Zanini C, Enrico P, Pescuma V, Favalli V, Bressi C, Brambilla P, Delvecchio G
Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, 20122 Milan, Italy.
J Affect Disord. 2025 Feb 15;371:333-343. doi: 10.1016/j.jad.2024.11.050. Epub 2024 Nov 16.
Depression is one of the most widespread diseases worldwide, with the highest rates of disability. Considering its chronic course, over the years several treatment options have been developed and validated, however still with high relapse rates. Therefore, in recent years, the so-called third wave psychotherapies have been developed for the treatment of psychiatric disorders. Among these, the Metacognitive therapy (MCT) has proven to be effective in treating depression. The aim of this review is to evaluate the efficacy of MCT as monotherapy or adjunctive treatment in reducing depressive symptoms in patients suffering from major depression or dysthymia.
From bibliographic research in PubMed until December 2023, we retrieved 12 original studies meeting our research criteria.
The total sample of patients undergoing metacognitive therapy (MCT) included 376 individuals, while the control groups comprised 300 subjects, with a gender ratio of the participants of 0.48 %. The results show that metacognitive therapy is an effective approach in reducing depressive symptoms in patients with a diagnosis of depression or dysthymia when used as add-on therapy, with an efficacy comparable to CBT and superior to pharmacotherapy and as monotherapy, with an efficacy comparable to therapy with antidepressants compared to the control group and compared to cognitive-behavioral therapy with higher rates of reduction of depressive symptoms after treatment and at six months. Preliminary data also indicate its efficacy in terms of reduction of depressive symptoms in elderly people, suggesting its possible use in this population.
The methodological heterogeneity in terms of treatment protocols of MCT and treatment control as well as the clinical heterogeneity of the sample employed may have limited the generalizability of the results.
The results suggest that the use of MCT, both as monotherapy and as an add-on treatment, is a valid therapeutic option for major depression, even at the later stages. However, further studies are needed for deeper our comprehension of the efficacy of MCT in depression.
抑郁症是全球最普遍的疾病之一，致残率极高。鉴于其病程慢性化，多年来已开发并验证了多种治疗方案，但复发率仍居高不下。因此，近年来，所谓的第三波心理治疗方法已被开发用于治疗精神疾病。其中，元认知疗法（MCT）已被证明对治疗抑郁症有效。本综述的目的是评估MCT作为单一疗法或辅助治疗在减轻重度抑郁症或心境恶劣障碍患者抑郁症状方面的疗效。
通过在PubMed上进行文献检索，截至2023年12月，我们检索到12项符合我们研究标准的原始研究。
接受元认知疗法（MCT）的患者总样本包括376人，而对照组包括300名受试者，参与者的性别比为0.48%。结果表明，元认知疗法作为附加疗法用于诊断为抑郁症或心境恶劣障碍的患者时，是减轻抑郁症状的有效方法，其疗效与认知行为疗法相当，优于药物疗法；作为单一疗法时，与对照组相比以及与认知行为疗法相比，其疗效与抗抑郁药治疗相当，治疗后及六个月时抑郁症状减轻率更高。初步数据还表明其在减轻老年人抑郁症状方面的疗效，提示其可能适用于该人群。
MCT治疗方案和治疗对照在方法学上的异质性以及所采用样本的临床异质性可能限制了结果的普遍性。
结果表明，MCT无论是作为单一疗法还是附加疗法，都是重度抑郁症的有效治疗选择，即使在后期阶段也是如此。然而，需要进一步研究以更深入地理解MCT在抑郁症中的疗效。
