School of Psychology, The University of Queensland, Australia; Psychiatry Department, Bahir Dar University, Ethiopia; National Centre for Youth Substance Use Research, The University of Queensland, Australia.
School of Psychology, The University of Queensland, Australia.
J Affect Disord. 2022 Jan 1;296:17-25. doi: 10.1016/j.jad.2021.09.046. Epub 2021 Sep 20.
Depression is one of the prevalent mental illnesses and leading cause of global disease burden. However, most people with depression do not access treatment. Remission without treatment may occur in some cases of depression. This study aimed to estimate the short-term remission (natural recovery) from untreated depression.
A systematic review and meta-analysis was registered on PROSPERO and conducted following PRISMA guidelines. EMBASE, PsycINFO, and PubMed were searched, supplemented with an additional hand search to identify studies reporting natural recovery from untreated depression. Study selection and screening were carried out by three independent reviewers. Methodological quality assessment of the included studies was conducted. Remission was defined as no longer meeting the diagnostic criteria or scoring below the cut off points of the validated tools as reported by the included studies. The data were synthesized using narrative summary and random-effects meta-analysis.
Sixteen waitlist-controlled trial studies were included in the systematic review and meta-analysis. The duration of follow-up ranged from 4 to 12 weeks with a median duration of 8 weeks. The overall pooled remission from untreated depression was 12.5%, 95% confidence interval (7.8, 18.0%). Due to lack of published data, we were unable to determine if the severity of depression symptoms was associated with remission rates.
Short-term remission from depression without treatment is uncommon. Across studies, 8 - 18% of people remitted without treatment within 12 weeks. Waitlist control groups may not represent all persons with depression.
抑郁症是一种常见的精神疾病，也是导致全球疾病负担的主要原因之一。然而，大多数抑郁症患者并未接受治疗。在某些情况下，未经治疗的抑郁症可能会自行缓解。本研究旨在评估未经治疗的抑郁症的短期缓解（自然康复）情况。
本研究在 PROSPERO 上进行了系统评价和荟萃分析，并遵循 PRISMA 指南进行。检索了 EMBASE、PsycINFO 和 PubMed，并进行了额外的手工搜索，以确定报告未经治疗的抑郁症自然康复的研究。由三名独立评审员进行研究选择和筛选。对纳入研究的方法学质量进行了评估。缓解定义为不再符合诊断标准或低于纳入研究报告的经过验证的工具的截止值。使用叙述性总结和随机效应荟萃分析综合数据。
系统评价和荟萃分析共纳入了 16 项等待对照试验研究。随访时间从 4 周到 12 周不等，中位数为 8 周。未经治疗的抑郁症总体缓解率为 12.5%，95%置信区间（7.8，18.0%）。由于缺乏已发表的数据，我们无法确定抑郁症状的严重程度是否与缓解率相关。
未经治疗的抑郁症在短期内自行缓解并不常见。在各项研究中，未经治疗的患者在 12 周内缓解的比例为 8-18%。等待对照组可能无法代表所有抑郁症患者。
