Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, PO Box 123 Broadway, Ultimo, NSW 2007, Australia.
Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, PO Box 123 Broadway, Ultimo, NSW 2007, Australia.
J Affect Disord. 2021 Jul 1;290:128-135. doi: 10.1016/j.jad.2021.04.067. Epub 2021 May 3.
Hoarding disorder (HD) is a new disorder in DSM-5. While cognitive-behavioral therapy (CBT) is seen as the gold standard approach to treatment, the literature in this field is still emerging.
The aim of the present study is to synthesize the current treatment outcome literature on CBT for HD, as well as secondary depressive symptoms, using a meta-analytic approach. Due to a lack of controlled trials only within-group effect sizes were calculated.
Sixteen studies were included in the meta-analysis (n = 505; mean age = 56 years; mean percentage female participants = 72%). Large effect sizes were found from pre-treatment to post-treatment (g = 1.11; 95% CI: 0.92-1.29) and from pre-treatment to follow-up (g = 1.25; 95% CI: 0.94-1.56) on HD symptoms. The gender distribution of the sample moderated treatment outcome, with larger effects seen in studies that included a larger proportion of female patients. Treatment modality (individual vs group), therapist training, use of home visits, trial type (efficacy vs effectiveness), number of treatment weeks, participant age, and study quality did not moderate treatment outcome. Small effect sizes were found from pre-treatment to post-treatment (g = 0.45; 95% CI: 0.28-0.61) for depressive symptoms and baseline depression severity, treatment modality, use of home visits, and assessment tool used did not moderate outcome.
The study is limited by the small number of studies available in this field.
This study demonstrates that CBT for HD is an effective treatment, however, controlled trials are needed, as are trials examining the long-term efficacy of CBT for HD.
囤积障碍（HD）是 DSM-5 中的一种新障碍。虽然认知行为疗法（CBT）被视为治疗的金标准方法，但该领域的文献仍在不断涌现。
本研究旨在通过元分析方法综合目前关于 CBT 治疗 HD 以及次要抑郁症状的治疗效果文献。由于缺乏对照试验，仅计算了组内效应量。
共有 16 项研究纳入元分析（n=505；平均年龄=56 岁；平均女性参与者比例=72%）。从治疗前到治疗后（g=1.11；95%置信区间：0.92-1.29）和从治疗前到随访（g=1.25；95%置信区间：0.94-1.56），HD 症状的效应量较大。样本中的性别分布调节了治疗效果，在纳入更多女性患者的研究中，效果更大。治疗方式（个体与团体）、治疗师培训、家庭访视的使用、试验类型（疗效与有效性）、治疗周数、参与者年龄和研究质量均未调节治疗效果。治疗前到治疗后的抑郁症状和基线抑郁严重程度（g=0.45；95%置信区间：0.28-0.61）的效应量较小，治疗方式、家庭访视的使用和评估工具的使用也未调节结果。
本研究受该领域可用研究数量较少的限制。
本研究表明，CBT 治疗 HD 是一种有效的治疗方法，但需要进行对照试验，以及检验 CBT 治疗 HD 的长期疗效的试验。
