Yilmaz Sakir, Huguet Anna, Kisely Steve, Rao Sanjay, Wang JianLi, Price Molly, Morriss Richard, Inder Maree, Perich Tania, Wright Kim
Department of Psychology, Abdullah Gul University.
Department of Psychology, University of Exeter.
Psychol Med. 2025 May 22;55:e154. doi: 10.1017/S0033291725001023.
Unlike conventional meta-analyses, individual patient data (IPD) meta-analysis assesses moderator variables at the level of each participant, which generates more precise and biased estimates. The objective of this study was to investigate whether psychological therapy reduces depression symptoms in people with Bipolar I and II disorders and examine whether baseline depression has a moderating effect on treatment outcomes. Through the use of several electronic databases, a systematic search was conducted. Eligible studies were randomized controlled trials evaluating a psychological intervention for adults diagnosed with Bipolar I or II disorder. Titles and abstracts were screened, followed by full texts. The authors of the included studies were asked to provide IPD from their trials. A multilevel model approach was used to analyze the data. From the 7552 studies found by our searches, six studies with 668 study participants were eligible. Intervention significantly reduced depression scores. There was a significant association between baseline depression and post treatment depression scores. There was no statistically significant interaction between condition allocation and baseline depression score. When IPD from the two most comparable studies were analyzed, CBT had reduced depression scores relative to the comparator condition. The study included patient data from only six studies which were heterogeneous in terms of intervention type, outcome measure, and comparators. Overall, the psychological interventions tested significantly reduced bipolar depression scores. There was no evidence of moderation by baseline depression scores.
与传统的荟萃分析不同，个体患者数据（IPD）荟萃分析在每个参与者层面评估调节变量，这会产生更精确且有偏差的估计。本研究的目的是调查心理治疗是否能减轻双相I型和II型障碍患者的抑郁症状，并检验基线抑郁对治疗结果是否有调节作用。通过使用多个电子数据库进行了系统检索。符合条件的研究为评估针对诊断为双相I型或II型障碍的成年人的心理干预的随机对照试验。先筛选标题和摘要，然后是全文。纳入研究的作者被要求提供其试验的个体患者数据。采用多层次模型方法分析数据。在我们检索到的7552项研究中，有6项研究、668名研究参与者符合条件。干预显著降低了抑郁评分。基线抑郁与治疗后抑郁评分之间存在显著关联。条件分配与基线抑郁评分之间没有统计学上的显著交互作用。对两项最具可比性的研究的个体患者数据进行分析时，认知行为疗法（CBT）相对于对照条件降低了抑郁评分。该研究仅纳入了6项研究的患者数据，这些研究在干预类型、结局测量和对照方面存在异质性。总体而言，所测试的心理干预显著降低了双相抑郁评分。没有证据表明基线抑郁评分有调节作用。
