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心理治疗对年轻人和老年人的抑郁症疗效相同吗?一项元回归分析。

Is psychotherapy for depression equally effective in younger and older adults? A meta-regression analysis.

作者信息

Cuijpers Pim, van Straten Annemieke, Smit Filip, Andersson Gerhard

机构信息

Department of Clinical Psychology and EMGO Institute, VU University Amsterdam, The Netherlands.

出版信息

Int Psychogeriatr. 2009 Feb;21(1):16-24. doi: 10.1017/S1041610208008089. Epub 2008 Dec 1.

Abstract

BACKGROUND

It is well established that psychotherapy is effective in the treatment of depression in younger as well as in older adults. Whether these psychotherapies are equally effective in younger and older age groups has not been examined in meta-analytic research.

METHODS

We conducted a systematic literature search and included 112 studies with 170 comparisons between a psychotherapy and a control group (with a total of 7,845 participants). Twenty studies with 26 comparisons were aimed at older adults.

RESULTS

We found no indication that psychotherapies were more or less effective for older adults compared to younger adults. The effect sizes of both groups of comparisons did not differ significantly from each other (older adults: d = 0.74; 95% CI: 0.49-0.99; younger adults: d = 0.67; 95% CI: 0.58-0.76). In a multivariate meta-regression analysis, in which we controlled for major characteristics of the participants, the interventions and the study designs, no indication of a difference between psychotherapy in younger and older adults was found.

CONCLUSIONS

There appears to be no significant difference between psychotherapy in younger and older adults, although it is not clear whether this is also true for clinical samples, patients with more severe depression, and the older old.

摘要

背景

心理治疗在治疗年轻人和老年人的抑郁症方面效果显著,这一点已得到充分证实。然而,这些心理治疗方法在年轻人和老年人中的效果是否相同,尚未在荟萃分析研究中得到检验。

方法

我们进行了系统的文献检索,纳入了112项研究,其中包括170项心理治疗组与对照组的比较(共有7845名参与者)。针对老年人的研究有20项,包含26组比较。

结果

我们没有发现任何迹象表明心理治疗对老年人的效果比年轻人更好或更差。两组比较的效应量没有显著差异(老年人:d = 0.74;95%置信区间:0.49 - 0.99;年轻人:d = 0.67;95%置信区间:0.58 - 0.76)。在多变量荟萃回归分析中,我们控制了参与者、干预措施和研究设计的主要特征,未发现年轻人和老年人心理治疗之间存在差异的迹象。

结论

年轻人和老年人的心理治疗似乎没有显著差异,尽管对于临床样本、重度抑郁症患者和高龄老人是否也是如此尚不清楚。

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