a Department of Clinical, Neuro and Developmental Psychology , VU University Amsterdam , Amsterdam , Netherlands.
b Amsterdam Public Health Research Institute , Amsterdam , Netherlands.
Psychother Res. 2019 Jan;29(1):15-29. doi: 10.1080/10503307.2017.1395922. Epub 2017 Nov 7.
A recent report from the US Institute of Medicine indicated that identifying core elements of psychosocial interventions is a key step in successfully bringing evidence-based psychosocial interventions into clinical practice. Component studies have the best design to examine these core elements. Earlier reviews resulted in heterogeneous sets of studies and probably missed many studies.
We conducted a comprehensive search of component studies on psychotherapies for adult depression and included 16 studies with 22 comparisons.
Fifteen components were examined of which four were examined in more than one comparison. The pooled difference between the full treatments and treatments with one component removed was g = 0.21 (95% CI: 0.03∼0.39). One study had sufficient statistical power to detect a small effect size and found that adding emotion regulation skills increased the effects of CBT. None of the other studies had enough power to detect an effect size smaller than g = 0.55. Only one study had low risk of bias.
The currently available component studies do not have the statistical power nor the quality to draw any meaningful conclusion about key ingredients of psychotherapies for adult depression.
美国医学研究所的一份最新报告指出，确定心理社会干预的核心要素是将基于证据的心理社会干预成功引入临床实践的关键步骤。组成研究具有最好的设计来检验这些核心要素。早期的综述导致了研究的异质性，可能遗漏了许多研究。
我们对成人抑郁症心理治疗的组成研究进行了全面检索，包括 16 项研究和 22 项比较。
共检查了 15 个组成部分，其中 4 个在超过 1 项比较中进行了检查。完整治疗与去除一个组成部分的治疗之间的 pooled 差异为 g = 0.21（95%CI：0.03∼0.39）。有一项研究具有足够的统计效力来检测小效应量，发现增加情绪调节技能会增加 CBT 的效果。其他研究均没有足够的效力来检测小于 g = 0.55 的效应量。只有一项研究的偏倚风险较低。
目前可用的组成研究既没有足够的统计效力，也没有足够的质量来对成人抑郁症心理治疗的关键要素得出任何有意义的结论。
