Biological markers evaluated in randomized trials of psychological treatments for depression: a systematic review and meta-analysis

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:101

Review

Cristea, Ioana A.^1,2  Karyotaki, Eirini³  Hollon, Steven D.⁴  Cuijpers, Pim⁵  Gentili, Claudio⁵ 

[1] Babes Bolyai Univ, Dept Clin Psychol & Psychotherapy, Cluj Napoca, Romania

[2] Vrije Univ Amsterdam, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands

[3] Vrije Univ Amsterdam, Amsterdam Publ Hlth Res Inst, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands

[4] Vanderbilt Univ, Dept Psychol, Nashville, TN 37240 USA

[5] Univ Padua, Dept Gen Psychol, Via Venezia 8, I-35135 Padua, Italy

关键词: Psychotherapy;    Biomarkers;    Depression;    Randomized controlled trial;    Meta-analysis;   

DOI  :  10.1016/j.neubiorev.2019.03.022

来源: Elsevier

【 摘 要 】

Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding. We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression. Fifty-one trials (5123 participants) and a pooled analysis were included. Biological markers were outcomes in 43 studies and predictors of treatment response in 9. At post-treatment, psychotherapy could not be distinguished from control conditions for glycaemic control (Hb1AC), 7 trials, Hedges' g= -.01, 95% CI -0.30 to 0.29, I-2 = 65% and cortisol concentration after-wake, 5 trials, Hedges' g= -.19, 95% CI -0.45 to 0.06, I-2 = 0%. Follow-up results were similar. For the other biological domains (immunological, neurobiological, inflammatory, weight, blood pressure), overall findings were mixed and often inconsistent. Few trials investigated prediction of response, with only neuroimaging markers showing promise. Across domains, we found limited evidence that benefits of psychological treatments for depression translate to biological outcomes.

【 授权许可】

Free