Knapen P M F J J
Tijdschr Psychiatr. 2008;50(6):365-75.
Psychotherapy is a popular treatment for many psychiatric symptoms and disorders. Finding evidence for the effectiveness of therapies and bridging the gap with daily practice are a challenge. The current state of psychotherapy is explored from the perspective of evidence-based medicine. Hundreds of meta-analyses, based on thousands of studies, showed an average effect size of 0.60. Discussion in this paper focuses on the achievements and limitations of research into methods and specific disorders. Much is known about the specificity of psychotherapies and about other issues relevant to service delivery. If patient-based indication is to be a goal for the future, we will need to have a differentiated spectrum of evidence-based psychotherapies. This approach will require the integration of effective elements taken from a variety of methods, the development of multi-dimensional indicators for patient-based indication, and research into cost-effectiveness to underpin the relevance of psychotherapy for the community at large.
心理治疗是治疗多种精神症状和障碍的常用方法。寻找治疗方法有效性的证据并弥合与日常实践之间的差距是一项挑战。本文从循证医学的角度探讨了心理治疗的现状。基于数千项研究的数百项荟萃分析显示，平均效应量为0.60。本文的讨论重点在于方法研究和特定障碍研究的成果与局限性。关于心理治疗的特异性以及与服务提供相关的其他问题，我们已经了解很多。如果以患者为基础的适应症成为未来的目标，我们将需要有一系列经过区分的循证心理治疗方法。这种方法将需要整合从多种方法中提取的有效要素，开发基于患者适应症的多维指标，并研究成本效益，以支持心理治疗对整个社区的相关性。
