Chowdhary N, Jotheeswaran A T, Nadkarni A, Hollon S D, King M, Jordans M J D, Rahman A, Verdeli H, Araya R, Patel V
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, and Sangath, India.
Institute of Psychiatry, King's College, London, UK, Public Health Foundation of India, and Sangath, India.
Psychol Med. 2014 Apr;44(6):1131-46. doi: 10.1017/S0033291713001785. Epub 2013 Jul 19.
Cultural adaptations of evidence-based psychological treatments (PTs) are important to enhance their universal applicability. The aim of this study was to review systematically the literature on adaptations of PTs for depressive disorders for ethnic minorities in Western countries and for any population in non-Western countries to describe the process, extent and nature of the adaptations and the effectiveness of the adapted treatments.
Controlled trials were identified using database searches, key informants, previous reviews and reference lists. Data on the process and details of the adaptations were analyzed using qualitative methods and meta-analysis was used to assess treatment effectiveness.
Twenty studies were included in this review, of which 16 were included in the meta-analysis. The process of adaptation was reported in two-thirds of the studies. Most adaptations were found in the dimensions of language, context and therapist delivering the treatment. The meta-analysis revealed a statistically significant benefit in favor of the adapted treatment [standardized mean difference (SMD) -0.72, 95% confidence interval (CI) -0.94 to -0.49].
Cultural adaptations of PTs follow a systematic procedure and lead primarily to adaptations in the implementation of the treatments rather than their content. Such PTs are effective in the treatment of depressive disorders in populations other than those for whom they were originally developed.
循证心理治疗（PTs）的文化适应对于提高其普遍适用性至关重要。本研究的目的是系统回顾西方国家针对少数民族以及非西方国家针对任何人群的抑郁症PTs适应情况的文献，以描述适应的过程、程度和性质以及适应后治疗的有效性。
通过数据库检索、关键信息提供者、既往综述和参考文献列表来识别对照试验。使用定性方法分析适应过程和细节的数据，并使用荟萃分析评估治疗效果。
本综述纳入了20项研究，其中16项纳入了荟萃分析。三分之二的研究报告了适应过程。大多数适应出现在语言、背景和提供治疗的治疗师等维度。荟萃分析显示适应后治疗有统计学意义的益处[标准化均数差（SMD）-0.72，95%置信区间（CI）-0.94至-0.49]。
PTs的文化适应遵循系统程序，主要导致治疗实施方面的适应而非内容方面的适应。此类PTs在治疗抑郁症方面对最初开发对象以外的人群有效。
