Papola Davide, Ostuzzi Giovanni, Gastaldon Chiara, Purgato Marianna, Del Giovane Cinzia, Pompoli Alessandro, Karyotaki Eirini, Sijbrandij Marit, Furukawa Toshi A, Cuijpers Pim, Barbui Corrado
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences; Section of Psychiatry, University of Verona, Verona, Italy
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation; Department of Neuroscience, Biomedicine and Movement Sciences; Section of Psychiatry, University of Verona, Verona, Italy.
BMJ Open. 2020 Dec 28;10(12):e038909. doi: 10.1136/bmjopen-2020-038909.
Panic disorder is among the most prevalent anxiety diseases. Although psychotherapy is recommended as first-line treatment for panic disorder, little is known about the relative efficacy of different types of psychotherapies. Moreover, there is little evidence concerning the effectiveness of different formats of major psychotherapeutic types, such as cognitive-behavioural therapy (CBT). In this protocol, we present an overarching project consisting of two systematic reviews and network meta-analyses (NMA) to shed light on which psychotherapy (NMA-1), and specifically, which CBT delivery format (NMA-2) should be considered most effective for adults suffering from panic disorder with or without agoraphobia.
Starting from a common pool of data, we will conduct two systematic reviews and NMA of randomised controlled trials examining panic disorder. A comprehensive search will be performed in electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Register of Controlled Trials-CENTRAL from database inception to 1 January 2021 to identify relevant studies. A systematic approach to searching, screening, reviewing and data extraction will be applied. Titles, abstract and-whenever necessary-full texts will be examined independently by at least two reviewers. The quality of the included studies will be assessed using the revised Cochrane risk of bias tool V.2. The primary efficacy outcome will be anxiety symptoms at study endpoint. The primary acceptability outcome will be all-cause discontinuation, as measured by the proportion of patients who had discontinued treatment for any reason at endpoint. Data will be pooled using a random-effects model. Pairwise and NMA will be conducted.
No ethical approval is necessary for these two studies, as there will be no collection of primary data. The results will be disseminated through peer-reviewed publications and presentations at national and international conferences and meetings.
惊恐障碍是最常见的焦虑症之一。尽管心理治疗被推荐为惊恐障碍的一线治疗方法，但对于不同类型心理治疗的相对疗效知之甚少。此外，关于主要心理治疗类型的不同形式（如认知行为疗法（CBT））的有效性，几乎没有证据。在本方案中，我们提出了一个总体项目，包括两项系统评价和网络荟萃分析（NMA），以阐明哪种心理治疗方法（NMA-1），特别是哪种CBT实施形式（NMA-2）对于患有或不患有广场恐惧症的惊恐障碍成人患者最为有效。
从一个共同的数据集出发，我们将对检查惊恐障碍的随机对照试验进行两项系统评价和NMA。将在电子数据库MEDLINE、Embase、PsycINFO以及Cochrane对照试验注册中心CENTRAL中进行全面检索，检索范围从数据库建立至2021年1月1日，以识别相关研究。将应用一种系统的检索、筛选、评审和数据提取方法。标题、摘要以及必要时的全文将由至少两名评审员独立审查。将使用修订后的Cochrane偏倚风险工具V.2评估纳入研究的质量。主要疗效结局将是研究终点时的焦虑症状。主要可接受性结局将是全因停药，以终点时因任何原因停止治疗的患者比例来衡量。数据将使用随机效应模型进行汇总。将进行成对分析和NMA。
这两项研究无需伦理批准，因为不会收集原始数据。研究结果将通过同行评审的出版物以及在国内和国际会议上的报告进行传播。
