Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: a systematic review.
Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: a systematic review.
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DOI：
10.1016/j.psym.2014.10.007
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发表时间：
2015-03
期刊：
影响因子：
3.4
通讯作者：
Cahn, B. Rael
中科院分区：
文献类型：
--
作者：
Jain, Felipe A.;Walsh, Roger N.;Eisendrath, Stuart J.;Christensen, Scott;Cahn, B. Rael
最近，冥想练习治疗抑郁症的应用已经引起了越来越多的临床和科学兴趣，这是由于副作用负担较低，多种药物的潜在减少，以及理论上的考虑，这些干预措施可能针对抑郁症的一些认知根源。我们的目的是确定支持这一申请的证据的状态。随机，对照试验的技术符合美国卫生保健研究和质量局（AHRQ）的冥想定义，参与者患有临床诊断的抑郁症，目前没有缓解，被选中。冥想疗法被分为实践（即如何应用）部分，并对试验结果进行了审查。确定了18项符合纳入标准的研究，包括7种不同的技术和1173例患者，其中基于正念的认知疗法所占比例最大。包括急性重度抑郁发作患者（N = 10项研究）和初始治疗后仍有亚急性临床症状的患者（N = 8）的研究表明，与对照组相比，组内抑郁症状中度至大幅减轻。技术和试验设计存在显著异质性。大量的证据表明，冥想疗法可能对患有临床抑郁症的患者在治疗的急性和亚急性阶段产生有益的影响。由于方法的缺陷和试验的异质性，大规模的随机对照试验与良好的描述比较干预措施和措施的期望是必要的，以澄清的作用，冥想在抑郁症治疗的医疗设备。
Recently, the application of meditative practices to the treatment of depressive disorders has met with increasing clinical and scientific interest, due to a lower side-effect burden, potential reduction of polypharmacy, as well as theoretical considerations that such interventions may target some of the cognitive roots of depression. We aimed to determine the state of the evidence supporting this application. Randomized, controlled trials of techniques meeting the Agency for Healthcare Research and Quality (AHRQ) definition of meditation, for participants suffering from clinically diagnosed depressive disorders, not currently in remission, were selected. Meditation therapies were separated into praxis (i.e. how they were applied) components, and trial outcomes were reviewed. Eighteen studies meeting inclusionary criteria were identified, encompassing seven distinct techniques and 1173 patients, with Mindfulness-Based Cognitive Therapy comprising the largest proportion. Studies including patients suffering from acute major depressive episodes (N = 10 studies), and those with residual subacute clinical symptoms despite initial treatment (N = 8), demonstrated moderate to large reductions in depression symptoms within group, and relative to control groups. There was significant heterogeneity of techniques and trial designs. A substantial body of evidence indicates that meditation therapies may have salutary effects on patients suffering from clinical depressive disorders during the acute and subacute phases of treatment. Due to methodological deficiences and trial heterogeneity, large-scale, randomized controlled trials with well-described comparator interventions and measures of expectation are needed to clarify the role of meditation in the depression treatment armamentarium.
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