School of Psychology, Deakin University, Burwood, VIC, Australia.
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Psychother Res. 2019 Oct;29(7):870-881. doi: 10.1080/10503307.2018.1497215. Epub 2018 Jul 13.
Dropout is one factor that might limit the effectiveness of interpersonal psychotherapy (IPT). Improved understanding of IPT dropout is an important research priority. This meta-analysis examined dropout rates from IPT in randomized controlled trials. Seventy-two trials met inclusion criteria. The weighted mean dropout rate from IPT was 20.6% (95% CI = 17.4-24.2). Dropout rates were similar for depressive (20.9%; 95% CI = 17.2-25.2), anxiety (16.1%; 95% CI = 11.1-22.9), and eating disorders (18.7%; 95% CI = 11.6-28.8). Dropout was highest when more stringent definitions of dropout were applied (e.g., failure to complete the entire IPT protocol versus failure to complete at least 50% of sessions) and was lowest when adolescent patients were sampled. There was some evidence that IPT was associated with significantly lower rates of dropout than both CBT and non-specific supportive therapies. These effects were generally replicated when analysing trials that provided a clear definition of treatment (rather than study) dropout. Overall, findings provide preliminary evidence to suggest that IPT may be an accepted and tolerated treatment option for patients with common mental health disorders. This review also highlights the need for future trials to rigorously report detail pertaining to patient dropout.
脱落是限制人际心理治疗（IPT）效果的一个因素。更好地了解 IPT 脱落是一个重要的研究重点。本荟萃分析检查了随机对照试验中 IPT 的脱落率。72 项试验符合纳入标准。IPT 的加权平均脱落率为 20.6%（95%CI=17.4-24.2）。抑郁（20.9%；95%CI=17.2-25.2）、焦虑（16.1%；95%CI=11.1-22.9）和饮食障碍（18.7%；95%CI=11.6-28.8）的脱落率相似。当采用更严格的脱落定义（例如，未能完成整个 IPT 方案与未能完成至少 50%的疗程）时，脱落率最高，当取样青少年患者时，脱落率最低。有一些证据表明，IPT 与 CBT 和非特异性支持性治疗相比，脱落率显著降低。当分析提供明确治疗（而非研究）脱落定义的试验时，这些效果得到了普遍验证。总体而言，研究结果初步表明，IPT 可能是常见精神健康障碍患者可接受和耐受的治疗选择。本综述还强调了未来试验需要严格报告与患者脱落相关的详细信息的必要性。
