Evidence-Based Research Center of Social Science & Health, Public Affair School of Nanjing University of Science & Technology, Nanjing 210000, China.
Evidence-Based Research Center of Social Science & Health, Public Affair School of Nanjing University of Science & Technology, Nanjing 210000, China.
J Affect Disord. 2020 Jan 1;260:728-737. doi: 10.1016/j.jad.2019.09.040. Epub 2019 Sep 10.
The aim of this study is to investigate the effectiveness of ACT on depression reduction and further examine the relationship between different follow-up periods, different degree of depression, and different age of patients through subgroup analysis.
Relevant electronic databases were searched from Jan 2010 to Aug 2018, including CNKI, WANFANG, PubMed, EMBASE, Cochrane Library, PsycINFO. Two reviewers independently screened for eligible studies, extracted data, and assessed risk of bias of the included studies. The Cochrane Collaboration's bias assessment tool was used to evaluate the risk of bias for included studies, and Review Manager 5.3 Software for the meta-analysis RESULTS: 18 studies with 1,088 participants were included in the review. Four studies were rated as high-quality studies, and the remaining 14 studies were rated as moderate quality studies. ACT significantly reduced depression as compared with the control group [SMD = 0.59, 95% CI (0.38, 0.81)]. The subgroup analysis found a significant difference between ACT and control group after post-intervention, three months follow up, mild depression group and adults group, [SMD= 0.62, 95% CI (0.35, 0.90), [SMD= 0.55, 95% CI (0.23, 0.87)], [SMD= 0.65, 95% CI (0.40, 0.91)], [SMD= 0.52, 95% CI (0.33, 0.71)] respectively.
The heterogeneity between included studies results in heterogeneity of the results. Most of the specific methods for random sequence generation and allocation concealment were not clear. The search results had limitations since only the published studies in Chinese and English were searched and lacked a search for gray and paper documents.
The current study suggested that ACT was significantly for reducing depressive symptoms compared with the control group, especially at three months of follow-up, adult group and mild depression. More research is needed to investigate the difference effects for minor group, moderate and severe depression and long-term follow-up.
本研究旨在探讨接受认知行为疗法（ACT）对抑郁症的治疗效果，并通过亚组分析进一步探讨不同随访时间、不同抑郁程度和不同年龄患者间的差异。
检索 2010 年 1 月至 2018 年 8 月的相关电子数据库，包括中国知网、万方数据知识服务平台、PubMed、EMBASE、Cochrane 图书馆、PsycINFO。由两位评价者独立筛选合格研究、提取数据，并评价纳入研究的偏倚风险。采用 Cochrane 协作偏倚风险评估工具评价纳入研究的偏倚风险，使用 Review Manager 5.3 软件进行荟萃分析。
共纳入 18 项研究，包含 1088 名参与者。其中 4 项研究被评为高质量研究，其余 14 项研究被评为中等质量研究。与对照组相比，ACT 显著降低了抑郁程度[SMD=0.59，95%CI（0.38，0.81）]。亚组分析发现，在干预后、3 个月随访时、轻度抑郁组和成年组中，ACT 与对照组间存在显著差异[SMD=0.62，95%CI（0.35，0.90）]、[SMD=0.55，95%CI（0.23，0.87）]、[SMD=0.65，95%CI（0.40，0.91）]、[SMD=0.52，95%CI（0.33，0.71）]。
纳入研究结果间存在异质性，导致结果异质性较大。大多数随机序列生成和分配隐藏的具体方法不明确。由于仅检索到中文和英文发表的研究，缺乏对灰色文献和纸质文献的检索，因此搜索结果存在一定局限性。
本研究表明，与对照组相比，ACT 显著降低了抑郁症状，特别是在 3 个月随访时、成年组和轻度抑郁组中。需要进一步研究以探讨其在未成年组、中重度抑郁和长期随访中的差异效果。
