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心理干预对轻中度抑郁症状青年的疗效:荟萃分析。

Efficacy of psychological interventions for young adults with mild-to-moderate depressive symptoms: A meta-analysis.

机构信息

Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.

School of Psychology, Universidad de Las Américas, Quito, Ecuador.

出版信息

J Psychiatr Res. 2022 Aug;152:366-374. doi: 10.1016/j.jpsychires.2022.06.034. Epub 2022 Jun 23.

Abstract

BACKGROUND

Psychological interventions are commonly used to treat mild-to-moderate depression, but their efficacy in young adults has not been exhaustively addressed. This meta-analysis aims to establish it in comparison to no treatment, wait-list, usual treatment, passive interventions, and other bona-fide treatments.

METHODS

The search was conducted in Scopus, MEDLINE, PsycINFO, ClinicalTrials.gov, the ISRCTN Registry, Cochrane CENTRAL, Clarivate BIOSIS Previews and the METAPSY database, retrieving studies from the start of records to April 2020. Eligibility criteria included samples of 16-30 years experiencing mild-to-moderate depressive symptoms and participating in randomized controlled trials (RCTs), non-RCTs, or pre-post studies measuring depressive symptomatology and featuring psychological treatments.

RESULTS

Up to 45 studies met criteria, consisting of 3,947 participants, assessed using the Quality Assessment Tool for Quantitative Studies and their results meta-analyzed assuming random effects. Psychological interventions proved to be efficacious in RCTs compared to no treatment (g = -0.68; 95% CI = -0.87, -0.48) and wait-list (g = -1.04; 95% CI = -1.25, -0.82), while depressive symptoms also improved in pre-post studies (g = -0.99; 95% CI = -1.32, -0.66). However, intervention efficacy was similar to usual care, passive, and bona-fide comparators. The heterogeneity found, a likely reporting bias and the low quality of most studies must be considered when interpreting these results.

CONCLUSIONS

Psychological treatments are efficacious to reduce depressive symptoms in young adults, but comparable to other interventions in the mild-to-moderate range. Moderators like depression severity or therapist involvement significantly influenced their efficacy, with results encouraging clinicians to adopt flexible and personalized approaches.

摘要

背景

心理干预常用于治疗轻度至中度抑郁症,但它们在年轻人中的疗效尚未得到充分研究。本荟萃分析旨在将其与不治疗、等待名单、常规治疗、被动干预和其他真实治疗进行比较。

方法

在 Scopus、MEDLINE、PsycINFO、ClinicalTrials.gov、ISRCTN 注册处、Cochrane 中央、Clarivate BIOSIS Previews 和 METAPSY 数据库中进行检索,从记录开始到 2020 年 4 月检索研究。纳入标准为年龄在 16-30 岁之间、有轻度至中度抑郁症状、参加随机对照试验(RCT)、非 RCT 或前后测研究、测量抑郁症状并采用心理治疗的样本。

结果

共有 45 项研究符合标准,共纳入 3947 名参与者,采用定量研究质量评估工具进行评估,并采用随机效应模型进行荟萃分析。与不治疗(g=-0.68;95%置信区间(CI)=-0.87,-0.48)和等待名单(g=-1.04;95%CI=-1.25,-0.82)相比,心理干预在 RCT 中有效,前后测研究也显示抑郁症状改善(g=-0.99;95%CI=-1.32,-0.66)。然而,干预效果与常规护理、被动和真实对照相当。在解释这些结果时,必须考虑到发现的异质性、可能存在的报告偏倚以及大多数研究的低质量。

结论

心理治疗对减轻年轻人的抑郁症状有效,但在轻度至中度范围内与其他干预措施相当。严重程度或治疗师参与等调节因素显著影响其疗效,结果鼓励临床医生采用灵活和个性化的方法。

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