The clinical efficacy of psychological interventions for bipolar depression: a systematic review and individual patient data (IPD) meta-analysis.

IF 5.5 2区 医学 Q1 PSYCHIATRY
Sakir Yilmaz, Anna Huguet, Steve Kisely, Sanjay Rao, JianLi Wang, Molly Price, Richard Morriss, Maree Inder, Tania Perich, Kim Wright
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Abstract

Unlike conventional meta-analyses, individual patient data (IPD) meta-analysis assesses moderator variables at the level of each participant, which generates more precise and biased estimates. The objective of this study was to investigate whether psychological therapy reduces depression symptoms in people with Bipolar I and II disorders and examine whether baseline depression has a moderating effect on treatment outcomes. Through the use of several electronic databases, a systematic search was conducted. Eligible studies were randomized controlled trials evaluating a psychological intervention for adults diagnosed with Bipolar I or II disorder. Titles and abstracts were screened, followed by full texts. The authors of the included studies were asked to provide IPD from their trials. A multilevel model approach was used to analyze the data. From the 7552 studies found by our searches, six studies with 668 study participants were eligible. Intervention significantly reduced depression scores. There was a significant association between baseline depression and post treatment depression scores. There was no statistically significant interaction between condition allocation and baseline depression score. When IPD from the two most comparable studies were analyzed, CBT had reduced depression scores relative to the comparator condition. The study included patient data from only six studies which were heterogeneous in terms of intervention type, outcome measure, and comparators. Overall, the psychological interventions tested significantly reduced bipolar depression scores. There was no evidence of moderation by baseline depression scores.

心理干预治疗双相抑郁症的临床疗效:一项系统综述和个体患者数据(IPD)荟萃分析。
与传统的荟萃分析不同,个体患者数据(IPD)荟萃分析在每个参与者的水平上评估调节变量,从而产生更精确和有偏见的估计。本研究的目的是调查心理治疗是否能减轻双相I型和II型患者的抑郁症状,并检查基线抑郁是否对治疗结果有调节作用。通过使用几个电子数据库,进行了系统的检索。符合条件的研究是随机对照试验,评估心理干预对诊断为双相I或II障碍的成年人的影响。先筛选标题和摘要,然后是全文。纳入研究的作者被要求提供他们试验的IPD。采用多层次模型方法对数据进行分析。从我们搜索到的7552项研究中,有6项研究有668名研究参与者符合条件。干预显著降低抑郁评分。基线抑郁和治疗后抑郁评分之间存在显著关联。条件分配与基线抑郁评分之间无统计学意义的交互作用。当两项最具可比性的研究分析IPD时,CBT相对于比较条件降低了抑郁评分。该研究仅包括来自6项研究的患者数据,这些研究在干预类型、结果测量和比较物方面存在异质性。总的来说,心理干预测试显著降低了双相抑郁得分。没有证据表明基线抑郁评分有缓和作用。
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来源期刊
Psychological Medicine
Psychological Medicine 医学-精神病学
CiteScore
11.30
自引率
4.30%
发文量
711
审稿时长
3-6 weeks
期刊介绍: Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.
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