Expanding and personalizing treatments for depression: a systematic review and meta-analysis of single-person trials

在德国，每年大约每100人中就有8人符合抑郁症的标准。抑郁症通常会对受影响的人，他们的家庭，他们的社会关系和他们的工作能力产生严重的后果。有几种治疗方法可用于抑郁症（例如，各种药物和各种形式的心理治疗），这些药物已经根据高科学标准在数百人的大规模研究中进行了测试。然而，五分之二的人对首次提供的治疗没有充分反应。与此同时，根据现有的结果，很难预测谁会对哪种现有的治疗作出反应。此外，具有不寻常或难以治疗特征的人（例如，高龄，伴随疾病，诊断不明确）通常被排除在大规模科学研究之外，因此尚不清楚治疗对他们的作用程度。所谓的“单人试验”确定或比较治疗对个人的影响。它们可以有效地补充传统的科学研究。首先，它们促进了对以前没有测试过或从其他疾病的护理中采用的新治疗方法的研究。其次，它们允许考虑通常被排除在大规模研究之外的个人。第三，它们可以在日常条件下进行，并直接为个人提供治疗效果的科学证据。本研究旨在对抑郁症治疗的单人试验证据进行系统评价。通过这样做，可以获得关于新疗法效果的证据、关于以前在研究中被忽视的人群的科学证据，以及关于在日常条件下进行的单人试验的有用性的信息。

In Germany, about eight out of every hundred people meet the criteria for depression every year. Depressive disorders often have serious consequences for those affected, their family, their social relationships, and their ability to work. Several treatments are available for depression (e.g., various medications and various forms of psychotherapy) that have been tested in large-scale studies according to high scientific standards with hundreds of people. However, two out of five people do not respond adequately to the treatment first offered. At the same time, based on the available results, it is hardly possible to predict who will respond to which of the available treatments. In addition, people with unusual or difficult-to-treat characteristics (for example, advanced age, concomitant diseases, unclear diagnosis) are often excluded from large-scale scientific studies, so it is unclear to what extent the treatments work for them. So-called "single-person trials" determine or compare the effect of treatments for individual persons. They can usefully complement traditional scientific studies. First, they facilitate the study of new treatments that have not been previously tested or that have been adopted from the care of other conditions. Second, they allow consideration of individuals who are usually excluded from large-scale studies. Third, they can be conducted under everyday conditions and provide scientific evidence of the effect of a treatment directly for the individual. The present study aims to perform a systematic review of the evidence from single-person trials on the treatment of depression. In doing so, evidence on the effect of new treatments, scientific evidence for groups of people previously neglected in studies, and information on the usefulness of single-person trials conducted under everyday conditions can be obtained.