首页 > 分享 > 心理治疗、抗抑郁药及其联合治疗抑郁症的持久效果：系统评价和荟萃分析

心理治疗、抗抑郁药及其联合治疗抑郁症的持久效果：系统评价和荟萃分析

花匠小妙招
2024-11-01 11:03

The final, formatted version of the article will be published soon.You have multiple emails registered with Frontiers:Please enter your email address:

这篇文章的最终格式化版本将很快发布。您在Frontiers注册了多封电子邮件：请输入您的电子邮件地址：

If you already have an account, please

如果您已经有账户，请

You don't have a Frontiers account ? You can

你没有Frontiers帐户？你可以

register hereIntroduction: Although depressive disorders are frequently associated with relapses, the sustained efficacy of therapies after their termination has been insufficiently investigated.Objective: The aim of this study was to evaluate the current evidence of enduring effects of psychotherapy, antidepressants and their combination after the end of treatment.

简介：虽然抑郁症经常与复发有关，但终止治疗后的持续疗效尚未得到充分研究。目的：本研究的目的是评估心理治疗，抗抑郁药及其联合治疗结束后持久效果的现有证据。

Methods: PubMed and PsychINFO were systematically screened according to PRISMA guidelines (except for preregistration)) resulting in 17 eligible RCTs with a total of 1154 participants. Only randomized controlled trials (RCTs) between 1980 and 2022 comparing the efficacy of psychotherapy, antidepressants and their combination in adult depression regarding relapse, recurrence or rehospitalization rates at follow-up at least 12 months after termination of therapy, which could be either acute phase, maintenance or relapse prevention therapy, were included.

方法：根据PRISMA指南（预注册除外）对PubMed和PsychINFO进行系统筛选，得到17项符合条件的随机对照试验，共有1154名参与者。只有1980年至2022年间的随机对照试验（RCT）比较了心理治疗，抗抑郁药及其联合治疗成人抑郁症的疗效，包括治疗终止后至少12个月的复发率，复发率或再住院率，可能是急性期，维持或复发预防治疗。

Risk of bias was assessed by using the Cochrane risk of bias tool. Results: ) In total 19 RCTs with a total of 1154 participants were included. In total 19 RCTS were identified.Psychotherapy was significantly superior to pharmacotherapy regarding relapse rates and Beck Depression Inventory scores at follow-up after acute treatment in two of nine RCTs.

通过使用Cochrane偏倚风险工具评估偏倚风险。结果：）共纳入19项随机对照试验，共1154名参与者。总共确定了19项随机对照试验。在9项随机对照试验中，有2项在急性治疗后的随访中，心理治疗在复发率和贝克抑郁量表评分方面明显优于药物治疗。

Combined treatment performed significantly better than pharmacotherapy, but not psychotherapy, regarding relapse and remission in five out of nine RCTs at least 12 months after treatment termination. Pairwise meta-analyses indicated a superiority of combined treatment compared to pharmacotherapy alone regarding relapse, recurrence, and rehospitalization rates (RR=0.60, 95%-CI: 0.37-0.97, p=.041) and for psychotherapy compared to pharmacotherapy alone regarding relapse and recurrence rates (RR=0.58, 95%-CI.

在治疗终止后至少12个月，9项随机对照试验中有5项复发和缓解，联合治疗的表现明显优于药物治疗，但不优于心理治疗。成对荟萃分析显示，与单独药物治疗相比，联合治疗在复发率，复发率和再住院率方面具有优势（RR=0.60，95%CI:0.37-0.97，p=0.041），与单独药物治疗相比，心理治疗在复发率和复发率方面具有优势（RR=0.58，95%CI）。