Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet.
Psychol Bull. 2017 Mar;143(3):321-325. doi: 10.1037/bul0000055.
Cognitive-behavioral therapy (CBT) has a solid evidence base as an effective treatment for depression. However, a recent meta-analysis (Johnsen & Friborg, 2015) including 70 studies, showed that the effect sizes of CBT for depression have been falling between 1977 and 2014. A possible important limitation in the Johnsen and Friborg (2015) study was that they did not investigate a leveling off in the decline over time of the effectiveness of CBT for depression. We therefore reanalyzed the data reported by Johnsen and Friborg (2015) using meta-analytic regression models that allowed for a curvilinear effect of publication year and also modeled separate estimates of the decline of treatment effect before and after 1995. Our analyses showed that adding a quadratic effect of time to a linear effect of time significantly improved the meta-analytic regression models (p = .017-.027). Furthermore, significant declines were only observed between 1977 and 1995 (p = .001-.009) and not between 1995 to 2014 (p = .987-.785). We conclude that the declining effect of CBT for depression observed by Johnsen and Friborg (2015) was highly influenced by 22 studies published before 1995 and that the 48 studies published after 1995 did not demonstrate such a decline. Thus, there are no indications that CBT for depression is gradually losing its value. (PsycINFO Database Record
认知行为疗法（CBT）作为一种有效的抑郁症治疗方法，具有坚实的证据基础。然而，最近的一项荟萃分析（Johnsen 和 Friborg，2015）包括 70 项研究，显示 CBT 治疗抑郁症的效果大小在 1977 年至 2014 年间一直在下降。Johnsen 和 Friborg（2015）研究的一个可能重要限制是，他们没有调查 CBT 治疗抑郁症的效果随时间的推移是否趋于平稳。因此，我们使用允许出版年份呈二次曲线效应的荟萃分析回归模型，重新分析了 Johnsen 和 Friborg（2015）报告的数据，并对 1995 年前和 1995 年后治疗效果下降的单独估计进行了建模。我们的分析表明，向线性时间效应中添加二次时间效应显著改善了荟萃分析回归模型（p =.017-.027）。此外，仅在 1977 年至 1995 年之间观察到显著下降（p =.001-.009），而在 1995 年至 2014 年之间没有观察到下降（p =.987-.785）。我们得出结论，Johnsen 和 Friborg（2015）观察到的 CBT 治疗抑郁症效果下降主要受 1995 年前发表的 22 项研究的影响，而 1995 年后发表的 48 项研究并未显示出这种下降。因此，没有迹象表明 CBT 治疗抑郁症的价值正在逐渐丧失。
