人际关系问题是成人抑郁症治疗效果的预测因素：个体参与者数据荟萃分析

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2025-03-27 DOI:10.1016/j.cpr.2025.102570

Juan Martín Gómez Penedo , Manuel Meglio , Christoph Flückiger , Frederik J. Wienicke , Jasmijn Breunese , Marco Menchetti , Paola Rucci , Robert Johansson , Joel M. Town , Allan A. Abbass , Peter Lilliengren , R. Michael Bagby , Lena C. Quilty , Lotte H.J.M. Lemmens , Suzanne C. van Bronswijk , Michael Barkham , William B. Stiles , Gillian E. Hardy , Peter Fonagy , Patrick Luyten , Ellen Driessen

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引用次数: 0

摘要

目的人际关系问题是抑郁症的一个基本特征，但对其与治疗结果关联的研究水平荟萃分析受到了主要研究分析和报告结果异质性的限制。我们进行了一项预注册的个体参与者数据荟萃分析（IPD-MA）来检验成人抑郁症的这种关系。这种荟萃分析策略可以通过标准化跨主要研究的数据分析来减少可变性。方法我们纳入了五种治疗成人抑郁症的疗效的研究，并在基线时评估人际关系问题。一期IPD-MA采用三水平混合模型进行，以确定基线总体人际困扰、代理和交流是否预测治疗后、12个月和24个月随访时的抑郁症状水平。研究了不同处理方式的调节作用。结果10项研究（包括n = 1282名受试者）符合纳入标准。只有总体人际困扰与治疗后（γ = 0.11, CI95[0.06, 0.16], r = 0.11）、12个月随访（γ = 0.17, CI95[0.08, 0.25], r = 0.17）和24个月随访（γ = 0.16, CI95[0.05, 0.26], r = 0.16）的结果呈负相关，表明效应较小。代理和交流维度与结果没有显著相关。治疗类型不显著调节人际痛苦与预后的关联。讨论结果显示，在短暂的抑郁症治疗中，患者基线总体人际困扰与随后的抑郁症治疗结果之间存在很小的关联。进一步的研究可能需要考虑治疗师的影响。注册号为osf.io/u46t7

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Interpersonal problems as a predictor of treatment outcome in adult depression: An individual participant data meta-analysis

Objectives

Interpersonal problems are a fundamental feature of depression, but study-level meta-analyses of their association with treatment outcome have been limited by heterogeneity in primary studies' analyses and reported results. We conducted a pre-registered individual participant data meta-analysis (IPD-MA) to examine this relationship for adult depression. This meta-analytic strategy can reduce variability by standardizing data analysis across primary studies.

Methods

We included studies examining the efficacy of five treatments for adult depression and assessing interpersonal problems at baseline. One-stage IPD-MA was conducted with three-level mixed models to determine whether baseline overall interpersonal distress, agency, and communion predicted depressive symptom level at post-treatment, 12-month, and 24-month follow-up. The moderating effect of treatment type was also investigated.

Results

Ten studies (including n = 1282 participants) met inclusion criteria. Only overall interpersonal distress was negatively related with outcomes at post-treatment (γ = 0.11, CI₉₅[0.06, 0.16], r = 0.11), 12-month follow-up (γ = 0.17, CI₉₅[0.08, 0.25], r = 0.17), and 24-month follow-up (γ = 0.16, CI₉₅[0.05, 0.26], r = 0.16), indicative of smaller effect sizes. The agency and communion dimensions were not significantly related to outcome. Treatment type did not significantly moderate interpersonal distress-outcome associations.

Discussion

Results show a small association between patient baseline overall interpersonal distress and subsequent depression treatment outcome in brief treatments for depression. Further studies might require to account for therapist effects.

Registration number osf.io/u46t7

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.