Department of Psychology, University of Sheffield, Sheffield, UK.
Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK.
Psychother Res. 2024 Mar;34(3):323-338. doi: 10.1080/10503307.2023.2227757. Epub 2023 Jul 5.
Conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy of individual humanistic-experiential therapies (HEPs) for depression.
Database searches (Scopus, Medline, and PsycINFO) identified RCTs comparing any HEP intervention with a treatment-as-usual (TAU) control or active alternative intervention for the treatment of depression. Included studies were assessed using the Risk of Bias 2 tool and narratively synthesized. Post-treatment and follow-up effect sizes were aggregated using random-effects meta-analysis and moderators of treatment effect were explored (PROSPERO: CRD42021240485).
Seventeen RCTs, synthesized across four meta-analyzes, indicated HEP depression outcomes were significantly better than TAU controls at post-treatment ( = 0.41, 95% CI [0.18, 0.65], = 735), but not significantly different at follow-up ( = 0.14, 95% CI [-0.30, 0.58], = 631). HEP depression outcomes were comparable to active treatments at post-treatment ( = -0.09, 95% CI [-0.26, 0.08], = 2131), but significantly favored non-HEP alternative interventions at follow-up ( = -0.21, 95% CI [-0.35, -0.07], = 1196).
Relative to usual care, HEPs are effective in the short-term and comparable to non-HEP alternative interventions at post-treatment, but not at follow-up. However, imprecision, inconsistency, and risk of bias concerns were identified as limitations of the evidence included. Future large-scale trials of HEPs with equipoise between comparator conditions are required.
系统评价和荟萃分析评估个体人文体验疗法（HEPs）治疗抑郁症的疗效的随机对照试验（RCTs）。
数据库搜索（Scopus、Medline 和 PsycINFO）确定了比较任何 HEP 干预与常规治疗（TAU）对照或积极替代干预治疗抑郁症的 RCTs。使用风险偏倚 2 工具评估纳入的研究，并进行叙述性综合。使用随机效应荟萃分析汇总治疗后和随访的效应量，并探讨治疗效果的调节因素（PROSPERO：CRD42021240485）。
四项荟萃分析综合了 17 项 RCT，结果表明，与 TAU 对照组相比，HEP 治疗抑郁症的结局在治疗后明显更好（ = 0.41，95%置信区间 [0.18，0.65]， = 735），但在随访时无显著差异（ = 0.14，95%置信区间 [-0.30，0.58]， = 631）。与活性治疗相比，HEP 治疗抑郁症的结局在治疗后相当（ = -0.09，95%置信区间 [-0.26，0.08]， = 2131），但在随访时明显优于非 HEP 替代干预（ = -0.21，95%置信区间 [-0.35，-0.07]， = 1196）。
与常规护理相比，HEPs 在短期治疗中有效，与非 HEP 替代干预在治疗后相当，但在随访时则不然。然而，纳入的证据存在精度、一致性和偏倚风险方面的问题。需要开展大规模的、具有可比性的对照条件的 HEP 试验。
