Driessen Ellen, Cohen Zachary D, Weissman Myrna M, Markowitz John C, Weitz Erica S, Hollon Steven D, Browne Dillon T, Rucci Paola, Corda Carolina, Menchetti Marco, Bagby R Michael, Quilty Lena C, O'Hara Michael W, Zlotnick Caron, Pearlstein Teri, Blom Marc B J, Altamura Mario, Gois Carlos, Schneider Lon S, Twisk Jos W R, Cuijpers Pim
Department of Clinical Psychology, Behavioural Science Institute, Radboud University, the Netherlands; and Depression Expertise Center, Pro Persona Mental Health Care, the Netherlands.
Department of Psychiatry, University of California Los Angeles, USA.
BJPsych Open. 2021 Feb 19;7(2):e56. doi: 10.1192/bjo.2021.4.
Antidepressant medication and interpersonal psychotherapy (IPT) are both recommended interventions in depression treatment guidelines based on literature reviews and meta-analyses. However, 'conventional' meta-analyses comparing their efficacy are limited by their reliance on reported study-level information and a narrow focus on depression outcome measures assessed at treatment completion. Individual participant data (IPD) meta-analysis, considered the gold standard in evidence synthesis, can improve the quality of the analyses when compared with conventional meta-analysis.
We describe the protocol for a systematic review and IPD meta-analysis comparing the efficacy of antidepressants and IPT for adult acute-phase depression across a range of outcome measures, including depressive symptom severity as well as functioning and well-being, at both post-treatment and follow-up (PROSPERO: CRD42020219891).
We will conduct a systematic literature search in PubMed, PsycINFO, Embase and the Cochrane Library to identify randomised clinical trials comparing antidepressants and IPT in the acute-phase treatment of adults with depression. We will invite the authors of these studies to share the participant-level data of their trials. One-stage IPD meta-analyses will be conducted using mixed-effects models to assess treatment effects at post-treatment and follow-up for all outcome measures that are assessed in at least two studies.
This will be the first IPD meta-analysis examining antidepressants versus IPT efficacy. This study has the potential to enhance our knowledge of depression treatment by comparing the short- and long-term effects of two widely used interventions across a range of outcome measures using state-of-the-art statistical techniques.
基于文献综述和荟萃分析,抗抑郁药物和人际心理治疗(IPT)均为抑郁症治疗指南中推荐的干预措施。然而,比较二者疗效的“传统”荟萃分析存在局限性,因为它们依赖所报告的研究层面信息,且仅狭隘地关注治疗结束时评估的抑郁结局指标。个体参与者数据(IPD)荟萃分析被视为证据综合的金标准,与传统荟萃分析相比,它可以提高分析质量。
我们描述了一项系统评价和IPD荟萃分析的方案,该分析将比较抗抑郁药和IPT在一系列结局指标上对成人急性期抑郁症的疗效,这些指标包括治疗后及随访时的抑郁症状严重程度、功能状况和幸福感(国际前瞻性系统评价注册库:CRD42020219891)。
我们将在PubMed、PsycINFO、Embase和Cochrane图书馆进行系统的文献检索,以识别比较抗抑郁药和IPT在成人抑郁症急性期治疗中的随机临床试验。我们将邀请这些研究的作者分享其试验的参与者层面数据。将使用混合效应模型进行单阶段IPD荟萃分析,以评估至少在两项研究中评估的所有结局指标在治疗后及随访时的治疗效果。
这将是第一项比较抗抑郁药与IPT疗效的IPD荟萃分析。本研究有可能通过使用最先进的统计技术,比较两种广泛使用的干预措施在一系列结局指标上的短期和长期效果,从而增强我们对抑郁症治疗的认识。