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2024.8.8
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心理治疗急性增强的跨诊断荟萃分析
A transdiagnostic meta-analysis of acute augmentations to psychological therapy
【摘要】至少有一半的精神疾病患者对心理治疗没有充分反应。在心理治疗期间急剧增强特定的生物或心理过程可能会改善治疗结果。然而,之前的研究仅限于特定的增强方法,通常在单一诊断类别内进行评估。我们的目标是评估心理治疗的急性增强在多大程度上减少了精神症状,并估计增强类型(例如脑刺激或迷幻药)的效果大小。我们检索了 Medline、PsycINFO 和 Embase,查找数据库建立至2022年5月25日期间发表的对照研究。我们进行了预先注册的随机效应荟萃分析 (PROSPERO CRD42021236403)。我们确定了108项研究 (N=5,889)。急性增强显着降低了心理健康问题的严重程度(Hedges’g=−0.27,95%CI:[−0.36,−0.18];P< 0.0001),特别是对于跨诊断维度“恐惧”和“痛苦”。该结果通过了考虑发表偏差的修剪填充分析。亚组分析显示,药理学、心理和躯体增强是有效的,但程度不同。急性增强方法是改善心理治疗效果的一条有前途的途径。
[Abstract] At least half of all patients with mental health disorders do not respond adequately to psychological therapy. Acutely enhancing particular biological or psychological processes during psychological therapy may improve treatment outcomes. However, previous studies are confined to specific augmentation approaches, typically assessed within single diagnostic categories. Our objective was to assess to what degree acute augmentations of psychological therapy reduce psychiatric symptoms and estimate effect sizes of augmentation types (for example, brain stimulation or psychedelics). We searched Medline, PsycINFO and Embase for controlled studies published between database inception and 25 May 2022. We conducted a preregistered random-effects meta-analysis (PROSPERO CRD42021236403). We identified 108 studies (N = 5,889). Acute augmentation significantly reduced the severity of mental health problems (Hedges’ g = −0.27, 95% CI: [−0.36, −0.18]; P < 0.0001), particularly for the transdiagnostic dimensions 'Fear' and 'Distress'. This result survived a trim-and-fill analysis to account for publication bias. Subgroup analyses revealed that pharmacological, psychological and somatic augmentations were effective, but to varying degrees. Acute augmentation approaches are a promising route to improve outcomes from psychological therapy.
论文原文:Camilla L. Nord, Beth Longley, Quentin Dercon, Veronica Phillips, Julia Funk, Siobhan Gormley, Rachel Knight, Alicia J. Smith & Tim Dalgleish (2023). A transdiagnostic meta-analysis of acute augmentations to psychological therapy. Nature - Mental Health, volume 1, pages 389–401 (15 May 2023). https://doi.org/10.1038/s44220-023-00048-6
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