Department of Psychiatry, Chethana Trust, Mysore, Karnataka, India.
Holdsworth Memorial Hospital Mandi Mohalla, Mysore, Karnataka, India ; Department of Biostatistics, University of Edgehill, Lancashire, UK.
Indian J Psychiatry. 2013 Oct;55(4):323-30. doi: 10.4103/0019-5545.120541.
Studies investigating effectiveness of group psychotherapy intervention in depression in persons with HIV have showed varying results with differing effect sizes. A systematic review of randomized controlled trials of group psychotherapy in depression in persons with HIV has been conducted to present the best available evidence in relation to its effect on depressive symptomatology. Electronic databases were searched to identify randomized controlled trials. Selected studies were quality assessed and data extracted by two reviewers. If feasible, it was planned to conduct a meta-analysis to obtain a pooled effect size of group psychotherapeutic interventions on depressive symptoms. Odds ratio for drop out from group was calculated. The studies were assessed for their quality using the Quality Rating Scale and other parameters for quality assessment set out by COCHRANE. The quality of reporting of the trials was compared against the Consolidated Standards of Reporting Trials (CONSORT) checklist for non-pharmacological studies (CONSORT-NPT). Four studies met the full inclusion criteria for systematic review. The trials included in the review examined group interventions based on the Cognitive behavioral therapy model against other therapeutic interventions or waiting list controls. In all four studies, group psychotherapy was an effective intervention for reducing depressive symptoms in persons with HIV in comparison to waiting list controls. The reported benefits from the group psychotherapy in comparison to active controls were less impressive. There were no statistically significant differences in drop outs at post treatments across group psychotherapy, wait list control, and other active interventions. The methodological quality of the studies varied. The quality of reporting of the studies was sub-optimal. The results of this systematic review support that group psychological interventions for depression in persons with HIV have a significant effect on depressive symptomatology. This review also indicates that group cognitive behavioral therapies are an acceptable psychological intervention for persons with HIV and comorbid depression.
研究表明，团体心理治疗干预对 HIV 感染者的抑郁症状的有效性存在不同的结果和不同的效果大小。本系统评价旨在通过对 HIV 感染者抑郁的团体心理治疗的随机对照试验进行综合评估，为其在抑郁症状上的疗效提供最佳的现有证据。检索电子数据库以确定随机对照试验。由两名评审员对选定的研究进行质量评估和数据提取。如果可行，计划进行荟萃分析以获得团体心理治疗干预对抑郁症状的综合效应大小。计算团体脱落的比值比。使用 Quality Rating Scale 以及 COCHRANE 制定的其他质量评估参数评估研究的质量。根据非药物研究的 CONSORT 清单（CONSORT-NPT）比较试验报告的质量。四项研究完全符合系统评价的纳入标准。纳入的试验研究了基于认知行为疗法模型的团体干预与其他治疗干预或等待名单对照。在所有四项研究中，与等待名单对照相比，团体心理治疗是一种有效的干预措施，可以减轻 HIV 感染者的抑郁症状。与积极对照相比，团体心理治疗的报告益处不那么明显。在团体心理治疗、等待名单对照和其他积极干预措施的治疗后，脱落率没有统计学差异。研究的方法学质量各不相同。研究报告的质量不理想。本系统评价的结果支持团体心理干预对 HIV 感染者的抑郁有显著的疗效。该综述还表明，团体认知行为疗法是一种可接受的针对 HIV 感染者和合并抑郁的心理干预措施。
