Greenberg R P, Bornstein R F, Greenberg M D, Fisher S
Department of Psychiatry and Behavioral Science, State University of New York Health Science Center, Syracuse 13210.
J Consult Clin Psychol. 1992 Oct;60(5):664-9; discussion 670-7. doi: 10.1037//0022-006x.60.5.664.
A meta-analysis of 22 studies of antidepressant outcome assessed the level of medication effects under conditions thought to be less subject to clinician bias than those in the typical double-blind drug trial. Studies were included only if, in addition to a newer antidepressant group, they also contained both standard antidepressant and placebo control groups. Effect sizes were quite modest and approximately one half to one quarter the size of those previously reported under more transparent conditions. Effect sizes that were based on clinician outcome ratings were significantly larger than those that were based on patient ratings. Patient ratings revealed no advantage for antidepressants beyond the placebo effect. Effect sizes were unrelated to sample sex ratios, patient age, inpatient or outpatient status, dosage level, and treatment duration. Findings highlight the fragility of the antidepressant effect.
一项对22项抗抑郁药疗效研究的荟萃分析，评估了在被认为比典型双盲药物试验更不易受临床医生偏见影响的条件下药物疗效水平。纳入的研究只有在除了一个新型抗抑郁药组外，还包含标准抗抑郁药和安慰剂对照组时才被纳入。效应量相当小，大约是之前在更透明条件下报告的效应量的二分之一到四分之一。基于临床医生疗效评分的效应量显著大于基于患者评分的效应量。患者评分显示，除了安慰剂效应外，抗抑郁药没有优势。效应量与样本性别比例、患者年龄、住院或门诊状态、剂量水平和治疗持续时间无关。研究结果突出了抗抑郁药效果的脆弱性。
