Pro Persona Overwaal Centre for anxiety, OCD and PTSD, Nijmegen, The Netherlands.
Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
Br J Clin Psychol. 2022 Sep;61(3):579-597. doi: 10.1111/bjc.12324. Epub 2021 Jul 23.
We reviewed the evidence regarding the effectiveness of schema therapy for anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD).
This systematic review followed the recommendation of the PRISMA guidelines. A database search (PsycINFO, MEDLINE, EMBASE, WEB OF SCIENCE, and Academic Search Ultimate) was conducted to identify eligible studies up until 2 April 2021. The search included the keywords ('schema therap*' or 'schema group therap*' or 'schema mode therap*' or 'schema focused' or 'young's model') and ('anxiety disorder*' or 'anxiety-related disorder*' or 'agoraphobia' or 'health anxiety' or 'phobi*' or 'panic disorder' or 'obsessive compulsive disorder' or 'OCD' or 'posttraumatic stress' or 'post traumatic stress' or 'PTSD' or 'hypochondria' or 'axis 1'). Included studies were appraised on methodological quality according to the Psychotherapy Outcome study Methodology Rating Form.
We identified 41 studies that were eligible based on the topic. However, only six (comprising 316 anxiety, OCD, and PTSD patients) could be included despite lenient methodological inclusion/exclusion criteria. Results showed that schema therapy can lead to beneficial effects in disorder-specific symptoms and early maladaptive schemas. Yet, we also uncovered substantial methodological limitations in most studies.
Schema therapy is a promising treatment for anxiety, OCD, and PTSD. Yet, there is a systematic problem in the quality of research despite growing clinical interest and application. We therefore concluded with a research agenda presenting recommendations for future research that will be crucial for building a solid evidence-base for schema therapy in chronic anxiety, OCD, and PTSD.
A systematic review on the effectiveness of schema therapy for anxiety disorders, OCD, and PTSD. Preliminary but limited evidence that schema therapy leads to beneficial effects in disorder-specific symptoms. Preliminary but limited evidence that schema therapy leads to beneficial effects in early maladaptive schemas in anxiety, OCD, and PTSD. More research of higher methodological quality is needed to provide more conclusive empirical support for the use of schema therapy for anxiety, OCD, and PTSD.
我们回顾了关于图式治疗对焦虑障碍、强迫症（OCD）和创伤后应激障碍（PTSD）的有效性的证据。
本系统评价遵循 PRISMA 指南的建议。通过数据库搜索（PsycINFO、MEDLINE、EMBASE、WEB OF SCIENCE 和 Academic Search Ultimate），截至 2021 年 4 月 2 日，确定了合格的研究。搜索包括关键词（“schema therap*”或“schema group therap*”或“schema mode therap*”或“schema focused”或“young's model”）和（“anxiety disorder*”或“anxiety-related disorder*”或“agoraphobia”或“health anxiety”或“phobi*”或“panic disorder”或“obsessive compulsive disorder”或“OCD”或“posttraumatic stress”或“post traumatic stress”或“PTSD”或“hypochondria”或“axis 1”）。根据心理治疗结果研究方法学评分表，对纳入研究的方法学质量进行了评估。
根据主题，我们确定了 41 项符合条件的研究。然而，尽管采用了宽松的方法学纳入/排除标准，仅有六项（包括 316 例焦虑、OCD 和 PTSD 患者）研究可以纳入。结果表明，图式治疗可以导致特定疾病症状和早期适应不良模式的有益效果。然而，我们也在大多数研究中发现了实质性的方法学局限性。
图式治疗是治疗焦虑、OCD 和 PTSD 的一种有前途的方法。然而，尽管临床关注度和应用不断增加，但研究质量仍然存在系统性问题。因此，我们总结了一个研究议程，提出了未来研究的建议，这对建立图式治疗在慢性焦虑、OCD 和 PTSD 中的坚实证据基础至关重要。
焦虑障碍、强迫症和创伤后应激障碍的图式治疗有效性的系统评价。初步但有限的证据表明，图式治疗可导致特定疾病症状的有益效果。初步但有限的证据表明，图式治疗可导致焦虑、强迫症和创伤后应激障碍中早期适应不良模式的有益效果。需要更多方法学质量更高的研究，为焦虑、强迫症和创伤后应激障碍中使用图式治疗提供更具结论性的实证支持。
