McNaughton Jennifer L
c/o Royal Victoria Hospital, 201 Georgian Dr, Barrie, ON L4M 6M2.
Can Fam Physician. 2009 Aug;55(8):789-96.
To assess existing, brief nonpharmacologic interventions that are available for primary care physicians with minimal training in psychotherapy to use in managing depression in adult patients.
MEDLINE was searched from 1996 to 2007, EMBASE was searched from 1980 to 2007, and EBM Reviews was searched from 1999 to 2007.
Several randomized controlled trials were selected using specified criteria. Selected articles were subsequently appraised and qualitatively analyzed.
Significant improvements on depression scales were found in 6 out of 8 studies (P < .05) using various brief interventions and formal control groups. Successful interventions included bibliotherapy, websites based on cognitive-behavioural therapy (CBT), and CBT-based computer programs. Completion rates were highest when interventions were shorter, more structured, and included frequent contact or reminders from study staff. Validity limitations included small sample sizes, non-blinding of studies, and an uncertain degree of generalizability.
Bibliotherapy, CBT-based websites, and CBT-based computer programs might be effective in assisting primary care physicians who have minimal training in psychotherapy in treating adult patients with depression. Health care personnel contact with patients undergoing these interventions might result in increased effectiveness. Future research is warranted in this area, and despite several limitations, findings from this study could help guide efforts in the development and evaluation of such research.
评估现有简短的非药物干预措施，供在心理治疗方面接受过极少培训的初级保健医生用于管理成年患者的抑郁症。
检索了1996年至2007年的MEDLINE、1980年至2007年的EMBASE以及1999年至2007年的循证医学综述。
使用特定标准选择了几项随机对照试验。随后对所选文章进行评估和定性分析。
在8项研究中的6项（P < 0.05）中，使用各种简短干预措施和正式对照组的情况下，抑郁症量表有显著改善。成功的干预措施包括阅读疗法、基于认知行为疗法（CBT）的网站以及基于CBT的计算机程序。当干预措施更短、结构更严谨且包括研究人员的频繁联系或提醒时，完成率最高。有效性的局限性包括样本量小、研究未设盲以及普遍适用性程度不确定。
阅读疗法、基于CBT的网站以及基于CBT的计算机程序可能有助于在心理治疗方面接受过极少培训的初级保健医生治疗成年抑郁症患者。医护人员与接受这些干预措施的患者接触可能会提高有效性。该领域未来有必要进行研究，尽管存在一些局限性，但本研究的结果有助于指导此类研究的开发和评估工作。
