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持久抑郁的心理治疗:生活质量和功能结果的系统评价和荟萃分析。

Psychological treatments for persistent depression: A systematic review and meta-analysis of quality of life and functioning outcomes.

机构信息

School of Health and Social Care, University of Essex.

出版信息

Psychotherapy (Chic). 2022 Sep;59(3):447-459. doi: 10.1037/pst0000448. Epub 2022 Jun 27.

Abstract

[Correction Notice: An Erratum for this article was reported in Vol 59(3) of (see record 2022-94545-001). In the article, there were errors in the abstract. The confidence interval in the sentence Quality of life at follow-up: pooled = 0.21 should appear as follows: 95% CI, 0.10-0.32. In the sentence The psychological interventions were associated with improvements in patients' functioning at end-of-treatment, the pooled should appear as = 0.35. The confidence interval in the sentence Functioning at follow-up resulted in: pooled g = 0.33 should appear as follows: 95% CI, 0.15-0.51. Figure 5 also has been corrected. All versions of this article have been corrected.] To date it is unclear whether psychological therapies have potential to improve quality of life and functioning in patients with persistent depression. This meta-analysis examines the effect of psychological therapies for improving quality of life and functioning in patients with persistent forms of depression. Data sources include Medline and Meta-Analytic Psychotherapy Database (METAPSY), searched 07/2021. Eligible studies were randomized controlled trials where participants had major depressive disorder on entry and met criteria for a persistent form of depression, for example, chronic, treatment resistant or recurrent depression. Standardized mean differences (Hedge's g) were calculated in random-effects meta-analyses. Fourteen studies met inclusion criteria ( = 1898). Psychological interventions were associated with improvements in patients' quality of life at the end of treatment: pooled = 0.24 (95% confidence intervals [CIs] 0.13-0.34); low to moderate levels of heterogeneity (² = 0% [95% CI 0%-41.2%]). Quality of life at follow-up: pooled = 0.21 (95% CI 0.01-0.32); low to high levels of heterogeneity considering the wide CI for ² (² = 10.36% [95% CI 0%-77.5%]). The psychological interventions were associated with improvements in patients' functioning at end of treatment: pooled = 0.34 (95% CI 0.21-0.48); low to high levels of heterogeneity considering the wide CI for ² (² = 0% [95% CI 0%-81.7%]). Functioning at follow-up resulted in: pooled = 0.33 (95% CI 0.15-0.50); low to high levels of heterogeneity considering the wide CI for ² (² = 0% [95% CI 0%-86.2%]). This meta-analysis highlights the potential benefits of psychological therapies for improving quality of life and functioning in patients with persistent depression, with strongest long-term effects for mindfulness-based cognitive therapy, interpersonal therapy in combination with antidepression medication, and long-term psychoanalytic psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

[勘误通知:本文的一个勘误报告在 (参见记录 2022-94545-001)的第 59 卷(3)中报告。在本文中,摘要中有错误。句子“生活质量随访:荟萃 = 0.21”中的置信区间应如下所示:95%CI,0.10-0.32。在句子“心理干预与治疗结束时患者功能的改善相关,荟萃 = 0.35”中, 应该出现 = 0.35。句子“随访时的功能结果:荟萃 g = 0.33”中的置信区间应如下所示:95%CI,0.15-0.51。图 5 也已更正。本文的所有版本都已更正。] 迄今为止,尚不清楚心理疗法是否有可能改善持续性抑郁症患者的生活质量和功能。本荟萃分析研究了心理疗法在改善持续性抑郁症患者生活质量和功能方面的效果。数据来源包括 Medline 和 Meta-Analytic Psychotherapy Database(METAPSY),于 2021 年 7 月进行了搜索。符合条件的研究是参与者在进入研究时有重性抑郁障碍且符合持续性抑郁形式标准的随机对照试验,例如慢性、治疗抵抗或复发性抑郁。采用随机效应荟萃分析计算标准化均数差值(Hedge's g)。有 14 项研究符合纳入标准(n = 1898)。心理干预与治疗结束时患者的生活质量改善相关:荟萃 = 0.24(95%置信区间 [CI] 0.13-0.34);低至中度异质性(² = 0% [95% CI 0%-41.2%])。随访时的生活质量:荟萃 = 0.21(95% CI 0.01-0.32);考虑到 ² 的 CI 较宽,异质性从低到高(² = 10.36% [95% CI 0%-77.5%])。心理干预与治疗结束时患者的功能改善相关:荟萃 = 0.34(95% CI 0.21-0.48);考虑到 ² 的 CI 较宽,异质性从低到高(² = 0% [95% CI 0%-81.7%])。随访时的功能结果为:荟萃 = 0.33(95% CI 0.15-0.50);考虑到 ² 的 CI 较宽,异质性从低到高(² = 0% [95% CI 0%-86.2%])。本荟萃分析强调了心理疗法在改善持续性抑郁症患者生活质量和功能方面的潜在益处,正念认知疗法、抗抑郁药物联合人际心理治疗和长期精神分析心理治疗具有最强的长期效果。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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