Cuijpers Pim, Miguel Clara, Ciharova Marketa, Harrer Mathias, Karyotaki Eirini
Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands; Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania.
Department of Clinical, Neuro and Developmental Psychology, WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, the Netherlands.
J Affect Disord. 2024 Mar 15;349:452-461. doi: 10.1016/j.jad.2024.01.073. Epub 2024 Jan 10.
Non-directive supportive therapy (NDST) is an important treatment of adult depression, but no recent meta-analysis has integrated the randomized trials examining its effects.
We conducted a meta-analysis comparing NDST to control conditions and to other therapies, by using an existing database of randomized trials of psychological treatments of depression in adults. This database was built through searches in PubMed, PsycINFO, Embase and the Cochrane Library.
48 randomized controlled trials (5075 participants), with 20 comparisons between NDST and a control group and 49 comparisons between NDST and another psychotherapy were included. Random effects meta-analyses found an effect size of NDST compared with control conditions of g = 0.53 (95 % CI, 0.34; 0.72) with moderate heterogeneity (I = 51; 95 % CI: 18; 71; PI = -0.02 to 1.09). NDST was less effective than other therapies (g = -0.21; 95 % CI: -0.31; -0.11). The difference with other therapies was significantly larger in studies in which NDST was used as a control group (p = .003). There was no significant difference between NDST and other therapies in which NDST was not used as a control group (k = 14; g = -0.05; 95 % CI: -0.17; 0.07).
NDST probably is an effective treatment of depression. The effects may be somewhat smaller than those of other therapies, but that may also be an artefact, because NDST is often used as a control group and may be designed as an "intent-to-fail" intervention in some studies.
非指导性支持疗法（NDST）是成人抑郁症的一种重要治疗方法，但近期尚无荟萃分析整合检验其疗效的随机试验。
我们通过使用现有的成人抑郁症心理治疗随机试验数据库，进行了一项将NDST与对照条件及其他疗法进行比较的荟萃分析。该数据库通过在PubMed、PsycINFO、Embase和Cochrane图书馆中检索建立。
纳入了48项随机对照试验（5075名参与者），其中NDST与对照组之间有20项比较，NDST与另一种心理治疗之间有49项比较。随机效应荟萃分析发现，与对照条件相比，NDST的效应量g = 0.53（95%CI：0.34；0.72），异质性中等（I = 51；95%CI：18；71；PI = -0.02至1.09）。NDST的疗效低于其他疗法（g = -0.21；95%CI：-0.31；-0.11）。在将NDST用作对照组的研究中，与其他疗法的差异显著更大（p = 0.003）。在未将NDST用作对照组的研究中，NDST与其他疗法之间无显著差异（k = 14；g = -0.05；95%CI：-0.17；0.07）。
NDST可能是一种有效的抑郁症治疗方法。其效果可能略小于其他疗法，但这也可能是一种假象，因为NDST经常被用作对照组，并且在一些研究中可能被设计为一种“意图失败”的干预措施。
