Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Worldviews Evid Based Nurs. 2012 Feb;9(1):2-17. doi: 10.1111/j.1741-6787.2011.00229.x. Epub 2011 Dec 16.
The goals of the meta-analysis were to investigate the overall effectiveness of cognitive behavioral group therapy (CBGT) for depression and relapse prevention in depression from 2000 to 2010, and to investigate how the variables (episode, residual symptoms, group size, control group, group manual, therapist experience, therapy frequency, session length, and take-home assignment) of a CBGT study could affect the effect size.
This study collected actual study designs sought of CBGT for depression published from 2000 to 2010. These studies were then cross-referenced using Medical Subject Headings (MeSH) with the following keywords: group therapy, cognitive therapy, cognitive behavioral therapy, cognitive behavioral group therapy, psychotherapy, depression, relapse, and recurrence. The quality of the studies was evaluated using Cochrane Collaboration Guidelines. The effect size of CBGT on depression and relapse prevention in depression used the formula devised by Hedges and Olkin (1985).
The study investigated the results of 32 studies on the effect of CBGT for depression. The CBGT had an immediate (g=-0.40) and continuous effect over 6 months (g=-0.38), but no continuous effect after 6 months (g=-0.06). The CBGT lowered the relapse rate of depression (RD = 0.16). Variables significantly different from each other in terms of immediate effect were: CBGT versus usual care, therapy sessions lasting longer than 1 hour, and take-home assignments. Preintervention severity of depression and patient turnover rate were found to be significantly related to the size of the immediate effect. The relapse rate after 6 months was significantly related only to "participants have no residual symptoms/participants did not mention residual symptoms."
Researchers and clinicians should take note that CBGT had a moderate effect on the level of depression and a small effect on the relapse rate of depression. The results of this study suggest that the patient should receive a course of therapy at least every 6 months.
本荟萃分析的目的在于调查 2000 年至 2010 年间认知行为团体治疗(CBGT)对抑郁症的总体疗效及预防复发的效果,并探讨 CBGT 研究中的变量(发作、残留症状、团体规模、对照组、团体手册、治疗师经验、治疗频率、疗程和家庭作业)如何影响效应大小。
本研究收集了 2000 年至 2010 年间发表的有关 CBGT 治疗抑郁症的真实研究设计。然后使用医学主题词(MeSH)与以下关键字交叉引用这些研究:团体治疗、认知疗法、认知行为疗法、认知行为团体疗法、心理疗法、抑郁症、复发和再发。使用 Cochrane 协作组指南评估研究质量。使用 Hedges 和 Olkin(1985)设计的公式评估 CBGT 对抑郁症和预防抑郁症复发的效果大小。
本研究调查了 32 项关于 CBGT 治疗抑郁症效果的研究结果。CBGT 对抑郁症具有即刻(g=-0.40)和持续 6 个月的效果(g=-0.38),但 6 个月后无持续效果(g=-0.06)。CBGT 降低了抑郁症的复发率(RD=0.16)。即刻效果差异有统计学意义的变量分别为:CBGT 与常规护理、疗程超过 1 小时、家庭作业。抑郁的预干预严重程度和患者周转率与即刻效果的大小显著相关。仅在 6 个月后复发率与“参与者无残留症状/参与者未提及残留症状”显著相关。
研究人员和临床医生应注意,CBGT 对抑郁症的严重程度有中度影响,对抑郁症的复发率有较小影响。本研究结果提示患者至少每 6 个月应接受一次疗程治疗。