CBT联合SSRIs对青少年抑郁症疗效的元分析

Efficacy of CBT combined with SSRIs in the treatment of adolescent depression: A meta-analysis

目的 探讨认知行为疗法(CBT)联合SSRIs类药物与单纯SSRIs类药物对青少年抑郁症的治疗效果。方法 通过中国知网数据库、万方数据库和维普中文科技期刊数据库,检索年限为2000~2020年的国内已发表的相关研究,将筛选符合标准的文献纳入CMA进行元分析及逐步回归分析。结果 元分析结果表明,治疗前及治疗后第4、6、8、12周的总体效果量分别是0.051、-3.727、-1.046、-3.005、-1.508,不同疗程的效果量差异具有统计学意义(P﹤0.05),CBT联合SSRIs类药物对青少年抑郁症的疗效优于单纯使用SSRIs类药物治疗,舍曲林效果好于其他药物。回归分析结果表明,舍曲林的效果最好,治疗后第4周联合治疗和药物治疗之间疗效的差异显著,当治疗达8周时两组疗效的差异达到最大。结论 认知行为疗法联合舍曲林对青少年抑郁症治疗效果更显著。

Objective To explore the effects of cognitive behavioral therapy(CBT) combined with SSRIs and SSRIs alone on adolescent depression. Methods Relevant literatures published in China from 2000 to 2020 were retrieved from CNKI, Wanfang Database, WeiPu Database and included in CMA for meta-analysis and stepwise regression analysis. Results The results of meta-analysis showed that the overall effect sizes before treatment, and at the 4th, 6th, 8thand 12thweekends after treatment were 0.051,-3.727,-1.046,-3.005 and-1.508, respectively. And the difference of effective sizes among different courses was significant(P﹤0.05). The effect of CBT combined with SSRIs on adolescent depression is significantly better than that of SSRIs alone and sertraline is more effective than other drugs. The results of regression analysis showed that sertraline had the best effect;the difference between combination therapy and pharmacotherapy was significant at the 4thweekend after treatment than before, and was greatest at the 8thweekend after treatment. Conclusion CBT combined with sertraline is more effective in the treatment of adolescent depression.