Psychological treatment of depression in primary care: a meta-analysis
Psychological treatment of depression in primary care: a meta-analysis
复制标题
DOI：
10.3399/bjgp09x395139
复制
发表时间：
2009-02-01
影响因子：
5.9
通讯作者：
Andersson, Gerhard
中科院分区：
文献类型：
--
作者：
Cuijpers, Pim;van Straten, Annemieke;Andersson, Gerhard
背景虽然大多数抑郁症是在初级保健中治疗的，并且一些研究已经检查了初级保健中心理治疗的效果，但是几乎没有进行任何荟萃分析研究，其中整合了这些研究的结果。并将这些结果与其他环境中的心理治疗进行比较。分析研究的影响，心理治疗的成人抑郁症在初级保健。设置初级保健。方法现有的数据库研究心理治疗的成人抑郁症，建立在PubMed、PsychINFO、EMBASE和国际论文摘要的系统检索基础上。随机试验中，心理治疗对成人初级保健患者抑郁症的影响进行了比较，以控制condition.ResultsIn 15个纳入研究，心理治疗与对照组的标准化平均效应大小为0.31（95%CI = 0.17至0.45），这对应于一个数字需要治疗（NNT）的5.75。在研究中，患者由他们的家庭医生转诊进行治疗的效果显著更高（d = 0.43; NNT = 4.20）比通过系统筛选招募患者的研究（d = 0.13，与零无显著差异; NNT = 13.51）。结论虽然研究数量相对较少，质量参差不齐，抑郁症的心理治疗在初级保健中被发现是有效的，特别是当全科医生转介抑郁症患者接受治疗时。
BackgroundAlthough most depressive disorders are treated in primary care and several studies have examined the effects of psychological treatment in primary care, hardly any meta-analytic research has been conducted in which the results of these studies are integrated.AimTo integrate the results of randomised controlled trials of psychological treatment of depression in adults in primary care, and to compare these results to psychological treatments in other settings.Design of studyA meta-analysis of studies examining the effects of psychological treatments of adult depression in primary care.SettingPrimary care.MethodAn existing database of studies on psychological treatments of adult depression that was built on systematic searches in PubMed, PsychINFO, EMBASE, and Dissertation Abstracts International was used. Randomised trials were included in which the effects of psychological treatments on adult primary care patients with depression were compared to a control condition.ResultsIn the 15 included studies, the standardised mean effect size of psychological treatment versus control groups was 0.31 (95% CI = 0.17 to 0.45), which corresponds with a numbers-needed-to-treat (NNT) of 5.75. Studies in which patients were referred by their GP for treatment had significantly higher effect sizes (d = 0.43; NNT = 4.20) than studies in which patients were recruited through systematic screening (d = 0.13, not significantly different from zero; NNT = 13.51).ConclusionsAlthough the number of studies was relatively low and the quality varied, psychological treatment of depression was found to be effective in primary care, especially when GPs refer patients with depression for treatment.