MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
School of Clinical Medicine, University of Cambridge, Cambridge, UK.
BMJ Open. 2019 Jun 12;9(6):e031110. doi: 10.1136/bmjopen-2019-031110.
Cognitive behavioural therapies (CBTs) are one of the most effective treatments for major depression. However, ~50% of individuals do not adequately respond to intervention and of those who do remit from a depressive episode, over 50% will experience later relapse. Identification of patient-level factors which moderate treatment response may ultimately help to identify cognitive barriers that could be targeted to improve treatment efficacy. This individual patient data meta-analysis explores one such potential moderator-the ability to retrieve specific, detailed memories of the autobiographical past-as cognitive-based therapeutic techniques draw heavily on the ability to use specific autobiographical information to challenge the dysfunctional beliefs which drive depression.
We have formed a collaborative network which will contribute known datasets. This will be supplemented by datasets identified through literature searches in Medline, PsycInfo, Web of Science, the Cochrane Central Register of Controlled Trials and WHO trials database between December 2018 and February 2019. Inclusion criteria are delivery of a cognitive or cognitive behavioural therapy for major depression, and measurement of autobiographical memory retrieval at preintervention. Primary outcomes are depressive symptoms and clinician-rated diagnostic status at postintervention, along with autobiographical memory specificity at postintervention. Secondary outcomes will consider each of these variables at follow-up. All analyses will be completed using random-effects models employing restricted maximum likelihood estimation. Risk of bias in included studies will be measured using the Revised Cochrane Risk of Bias Tool.
The findings will be published in a peer-reviewed journal. Study results will contribute to better understanding of the role of autobiographical memory in patient response to CBTs, and may help to inform personalised medicine approaches to treatment of depression.
CRD42018109673.
认知行为疗法(CBT)是治疗重度抑郁症最有效的方法之一。然而,约有 50%的患者对干预措施反应不足,而那些从抑郁发作中缓解的患者中,超过 50%的患者会在后期复发。识别调节治疗反应的患者个体因素可能最终有助于确定认知障碍,从而改善治疗效果。这项个体患者数据的荟萃分析探讨了一个这样的潜在调节因素——检索自传体过去具体、详细记忆的能力——因为基于认知的治疗技术主要依赖于使用特定自传体信息来挑战驱动抑郁的功能失调信念。
我们已经组建了一个合作网络,该网络将提供已知的数据集。此外,我们还将通过在 2018 年 12 月至 2019 年 2 月期间在 Medline、PsycInfo、Web of Science、Cochrane 中央对照试验注册中心和世界卫生组织试验数据库中进行文献检索,确定数据集。纳入标准是提供认知或认知行为治疗重度抑郁症,并在干预前测量自传体记忆检索。主要结局是干预后抑郁症状和临床诊断状态,以及干预后自传体记忆特异性。次要结局将考虑随访时的每个变量。所有分析都将使用随机效应模型,采用受限极大似然估计。纳入研究的偏倚风险将使用修订后的 Cochrane 偏倚风险工具进行评估。
研究结果将发表在同行评议的期刊上。研究结果将有助于更好地理解自传体记忆在患者对 CBT 反应中的作用,并可能有助于为抑郁症的个性化医学治疗方法提供信息。
PROSPERO 注册号:CRD42018109673。