抑郁症的随机对照心理治疗：一项大型的系统综述与元分析

epression is a major global public health challenge and a leading cause of disability related to mental health. The global prevalence of depression is 4.4%, with a 12-month prevalence of 4-5% among adolescents. Depression not only threatens patients education, interpersonal relationships, and career development but is also prospectively associated with early death factors such as obesity, heart disease, and suicide. Various psychological treatments have shown significant effectiveness in alleviating depressive symptoms, improving quality of life, and reducing long-term recurrence rates. These methods include cognitive-behavioral therapy (CBT), behavioral activation therapy, third-wave cognitive-behavioral therapies, interpersonal therapy, and others. Randomized controlled trials (RCTs) are the gold standard for assessing the efficacy and safety of medical interventions, including psychological treatments. RCTs randomly allocate participants to treatment and control groups, ensuring baseline characteristics are similar across groups, thereby reducing bias and increasing the reliability of the results. Data for the study were sourced from the publicly available METAPSY database. The study included research from 1966 to January 2022. Studies had to be randomized controlled trials and report effect sizes for both psychological treatment and control groups. Inclusion criteria encompassed major depressive disorder, depressive states, and chronic depression. The current study is a comprehensive systematic review and meta-analysis evaluating the effectiveness of psychological treatments for depression. The study includes 415 research articles, encompassing 520 effect sizes, and involving 60,127 participants. Eight major psychological treatments were assessed, with an overall effect size of 0.72, indicating significant efficacy in alleviating depressive symptoms, particularly cognitive-behavioral therapy (CBT) which stood out prominently. Other treatments, such as behavioral activation therapy, third-wave cognitive-behavioral therapies, and interpersonal therapy, also demonstrated significant effects. Additionally, factors such as the type of control group, region, method of depression diagnosis, form of intervention, recruitment method, target population, and age significantly moderated the effects of psychological treatments. Despite providing extensive data, the study had some limitations, such as publication bias, broad definitions of depression, and variability in effect assessments. Future research should standardize definitions and evaluation criteria for depression and record therapists professional backgrounds in detail to improve comparability and accuracy. The study confirms the significant role of psychological treatments in managing depression, especially in resource-limited settings, demonstrating considerable therapeutic potential. It provides a scientific basis for the application of psychological treatments in public health and emphasizes the importance of further optimizing and promoting these treatments.