Leicestershire Partnership NHS Trust, Leicester, UK.
Liverpool Reviews and Implementation Group, Department of Health Data Science, University of Liverpool, Liverpool, UK.
Acta Psychiatr Scand. 2021 Jan;143(1):6-21. doi: 10.1111/acps.13242. Epub 2020 Oct 27.
To perform a network meta-analysis (NMA) to compare the long-term effectiveness of mindfulness-based cognitive therapy (MBCT) with available strategies for prevention and time to depressive relapse.
Seven electronic databases were searched up to June 2019. Studies evaluated MBCT for the management of depression-related outcomes and follow-up assessments occurred at 12 months or longer.
Twenty-three publications were included, 17 of which were randomised controlled trials (RCTs). Data from 14 RCTs including 2077 participants contributed to meta-analysis (MA) and NMA to assess relapse of depression and 13 RCTs with 2017 participants contributed to MA and NMA for time to relapse of depression. NMAs showed statistically significant advantages for MBCT over treatment as usual (TAU) for relapse of depression (RR = 0.73, 95% CI 0.54 to 0.98) and for MBCT over TAU and placebo for time to relapse of depression (MBCT vs TAU: HR = 0.57, 95% CI 0.37 to 0.88; MBCT vs placebo: HR = 0.23, 95% CI 0.08 to 0.67). Subgroup meta-analysis of relapse of depression by previous number of depressive episodes showed similar results between subgroups. Subgroup meta-analysis by the use or not of booster sessions suggests these may lead to improved effectiveness.
MBCT is more effective than TAU in the long-term in preventing relapse of depression and has statistically significant advantages over TAU and placebo for time to relapse of depression. No statistically significant differences were observed between MBCT and active treatment strategies for rate of relapse or time to relapse of depression.
进行网络荟萃分析（NMA），比较正念认知疗法（MBCT）与现有预防策略在预防抑郁复发和达到抑郁复发时间方面的长期疗效。
检索了 7 个电子数据库，截至 2019 年 6 月。评估 MBCT 用于管理与抑郁相关结局的研究，并在 12 个月或更长时间进行随访评估。
纳入了 23 篇文献，其中 17 篇为随机对照试验（RCT）。来自 14 项 RCT 的数据，包括 2077 名参与者，用于荟萃分析（MA）和 NMA 评估抑郁复发；来自 13 项 RCT 的数据，包括 2017 名参与者，用于 MA 和 NMA 评估抑郁复发时间。NMA 显示，MBCT 与常规治疗（TAU）相比，在抑郁复发方面具有统计学意义上的优势（RR=0.73，95%CI 0.54 至 0.98），在抑郁复发时间方面，MBCT 也优于 TAU 和安慰剂（MBCT 与 TAU：HR=0.57，95%CI 0.37 至 0.88；MBCT 与安慰剂：HR=0.23，95%CI 0.08 至 0.67）。按既往抑郁发作次数进行抑郁复发亚组 MA 分析，结果在各亚组间相似。按是否使用强化疗程进行的亚组 MA 分析提示，这些疗程可能会提高疗效。
MBCT 在预防抑郁复发方面比 TAU 更有效，在达到抑郁复发时间方面，MBCT 与 TAU 和安慰剂相比具有统计学意义上的优势。但在抑郁复发率或达到抑郁复发时间方面，MBCT 与积极治疗策略之间没有观察到统计学上的显著差异。
