Yu Xin, Zhao Bing, Yin Tongtong, Qu Haiying, Zhang Jingxuan, Cheng Xiaojing, Chen Xu
School of Special Education and Rehabilitation, BinZhou Medical University, Yantai, China.
Department of Psychiatry, Shandong Mental Health Center, Shandong University, Jinan, China.
Front Psychiatry. 2025 May 19;16:1506822. doi: 10.3389/fpsyt.2025.1506822. eCollection 2025.
This study conducted a systematic review of published randomized controlled trials (RCTs) to evaluate the efficacy of acceptance and commitment therapy (ACT) for adolescent depression, while also examining its pertinent characteristics.
We conducted systematic searches of electronic databases in accordance with PRISMA guidelines to ensure rigorous screening, data extraction, and quality assessment. Additionally, we employed random-effects models and performed subgroup analyses.
A meta-analysis of 25 studies with 2,352 participants showed that ACT significantly reduced depressive symptoms in adolescents. Improvements in psychological flexibility significantly predicted reductions in depression. Subgroup analysis revealed that, at post-test, ACT was significantly more effective than wait-list controls in reducing depressive symptoms, though it was not superior to Treatment As Usual or active treatment groups. Furthermore, offline ACT was significantly more effective than Internet-based ACT in reducing depressive symptoms. Comparisons of intervention settings also indicated that ACT was more effective in group settings than individual ones. However, no significant difference was found between clinical and non-clinical samples.
The current study suggests that ACT effectively reduces depressive symptoms, with psychological flexibility playing a crucial role in this improvement. Intervention forms and sample types should be considered when implementing ACT interventions. Extensive research is still needed for further exploration.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023494677, identifier CRD42023494677.
本研究对已发表的随机对照试验（RCT）进行了系统评价，以评估接纳与承诺疗法（ACT）对青少年抑郁症的疗效，并考察其相关特征。
我们按照PRISMA指南对电子数据库进行了系统检索，以确保严格的筛选、数据提取和质量评估。此外，我们采用随机效应模型并进行了亚组分析。
对25项研究、2352名参与者的荟萃分析表明，ACT显著减轻了青少年的抑郁症状。心理灵活性的改善显著预示着抑郁症状的减轻。亚组分析显示，在测试后，ACT在减轻抑郁症状方面显著比等待列表对照组更有效，尽管它并不优于常规治疗或积极治疗组。此外，线下ACT在减轻抑郁症状方面显著比基于互联网的ACT更有效。干预环境的比较也表明，ACT在团体环境中比个体环境中更有效。然而，临床样本和非临床样本之间未发现显著差异。
当前研究表明，ACT能有效减轻抑郁症状，心理灵活性在这一改善过程中起关键作用。实施ACT干预时应考虑干预形式和样本类型。仍需进行广泛研究以进一步探索。
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023494677，标识符CRD42023494677 。
