Comparative efficacy of interpersonal psychotherapy and antidepressant medication for adult depression: a systematic review and individual participant data meta-analysis.

IF 5.9 2区 医学 Q1 PSYCHIATRY Psychological Medicine Pub Date : 2024-11-04 DOI:10.1017/S0033291724001788
Zachary D Cohen, Jasmijn Breunese, John C Markowitz, Erica S Weitz, Steven D Hollon, Dillon T Browne, Paola 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, Frederik J Wienicke, Pim Cuijpers, Ellen Driessen
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Abstract

Interpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional meta-analyses. This IPD meta-analysis compared the efficacy of IPT and antidepressants on various outcomes at post-treatment and follow-up (PROSPERO: CRD42020219891). A systematic literature search conducted May 1st, 2023 identified randomized trials comparing IPT and antidepressants in acute-phase treatment of adults with depression. Anonymized IPD were requested and analyzed using mixed-effects models. The prespecified primary outcome was post-treatment depression symptom severity. Secondary outcomes were all post-treatment and follow-up measures assessed in at least two studies. IPD were obtained from 9 of 15 studies identified (N = 1536/1948, 78.9%). No significant comparative treatment effects were found on post-treatment measures of depression (d = 0.088, p = 0.103, N = 1530) and social functioning (d = 0.026, p = 0.624, N = 1213). In smaller samples, antidepressants performed slightly better than IPT on post-treatment measures of general psychopathology (d = 0.276, p = 0.023, N = 307) and dysfunctional attitudes (d = 0.249, p = 0.029, N = 231), but not on any other secondary outcomes, nor at follow-up. This IPD meta-analysis is the first to examine the acute and longer-term efficacy of IPT v. antidepressants on a broad range of outcomes. Depression treatment trials should routinely include multiple outcome measures and follow-up assessments.

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人际心理治疗和抗抑郁药物治疗成人抑郁症的疗效比较:系统综述和个体参与者数据荟萃分析。
人际心理治疗(IPT)和抗抑郁药物治疗都是成人抑郁症的一线干预措施,但它们的长期疗效以及对抑郁症状以外的其他结果指标的相对疗效尚不清楚。与传统的荟萃分析相比,个体参与者数据(IPD)荟萃分析能提供更精确的效果估计。这项IPD荟萃分析比较了IPT和抗抑郁药在治疗后和随访期间对各种结果的疗效(PROSPERO:CRD42020219891)。2023 年 5 月 1 日进行的系统性文献检索确定了在成人抑郁症急性期治疗中比较 IPT 和抗抑郁药的随机试验。研究人员申请了匿名 IPD,并使用混合效应模型进行了分析。预设的主要结果是治疗后抑郁症状的严重程度。次要结果为至少两项研究中评估的所有治疗后和随访措施。在确定的 15 项研究中,有 9 项获得了 IPD(N = 1536/1948,78.9%)。在抑郁(d = 0.088,p = 0.103,N = 1530)和社会功能(d = 0.026,p = 0.624,N = 1213)的治疗后测量中,未发现明显的比较治疗效果。在较小的样本中,抗抑郁药在治疗后的一般精神病理学测量(d = 0.276,p = 0.023,N = 307)和功能失调态度(d = 0.249,p = 0.029,N = 231)方面的表现略优于 IPT,但在其他次要结果和随访中的表现则不尽相同。这项IPD荟萃分析首次研究了IPT与抗抑郁药在一系列结果上的急性和长期疗效。抑郁症治疗试验应常规包含多种结果测量和随访评估。
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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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