認知行為團體治療對憂鬱症之成效：2000-2010年之統合分析

Meta-analysis of Cognitive-Behavioral Group Therapy for Depression 2000-2010

馮瓊儀(Chiueng-Yi Feng)

指導教授 ： 周桂如

臺北醫學大學/護理學院/護理學研究所/碩士(2010年)

摘要

研究目的︰本研究為探討及瞭解近十年認知行為團體治療主要對於憂鬱症在改善憂鬱程度及降低憂鬱症復發率的整體成效，並探討認知行為團體治療的研究特徵對效果量的影響。
研究方法︰本研究廣泛蒐集國內外西元2000年至2010年以英文發表的認知行為團體治療針對憂鬱症的量性研究作為研究樣本，篩檢符合本研究標準的研究樣本，運用統合分析的方法計算認知行為團體治療對憂鬱症的憂鬱程度與憂鬱症復發率整體效果量，及不同研究特徵間效果量的差異及與效果量的相關性。
結果︰本研究共納入32篇研究，認知行為團體治療對於改善憂鬱程度，認知行為團體治療具有立即效果(g=-0.40)及6個月內的持續性效果（g＝-0.38），但無超過6個月之持續性效果（g＝-0.06）；對於降低憂鬱症復發率，認知行為團體治療具有降低憂鬱症復發率的超過6個月持續性效果（risk difference, RD＝0.16）。在研究特徵次群組分析中有數個研究特徵在憂鬱程度立即效果量中有顯著差異，如研究採用一般照護作為控制組、每次團體進行1小時以上、有回家作業練習有較大的效果量，在研究特徵統合回歸分析中，參與者前測HRSD分數及參與者流失率與憂鬱程度立即效果量有顯著相關性；在憂鬱症復發率超過6個月效果量中只有參與者無/未說明殘存症狀有顯著較大的效果量。
結論︰認知行為團體治療對憂鬱症患者的憂鬱程度及憂鬱症復發率是具有小量效果，提供未來研究者及臨床實務者在照護憂鬱症患者的參考依據，並建議若欲讓患者持續保有治療效果，則建議至少每6個月再進行一次治療。

關鍵字

認知行為團體治療；憂鬱症；憂鬱症復發率；統合分析

並列摘要

Objective：This research investigates and understand the comprehensive effects of cognitive-behavior group therapy mainly for depressive disorder on depression and the rate of depression recurrence in recent years. Moreover, the features of cognitive-behavioral group therapy have an impact on effect size is discussed in this thesis as well.
Method：This research gathers a wide range of domestic and foreign quantitative studies that cognitive-behavioral group therapy for depression in English from 2000 to 2010. We screen these study sample that consistent with included criteria, use the technique of meta-analysis to determine an overall effect size of cognitive-behavioral group therapy for depressive disorder on depression and the rate of depression recurrence, the differences and correlation of effect sizes between the features with different levels.
Results：This study included 32 studies, We find overall effect size of cognitive-behavioral group therapy for improving the degree of depression at posttreatment (g =- 0.40) and within 6 months follow-up (g =- 0.38), but no more than 6 months follow-up (g =- 0.06), reducing the recurrence rate of depression over 6 months follow-up (risk difference, RD = 0.16). There are several features with significant differences in the greater effect sizes of depression at posttreatment , such as usual care as a control group, each group for 1 hour or more, with homework exercises. The participants’ HRSD scores of depression at pretest and drop out rate were significant predictors of the effect size of depression at posttreatment. Moreover, participants without residual symptoms was only significant predictor of the effect size of depression within 6 months follow-up.
Conclusion：cognitive-behavioral group therapy for depression had small effect sizes on depression and relapse rate to provides future researchers and clinical workers with useful references for caring patients with depression. It is recommended at least every 6 months to conduct cognitive-behavioral group therapy again for patients with depression to keep treatment effect.

並列關鍵字

cognitive-behavioral group therapy；depression；relapse and/or recurrence；Meta-analysis

參考文獻

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