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World Psychiatry:荟萃分析认知行为治疗重度抑郁及焦虑的有效性?

2016-10-29 MedSci MedSci原创

研究者考虑发表偏倚、试验质量及对照组对预后的影响,研究当前应用认知行为疗法(CBT)治疗抑郁症(MDD),广泛性焦虑症(GAD),惊恐障碍(PAD)和社交焦虑障碍(SAD)的治疗效果。在荟萃分析中,研究包括随机比较CBT与对照条件试验(等待治疗,未治疗组或安慰剂)治疗急性MDD,GAD,PAD或SAD的疗效,这些疾病在结构化面谈的基础上诊断的。对纳入的144个试验(184对照)进行分析发现, CB

研究者考虑发表偏倚、试验质量及对照组对预后的影响,研究当前应用认知行为疗法(CBT)治疗抑郁症(MDD),广泛性焦虑症(GAD),惊恐障碍(PAD)和社交焦虑障碍(SAD)的治疗效果。

在荟萃分析中,研究包括随机比较CBT与对照条件试验(等待治疗,未治疗组或安慰剂)治疗急性MDD,GAD,PAD或SAD的疗效,这些疾病在结构化面谈的基础上诊断的。对纳入的144个试验(184对照)进行分析发现, CBT治疗这四种疾病的整体效果差异很大,MDD的g = 0.75,GAD的g = 0.80,PAD的g = 0.81,SAD的g= 0.88。发表偏倚主要影响GAD(调整g = 0.59)和MDD(调整g = 0.65)的CBT治疗的效果,而不影响PAD和SAD的CBT治疗的效果。只有17.4%的纳入试验被认为是高质量的,这主要是影响PAD(g= 0.61)和SAD(g = 0.76)的效果。焦虑障碍的试验中超过80%的试验应用等待治疗对照组,较少的研究应用其他对照组。

研究认为,CBT可有效治疗MDD,GAD,PAS和SAD;当对照条件是等待治疗时,CBT治疗效果最好,当对照组为未治疗或安慰剂治疗时,CBT治疗效果欠佳;而且由于高质量的试验较少,研究结果仍然不确定,应谨慎考虑。

原始出处:

Cuijpers P, Cristea IA, et al. How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta-analytic update of the evidence. World Psychiatry. 2016 Oct.


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    2017-04-01 venlin
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