The effects of cognitive and behavioural therapies for anxiety disorders on depression: a meta-analysis
The effects of cognitive and behavioural therapies for anxiety disorders on depression: a meta-analysis
复制标题
DOI：
10.1017/s0033291716002348
复制
发表时间：
2016-12-01
影响因子：
6.9
通讯作者：
Berking, M.
中科院分区：
文献类型：
--
作者：
Cuijpers, P.;Cristea, I. A.;Berking, M.
背景。认知行为治疗焦虑症对抑郁症的影响已经在之前的荟萃分析中进行了检验，表明这些治疗对抑郁症有相当大的影响。在当前的荟萃分析中，我们研究了焦虑障碍治疗对抑郁症的影响在广泛性焦虑障碍（GAD）、社交焦虑障碍（SAD）和恐慌障碍（PD）中是否存在差异。我们还比较了这些治疗与认知和行为治疗对重度抑郁症（MDD）的影响。我们检索了PubMed、PsycINFO、EMBASE和Cochrane数据库，包括47项关于焦虑症的试验和34项关于mdd的试验。焦虑障碍的基线抑郁严重程度略低于重度抑郁症，但在大多数研究中仍为轻度至中度。三种焦虑症的基线严重程度不同。治疗焦虑症的效应值为：PD = 0.47, GAD = 0.68, SAD = 0.69。在大多数分析中，这些效应量与治疗重度抑郁症的效应量（g = 0.81）之间的差异并不显著，我们发现很少有迹象表明焦虑障碍的效果不同。我们确实发现组内效应量导致抑郁症（g = 1.50）显著大于焦虑症（g = 0.73-0.91）的效应量（p < 0.001）。在大多数研究中，偏倚风险是相当大的。参与焦虑症认知行为疗法试验的患者抑郁程度很高。这些治疗对抑郁症有相当大的效果，这些效果与治疗原发性重度抑郁症的效果相当。
Background. The effects of cognitive behavioural therapy of anxiety disorders on depression has been examined in previous meta-analyses, suggesting that these treatments have considerable effects on depression. In the current meta-analysis we examined whether the effects of treatments of anxiety disorders on depression differ across generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder (PD). We also compared the effects of these treatments with the effects of cognitive and behavioural therapies of major depression (MDD).Method. We searched PubMed, PsycINFO, EMBASE and the Cochrane database, and included 47 trials on anxiety disorders and 34 trials on MDD.Results. Baseline depression severity was somewhat lower in anxiety disorders than in MDD, but still mild to moderate in most studies. Baseline severity differed across the three anxiety disorders. The effect sizes found for treatment of the anxiety disorders ranged from g = 0.47 for PD, g = 0.68 for GAD and g = 0.69 for SAD. Differences between these effect sizes and those found in the treatment of MDD (g = 0.81) were not significant in most analyses and we found few indications that the effects differed across anxiety disorders. We did find that within-group effect sizes resulted in significantly (p < 0.001) larger effect sizes for depression (g = 1.50) than anxiety disorders (g = 0.73-0.91). Risk of bias was considerable in the majority of studies.Conclusions. Patients participating in trials of cognitive behavioural therapy for anxiety disorders have high levels of depression. These treatments have considerable effects on depression, and these effects are comparable to those of treatment of primary MDD.