A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder
A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder
复制标题
DOI：
10.1016/j.cpr.2004.08.004
复制
发表时间：
2004-12-01
影响因子：
12.8
通讯作者：
Westen, D
中科院分区：
文献类型：
--
作者：
Eddy, KT;Dutra, L;Westen, D
许多定性和荟萃分析综述指出了心理治疗和药物干预对强迫症（OCD）的疗效。在这篇文章中，我们报告了一个多维荟萃分析的心理和药物治疗研究的强迫症发表在1980年和2001年之间，检查了一系列变量以前没有荟萃分析，包括排除率和排除标准，患者的百分比改善或恢复治疗后，平均治疗后神经病学和长期结果。这些额外的指标提供了对现有数据及其对临床实践的影响的优势和局限性的更细致入微的看法。行为和认知行为疗法，以及一系列的药物干预，导致普通患者的实质性改善，其中个体心理疗法和氯丙咪嗪和其他5-羟色胺再摄取抑制剂在多个指标上表现最好。然而，强迫症症状持续在中等水平，即使在适当的治疗过程中，并没有可复制的数据是在第一年或以后的任何形式的治疗保持收益。未来的研究应该跟踪研究参与者的招募和排除，包括更多的共病患者，并专注于使用多个结局指标的长期随访。还表明需要对药物和心理治疗相结合的干预措施进行更多的研究。(C)2004爱思唯尔有限公司保留所有权利。
A number of qualitative and meta-analytic reviews point to the efficacy of psychotherapeutic and pharmacological interventions for obsessive-compulsive disorder (OCD). In this article, we report a multidimensional meta-analysis of psychological and pharmacological treatment studies for OCD published between 1980 and 2001, examining a range of variables not previously meta-analyzed, including exclusion rates and exclusion criteria, percent of patients improved or recovered post-treatment, mean post-treatment symptomatology, and long-term outcome. These additional metrics provide a more nuanced view of the strengths and limitations: of the existing data and their implications for clinical practice. Behavioral and cognitive-behavioral therapy, and a range of pharmacological interventions, lead to substantial improvement for the average patient, with individual psychotherapies and clomipramine and other Serotonin reuptake inhibitors faring best across multiple metrics. However, OCD symptoms persist at moderate levels even following adequate treatment course, and no replicable data are available on maintenance of gains for either form of treatment at I year or beyond. Future research should track recruitment and exclusion of study participants, include more comorbid patients, and focus on longer-term follow-up using multiple indices of outcome. More research on combined pharmacological and psychotherapeutic interventions is also indicated. (C) 2004 Elsevier Ltd. All rights reserved.