The efficacy of antidepressant medication versus interpersonal psychotherapy for depression in middle-aged women: a systematic review and individual participant data meta-analysis

IF 3.2 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health Pub Date : 2026-07-20 DOI:10.1007/s00737-026-01730-1

Sanne N.E. van Haaren, Zachary D. Cohen, Jasmijn Breunese, Frederik J. Wienicke, John C. Markowitz, Erica S. Weitz, Steven D. Hollon, Dillon T. Browne, Paula Rucci, Carolina Corda, Marco Menchetti, Myrna M. Weissman, R. Michael Bagby, Lena C. Quilty, Marc B.J. Blom, Mario Altamura, Ingo Zobel, Elisabeth Schramm, Carlos Gois, Jos W.R. Twisk, Pim Cuijpers, Ellen Driessen

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Abstract

Purpose

Depression is highly prevalent in middle-aged women (MAW), but head-to-head comparisons of first-line interventions in this population are scarce. This systematic review and individual participant data (IPD) meta-analysis examined the comparative efficacy of antidepressant medication (ADM) and interpersonal psychotherapy (IPT) for MAW (aged 40–64) versus other adults (men and non-MAW) on depression, quality of life, and interpersonal problem measures.

Methods

PubMed, PsycINFO, Embase, and the Cochrane Library were searched January 1, 2025 to identify randomized trials comparing ADM and IPT for adults with depression. IPD were requested and analyzed using mixed-effects models.

Results

IPD were obtained from 9 of the 15 (60%) identified studies, comprising 1,490 participants (527 MAW, 963 other adults). MAW status did not significantly moderate ADM versus IPT comparative efficacy on depression (p = .10) and interpersonal problems (p = .29) outcomes. The two treatments did not significantly differ in treatment effect in the MAW group (depression: b = -0.03, p = .76; interpersonal problems: b = -0.20, p = .31). MAW status significantly moderated comparative efficacy on quality of life measures (b = 0.37, p = .02). Whereas IPT was non-significantly more efficacious than ADM for MAW (b = -0.18, p = .15), ADM were non-significantly more efficacious than IPT for other adults (b = 0.19, p = .051).

Conclusion

This is the first IPD meta-analysis directly comparing depression treatments in MAW. The absence of treatment effect differences indicates that other factors (e.g., patient preference) may guide choice between IPT and ADM in this population.

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抗抑郁药物与人际心理治疗对中年妇女抑郁症的疗效：系统回顾和个体参与者数据荟萃分析。

目的：抑郁症在中年妇女（MAW）中非常普遍，但在这一人群中，一线干预措施的面对面比较很少。本系统综述和个体参与者数据（IPD）荟萃分析检验了抗抑郁药物（ADM）和人际心理治疗（IPT）对MAW（40-64岁）与其他成年人（男性和非MAW）在抑郁、生活质量和人际问题测量方面的比较疗效。方法：于2025年1月1日检索PubMed、PsycINFO、Embase和Cochrane图书馆，以确定比较ADM和IPT治疗成人抑郁症的随机试验。使用混合效应模型对IPD进行了要求和分析。结果：15项研究中的9项（60%）获得了IPD，包括1490名参与者（527名MAW， 963名其他成年人）。MAW状态并没有显著调节ADM与IPT在抑郁（p = 0.10）和人际关系问题（p = 0.29）结局方面的比较疗效。MAW组两组治疗效果无显著差异（抑郁：b = -0.03, p = 0.76；人际关系：b = -0.20, p = 0.31）。MAW状态显著调节了生活质量测量的比较疗效（b = 0.37, p = 0.02）。对于MAW， IPT比ADM更有效（b = -0.18, p = 0.15），而对于其他成人，ADM比IPT更有效（b = 0.19, p = 0.051）。结论：这是第一个直接比较MAW抑郁症治疗的IPD荟萃分析。治疗效果差异的缺失表明，其他因素（如患者偏好）可能指导该人群在IPT和ADM之间的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Women's Mental Health 医学-精神病学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.