validate the results.