Effectiveness of Cognitive Behavioral Therapy for Depression in Patients Receiving Disability Benefits: A Systematic Review and Individual Patient Data Meta-Analysis

被引：9

作者：

Ebrahim, Shanil ^{[1
]}

Montoya, Luis ^{[2
]}

Wanda Truong ^{[3
]}

Hsu, Sandy ^{[4
]}

el Din, Mostafa Kamal ^{[5
]}

Carrasco-Labra, Alonso ^{[1
,6
]}

Busse, Jason W. ^{[7
]}

Walter, Stephen D. ^{[1
,8
]}

Heels-Ansdell, Diane ^{[1
]}

Couban, Rachel ^{[7
]}

Patelis-Siotis, Irene ^{[9
]}

Bellman, Marg ^{[10
]}

de Graaf, L. Esther ^{[11
]}

Dozois, David J. A. ^{[12
]}

Bieling, Peter J.

Guyatt, Gordon H. ^{[1
,13
]}

机构：

[1] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada

[2] Santo Tomas Univ, Dept Dent, Bogota, Colombia

[3] McMaster Univ, McMaster Integrat Neurosci Discovery & Study Prog, Hamilton, ON, Canada

[4] McMaster Univ, Dept Oncol, Hamilton, ON, Canada

[5] Ain Shams Univ, Fac Med, Cairo, Egypt

[6] Univ Chile, Fac Dent, Evidence Based Dent Unit, Santiago, Chile

[7] McMaster Univ, Dept Anesthesia, Hamilton, ON, Canada

[8] McMaster Univ, Dept Math & Stat, Hamilton, ON, Canada

[9] St Josephs Healthcare, Mood Disorders Program, Hamilton, ON, Canada

[10] Sun Life Financial, Natl Disabil Serv, Policy & Procedure Dept, Toronto, ON, Canada

[11] Erasmus MC Univ, Med Ctr, Dept Med Psychol & Psychotherapy, Rotterdam, Netherlands

[12] Univ Western Ontario, Dept Psychol, London, ON, Canada

[13] McMaster Univ, Dept Med, Hamilton, ON, Canada

来源：

PLOS ONE | 2012年 / 7卷 / 11期

基金：

加拿大健康研究院;

关键词：

MONEY MATTERS; PRIMARY-CARE; COMPENSATION; ANXIETY; WORKERS; PSYCHOPATHOLOGY; ASSOCIATION; DISORDER; EFFICACY; SURGERY;

D O I：

10.1371/journal.pone.0050202

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Objectives: To systematically summarize the randomized trial evidence regarding the relative effectiveness of cognitive behavioural therapy (CBT) in patients with depression in receipt of disability benefits in comparison to those not receiving disability benefits. Data Sources: All relevant RCTs from a database of randomized controlled and comparative studies examining the effects of psychotherapy for adult depression (http://www.evidencebasedpsychotherapies.org), electronic databases (MEDLINE, EMBASE, PSYCINFO, AMED, CINAHL and CENTRAL) to June 2011, and bibliographies of all relevant articles. Study Eligibility Criteria, Participants and Intervention: Adult patients with major depression, randomly assigned to CBT versus minimal/no treatment or care-as-usual. Study Appraisal and Synthesis Methods: Three teams of reviewers, independently and in duplicate, completed title and abstract screening, full text review and data extraction. We performed an individual patient data meta-analysis to summarize data. Results: Of 92 eligible trials, 70 provided author contact information; of these 56 (80%) were successfully contacted to establish if they captured receipt of benefits as a baseline characteristic; 8 recorded benefit status, and 3 enrolled some patients in receipt of benefits, of which 2 provided individual patient data. Including both patients receiving and not receiving disability benefits, 2 trials (227 patients) suggested a possible reduction in depression with CBT, as measured by the Beck Depression Inventory, mean difference [MD] (95% confidence interval [CI]) = -2.61 (-5.28, 0.07), p = 0.06; minimally important difference of 5. The effect appeared larger, though not significantly, in those in receipt of benefits (34 patients) versus not receiving benefits (193 patients); MD (95% CI) = -4.46 (-12.21, 3.30), p = 0.26. Conclusions: Our data does not support the hypothesis that CBT has smaller effects in depressed patients receiving disability benefits versus other patients. Given that the confidence interval is wide, a decreased effect is still possible, though if the difference exists, it is likely to be small.

引用

页数：8