高强度与低强度精神分析导向的长期治疗的疗效及结局的决定因素：长期精神分析治疗研究（MeLAS）的个体参与者数据荟萃分析。

Efficacy of high-intensity versus low-intensity psychoanalytically oriented long-term treatments and determinants of outcome: individual participant data Meta-analysis of Long-term Analytic treatment Studies (MeLAS).

机构信息

Psychosomatic Medicine and Psychotherapy, University Medical Center of The Johannes Gutenberg University, Mainz, Germany

Psychosomatic Medicine and Psychotherapy, University Medical Center of The Johannes Gutenberg University, Mainz, Germany.

出版信息

BMJ Open. 2023 Jul 19;13(7):e069332. doi: 10.1136/bmjopen-2022-069332.

DOI:10.1136/bmjopen-2022-069332

PMID:37474167

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10357799/

Abstract

INTRODUCTION

Long-term psychodynamic/psychoanalytic psychotherapy (LTPP) is a prevalent treatment option for complex mental disorders. Yet, little is known about the role of treatment intensity in LTPP. We present a study protocol for a systematic review and individual participant data (IPD) meta-analysis aggregating and analysing individual data from randomised and quasi-experimental trials by meta-analysis. The purpose is to (1) determine the treatment effectiveness of LTPP with low versus high intensity (up to 2 weekly sessions vs three or more), (2) compare their joint effectiveness to shorter therapies and treatments as usual, (3) identify predictors and moderators of treatment outcomes and (4) determine reciprocal relationships between different outcome domains (symptomatic and structural/personality change) over the courses of LTPP.

METHODS AND ANALYSIS

We include studies from (randomised controlled trial, RCT) and quasi-experimental trials, where at least one condition was LTPP of high or low frequency. Long-term treatment is defined as ≥1 year or ≥50 sessions. To be eligible studies must include a standardised outcome measure of symptoms (global or disorder specific) with at least one proof of reliability. The primary outcome is symptom reduction (global or specific), secondary outcome criteria are reliable change, remission, functional capacities, personality, personality functioning and interpersonal pathology. Relevant studies will mainly be identified by searching relevant databases: PubMed, PsycINFO (via EBSCO), Web of Science (via Elsevier), Chochrane's Central Register of Controlled Trials (via Wiley). Risk of bias will be evaluated in line with the Cochrane assessments tools for quasi-experimental trials and RCTs, respectively.

ETHICS AND DISSEMINATION

Aggregation of data from primary trials collected based on ethics votes. Dissemination into clinical practice via open access publications of findings.

PROSPERO REGISTRATION NUMBER

CRD42022304982; Pre-results.

摘要

简介

长期精神动力学/精神分析心理治疗（LTPP）是治疗复杂精神障碍的一种流行治疗选择。然而，对于 LTPP 中的治疗强度的作用知之甚少。我们提出了一项系统评价和个体参与者数据（IPD）荟萃分析的研究方案，该方案通过荟萃分析汇总和分析来自随机和准实验试验的个体数据。目的是：（1）确定低强度与高强度 LTPP 的治疗效果（每周最多 2 次治疗与 3 次或更多次治疗）；（2）将其与更短的治疗和常规治疗进行比较；（3）确定治疗结果的预测因素和调节因素；（4）确定 LTPP 过程中不同结果领域（症状和结构/人格变化）之间的相互关系。

方法和分析

我们纳入了来自（随机对照试验，RCT）和准实验试验的研究，其中至少有一个条件是高频或低频的 LTPP。长期治疗定义为≥1 年或≥50 次治疗。符合条件的研究必须包括至少一种可靠的症状（整体或特定障碍）标准化结局测量。主要结局是症状减轻（整体或特定），次要结局标准是可靠变化、缓解、功能能力、人格、人格功能和人际关系病理学。相关研究主要通过搜索以下相关数据库来确定：PubMed、PsycINFO（通过 EBSCO）、Web of Science（通过 Elsevier）、Cochrane 对照试验中心注册（通过 Wiley）。风险偏差将根据 Cochrane 对准实验试验和 RCT 的评估工具进行评估。