Durham VA MIRECC and Duke University Medical Center, USA.
Int J Psychiatry Med. 2012;43(2):129-51. doi: 10.2190/PM.43.2.c.
Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < or =8 sessions) for depression.
We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms.
We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from -0.33 to -0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES -0.42, 95% CI -0.74 to -0.10, 12 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES -0.24, 95% CI -0.42 to -0.06, 12 = 0%).
Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.
由于 12 到 20 次的基于证据的心理治疗可能被认为对于初级保健中的抑郁症治疗过于冗长和耗时，因此许多研究都探讨了缩短心理治疗方案。本研究旨在进行系统评价和荟萃分析，以确定简短心理治疗（即 < 或 = 8 次）对抑郁症的疗效。
我们使用联合文献检索在 PubMed、EMBASE、PsycINFO 和互联网上可获取的心理治疗临床试验数据库进行了两次系统搜索：一次是针对现有系统评价，另一次是针对随机对照试验（RCT）。纳入的研究评估了八次或更少次数的基于证据的心理治疗，针对成年人抑郁症，包含可接受的对照条件，以英文发表，并使用经过验证的抑郁症状测量工具。
我们保留了 2 项系统评价和 15 项 RCT，评估认知行为疗法、问题解决疗法和正念认知疗法。系统评价发现简短心理疗法比对照更有效，效应大小范围从 -0.33 到 -0.25。我们的荟萃分析发现认知行为疗法六到八次比对照更有效（ES -0.42，95% CI -0.74 至 -0.10，12 = 56%）。敏感性分析控制了统计学异质性，但显示出较小的治疗效果（ES -0.24，95% CI -0.42 至 -0.06，12 = 0%）。
抑郁症可以通过六到八次的心理治疗有效治疗，特别是认知行为疗法和问题解决疗法。通过培训医疗保健提供者提供简短心理治疗，可以改善非药物治疗抑郁症的途径。
