Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany.
BMC Psychiatry. 2010 Nov 23;10:95. doi: 10.1186/1471-244X-10-95.
Chronic depressions represent a substantial part of depressive disorders and are associated with severe consequences. Several studies were performed addressing the effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depressions. Yet, a systematic review comparing the effectiveness of multiple treatment options and considering all subtypes of chronic depressions is still missing.
METHODS/DESIGN: Aim of this project is to summarize empirical evidence on efficacy and effectiveness of treatments for chronic depression by means of a systematic review. The primary objectives of the study are to examine, which interventions are effective; to examine, if any differences in effectiveness between active treatment options exist; and to find possible treatment effect modifiers. Psychotherapeutic, pharmacological, and combined treatments will be considered as experimental interventions and no treatment, wait-list, psychological/pharmacological placebo, treatment as usual, and other active treatments will be seen as comparators. The population of patients will include adults with chronic major depression, dysthymia, double depression, or recurrent depression without complete remission between episodes. Outcomes of the analyses are depressive symptoms, associated consequences, adverse events, and study discontinuation. Only randomized controlled trials will be considered.
Given the high prevalence and serious consequences of chronic depression and a considerable amount of existing primary studies addressing the effectiveness of different treatments the present systematic review may be of high relevance. Special attention will be given to the use of current methodological standards. Findings are likely to provide crucial information that may help clinicians to choose the appropriate treatment for chronically depressed patients.
慢性抑郁症是抑郁症的一个重要组成部分，与严重后果相关。已经有几项研究针对慢性抑郁症的心理治疗、药物治疗和联合治疗的有效性进行了探讨。然而，仍缺乏对多种治疗方案的有效性进行比较并考虑所有慢性抑郁症亚型的系统评价。
方法/设计：本项目旨在通过系统评价总结慢性抑郁症治疗的疗效证据。该研究的主要目的是检验哪些干预措施是有效的；检验是否存在任何有效治疗选择之间的差异；并寻找可能的治疗效果修饰剂。心理治疗、药物治疗和联合治疗将被视为实验性干预措施，而无治疗、等待名单、心理/药物安慰剂、常规治疗和其他有效治疗将被视为对照。研究人群将包括患有慢性重度抑郁症、心境恶劣障碍、双相抑郁或复发性抑郁症但发作间无完全缓解的成年人。分析的结果是抑郁症状、相关后果、不良事件和研究中止。只有随机对照试验才会被考虑。
鉴于慢性抑郁症的高患病率和严重后果，以及大量现有的针对不同治疗方法有效性的主要研究，本系统评价可能具有重要意义。特别关注当前方法学标准的使用。研究结果可能提供关键信息，帮助临床医生为慢性抑郁症患者选择合适的治疗方法。
