基于试验的认知疗法治疗抑郁和焦虑症状：疗效及脱落率的系统评价与荟萃分析
Trial-Based Cognitive Therapy for depressive and anxious symptoms: A systematic review and meta-analysis of efficacy and dropout rates.
作者信息
Hemanny Curt, Dos Santos Carine Oliveira, Moris Flávia Tirado Leite, Melnik Tamara
机构信息
Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Avenida Reitor Miguel Calmon, Vale do Canela, Salvador, Bahia ZIP-code: 40.110-902, Brazil.
Universidade Federal da Bahia, Avenida Reitor Miguel Calmon, Vale do Canela, Salvador, Bahia ZIP-code: 40.110-902, Brazil.
出版信息
J Mood Anxiety Disord. 2023 Jun 8;1:100005. doi: 10.1016/j.xjmad.2023.100005. eCollection 2023 Jun.
BACKGROUND
With depression and anxiety disorders increasing globally, effective therapies like Trial-Based Cognitive Therapy (TBCT), a novel Cognitive-Behavioral Therapy (CBT) variant, are crucial. This systematic review and meta-analysis aim to assess TBCT's efficacy in reducing depression and anxiety symptoms and its dropout rates compared with other psychotherapies.
METHODS
Comprehensive searches across databases like CENTRAL, PUBMED/MEDLINE, PsycINFO, LILACS/BVS, Clinicaltrials.gov, WHO International Clinical Trials Registry Platform, and Google Scholar were conducted. Eligibility was determined based on the trial's ability to potentially benefit from TBCT and measures of depression or anxiety symptoms using validated scales. Ten RCTs involving 1245 participants were included. The meta-analysis considered post-treatment assessments, dropout rates, and risk of bias. This study was registered on PROSPERO (CRD42021252907).
RESULTS
We identified 10 RCTs involving 1245 participants with various conditions, including Social Anxiety Disorder, Major Depressive Disorder, Post-Traumatic Stress Disorder, and Obsessive-Compulsive Disorder. The meta-analysis of 5 RCTs found no significant difference in symptom reduction between TBCT and other first-choice psychotherapies. TBCT's dropout rates were comparable to other psychotherapies. The majority of RCTs had a low risk of bias.
CONCLUSIONS
TBCT shows comparable efficacy to other psychotherapies in both short-term symptom reduction and long-term treatment gains across various mental health conditions. Its flexibility across different settings and conditions supports its utility in diverse therapeutic contexts. Despite these promising results, more rigorous and geographically diverse studies are necessary to confirm these findings. TBCT offers a promising alternative approach in the psychotherapeutic intervention landscape for mental health disorders.
背景
随着全球抑郁症和焦虑症发病率的上升，像基于试验的认知疗法（TBCT）这种新型认知行为疗法（CBT）变体等有效疗法至关重要。本系统评价和荟萃分析旨在评估TBCT与其他心理疗法相比在减轻抑郁和焦虑症状方面的疗效及其脱落率。
方法
对CENTRAL、PUBMED/MEDLINE、PsycINFO、LILACS/BVS、Clinicaltrials.gov、世界卫生组织国际临床试验注册平台和谷歌学术等数据库进行了全面检索。根据试验是否有可能从TBCT中获益以及使用经过验证的量表测量抑郁或焦虑症状来确定纳入标准。纳入了10项涉及1245名参与者的随机对照试验（RCT）。荟萃分析考虑了治疗后评估、脱落率和偏倚风险。本研究已在PROSPERO（CRD42021252907）上注册。
结果
我们确定了10项涉及1245名患有各种疾病的参与者的随机对照试验，这些疾病包括社交焦虑症、重度抑郁症、创伤后应激障碍和强迫症。对5项随机对照试验的荟萃分析发现，TBCT与其他首选心理疗法在症状减轻方面没有显著差异。TBCT的脱落率与其他心理疗法相当。大多数随机对照试验的偏倚风险较低。
结论
在各种心理健康状况下，TBCT在短期症状减轻和长期治疗效果方面与其他心理疗法显示出相当的疗效。它在不同环境和条件下的灵活性支持了其在多种治疗背景下的实用性。尽管有这些令人鼓舞的结果，但仍需要更严格和地域上更具多样性的研究来证实这些发现。TBCT在心理健康障碍的心理治疗干预领域提供了一种有前景的替代方法。
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