Wienicke Frederik J, Beutel Manfred E, Zwerenz Rüdiger, Brähler Elmar, Fonagy Peter, Luyten Patrick, Constantinou Matthew, Barber Jacques P, McCarthy Kevin S, Solomonov Nili, Cooper Peter J, De Pascalis Leonardo, Johansson Robert, Andersson Gerhard, Lemma Alessandra, Town Joel M, Abbass Allan A, Ajilchi Bita, Connolly Gibbons Mary Beth, López-Rodríguez Jaime, Villamil-Salcedo Valerio, Maina Giuseppe, Rosso Gianluca, Twisk Jos W R, Burk William J, Spijker Jan, Cuijpers Pim, Driessen Ellen
Department of Clinical Psychology, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.
Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Clin Psychol Rev. 2023 Apr;101:102269. doi: 10.1016/j.cpr.2023.102269. Epub 2023 Mar 16.
Short-term psychodynamic psychotherapy (STPP) is frequently used to treat depression, but it is unclear which patients might benefit specifically. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses and identify patient-level moderators. This IPD meta-analysis examined the efficacy and moderators of STPP for depression compared to control conditions.
PubMed, PsycInfo, Embase, and Cochrane Library were searched September 1st, 2022, to identify randomized trials comparing STPP to control conditions for adults with depression. IPD were requested and analyzed using mixed-effects models.
IPD were obtained from 11 of the 13 (84.6%) studies identified (n = 771/837, 92.1%; mean age = 40.8, SD = 13.3; 79.3% female). STPP resulted in significantly lower depressive symptom levels than control conditions at post-treatment (d = -0.62, 95%CI [-0.76, -0.47], p < .001). At post-treatment, STPP was more efficacious for participants with longer rather than shorter current depressive episode durations.
These results support the evidence base of STPP for depression and indicate episode duration as an effect modifier. This moderator finding, however, is observational and requires prospective validation in future large-scale trials.
短期心理动力心理治疗（STPP）常用于治疗抑郁症，但尚不清楚哪些患者可能会特别受益。个体参与者数据（IPD）荟萃分析比传统荟萃分析能提供更精确的效应估计，并识别患者层面的调节因素。这项IPD荟萃分析研究了与对照条件相比，STPP治疗抑郁症的疗效和调节因素。
于2022年9月1日检索了PubMed、PsycInfo、Embase和Cochrane图书馆，以确定将STPP与抑郁症成人对照条件进行比较的随机试验。索取IPD并使用混合效应模型进行分析。
从13项已识别研究中的11项（84.6%）获得了IPD（n = 771/837，92.1%；平均年龄 = 40.8，标准差 = 13.3；79.3%为女性）。在治疗后，STPP导致的抑郁症状水平显著低于对照条件（d = -0.62，95%CI [-0.76，-0.47]，p <.001）。在治疗后，STPP对当前抑郁发作持续时间较长而非较短的参与者更有效。
这些结果支持了STPP治疗抑郁症的证据基础，并表明发作持续时间是一个效应修饰因素。然而，这一调节因素的发现是观察性的，需要在未来的大规模试验中进行前瞻性验证。
