The evidence for cognitive behavioural therapy in any condition, population or context: a meta-review of systematic reviews and panoramic meta-analysis.
The evidence for cognitive behavioural therapy in any condition, population or context: a meta-review of systematic reviews and panoramic meta-analysis.
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认知行为疗法在任何情况，人群或环境中的证据：系统评价和全景荟萃分析的荟萃审查。
DOI：
10.1017/s0033291720005292
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发表时间：
2021-01
影响因子：
6.9
通讯作者：
Lamb SE
中科院分区：
文献类型：
--
作者：
Fordham B;Sugavanam T;Edwards K;Stallard P;Howard R;das Nair R;Copsey B;Lee H;Howick J;Hemming K;Lamb SE
大多数心理治疗研究致力于调查认知行为疗法（CBT）在不同条件，人群和背景下的有效性。我们的目的是总结目前的系统评价证据，并评估CBT在不同条件下效果的一致性。我们纳入了CBT随机对照试验的综述：人群，条件，格式，背景，任何类型的对照品，并以英语发表。我们检索了1992年至2019年1月期间的DARE、科克伦、MEDLINE、EMBASE、PsycINFO、CINAHL、CDAS和OpenGrey。对评论进行质量评估，提取和总结其数据。对健康相关生活质量（HRQoL）的影响在条件组内汇总。如果跨条件异质性为I2 <75%，我们使用随机效应全景荟萃分析合并效应。我们总结了494篇综述（221128名参与者），代表了14/20的身体状况和13/20的精神状况（世界卫生组织的国际疾病分类）。大多数评论质量较低（351/494），调查了面对面的CBT（397/494）和成人（378/494）。很少有综述包括在亚洲、南美洲或非洲进行的试验（45/494）。CBT对HRQoL产生了适度的跨条件获益（标准化平均差异0.23; 95%置信区间0.14-0.33，I2 = 32%）。该效应的相关预测区间为-0.05至0.50，表明CBT在我们目前没有证据的情况下仍然有效。虽然在证据基础的完整性方面仍然存在一些差距，但我们需要认识到CBT提供的一般益处的一致证据。
The majority of psychological treatment research is dedicated to investigating the effectiveness of cognitive behavioural therapy (CBT) across different conditions, population and contexts. We aimed to summarise the current systematic review evidence and evaluate the consistency of CBT's effect across different conditions. We included reviews of CBT randomised controlled trials in any: population, condition, format, context, with any type of comparator and published in English. We searched DARE, Cochrane, MEDLINE, EMBASE, PsycINFO, CINAHL, CDAS, and OpenGrey between 1992 and January 2019. Reviews were quality assessed, their data extracted and summarised. The effects upon health-related quality of life (HRQoL) were pooled, within-condition groups. If the across-condition heterogeneity was I2 < 75%, we pooled effects using a random-effect panoramic meta-analysis. We summarised 494 reviews (221 128 participants), representing 14/20 physical and 13/20 mental conditions (World Health Organisation's International Classification of Diseases). Most reviews were lower-quality (351/494), investigated face-to-face CBT (397/494), and in adults (378/494). Few reviews included trials conducted in Asia, South America or Africa (45/494). CBT produced a modest benefit across-conditions on HRQoL (standardised mean difference 0.23; 95% confidence intervals 0.14–0.33, I2 = 32%). The effect's associated prediction interval −0.05 to 0.50 suggested CBT will remain effective in conditions for which we do not currently have available evidence. While there remain some gaps in the completeness of the evidence base, we need to recognise the consistent evidence for the general benefit which CBT offers.