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认知行为疗法的疗效:荟萃分析综述

The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses.

作者信息

Hofmann Stefan G, Asnaani Anu, Vonk Imke J J, Sawyer Alice T, Fang Angela

机构信息

Boston University, Boston, MA.

出版信息

Cognit Ther Res. 2012 Oct 1;36(5):427-440. doi: 10.1007/s10608-012-9476-1. Epub 2012 Jul 31.

Abstract

Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples.

摘要

认知行为疗法(CBT)是一种广受欢迎的治疗方法,已应用于各种问题。本综述的目的是对检验CBT疗效的荟萃分析进行全面调查。我们识别出269项荟萃分析研究,并对其中106项关于CBT针对以下问题的荟萃分析进行了代表性样本回顾:物质使用障碍、精神分裂症及其他精神障碍、抑郁症和心境恶劣障碍、双相情感障碍、焦虑症、躯体形式障碍、进食障碍、失眠、人格障碍、愤怒和攻击行为、犯罪行为、一般压力、因一般医疗状况导致的困扰、慢性疼痛和疲劳、与妊娠并发症及女性荷尔蒙状况相关的困扰。另外的荟萃分析综述检验了CBT对儿童和老年人各种问题的疗效。对焦虑症、躯体形式障碍、贪食症、愤怒控制问题和一般压力的CBT治疗有最有力的支持。11项研究比较了CBT与其他治疗或对照条件之间的反应率。在这些综述中的7项里,CBT显示出比对照条件更高的反应率,只有一项综述报告CBT的反应率低于对照治疗。总体而言,CBT的证据基础非常坚实。然而,需要进一步研究以检验CBT在随机对照研究中的疗效。此外,除了儿童和老年人群体,尚未有关于特定亚组(如少数民族和低收入样本)的CBT荟萃分析研究报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/196d/3584580/63a9ee52a86c/nihms394950f1.jpg

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