国内CBT联合药物干预强迫症的效果及影响因素:一项元分析  

The Effectiveness of CBT Combined with Drugs for Obsessive-compulsive Disorder in China: A Meta-analysis

作　　者：刘正杰 康有为 李张琴 武琪敏 张仲明 LIU Zheng-jie;KANG You-wei;LI Zhang-qin;WU Qi-min;ZHANG Zhong-ming(Faculty of Psychology,Southwest University,Chongqing 400715,China)

机构地区：[1]西南大学心理学部,重庆400715

出　　处：《中国临床心理学杂志》2021年第3期639-647,共9页Chinese Journal of Clinical Psychology

基　　金：国家自然科学基金“强迫症的认知神经机制及其干预策略——以强迫清洗亚型为例”(31171006)

摘　　要：目的:采用元分析方法探究国内认知行为疗法联合药物干预强迫症的效果及其影响因素。方法:通过系统检索多个中文数据库,共计纳入文献62篇,总样本量N=7476,运用R软件(V3.6.3)进行效应量合并以及调节效应分析。结果:国内认知行为疗法联合药物干预强迫症的合并效应量为g=-0.73(填补发表偏倚后g=-0.5),合并比值比OR=3.25(填补发表偏倚后OR=2.83);仅考虑单个变量的调节作用时,干预效果受被试平均年龄、干预周期、药物类型和盲法使用四个因素调节;在多元回归模型中,干预周期、药物类型和盲法使用对干预效果的调节效应仍然显著,其余变量的调节效应均不显著。结论:国内认知行为疗法联合药物干预强迫症的治疗效果较好,且优于单纯药物治疗或单纯认知行为治疗。Objective:In order to explore the effectiveness of cognitive-behavioral therapy(CBT)combined with drugs for obsessive-compulsive disorder in China and its moderating factors,a meta-analysis was used in this study.Methods:62 articles with a total sample size of 7476 were included through systematic retrieval of multiple Chinese databases.The effect size was pooled and moderation effect was analyzed by R software(V3.6.3).Results:The pooled effect size of CBT combined with drug for obsessive-compulsive disorder in China was-0.73(g=-0.5 after adjusting publication bias),and the pooled odds ratio was 3.25(OR=2.83 after adjusting publication bias);When only considering the moderation of single variable,the intervention effect was moderated by four factors:average age,intervention cycle,drug type and blind method;In the multiple regression model,the moderation effect of intervention cycle,drug type and blind method on the intervention effect were still significant,and the other variables had no significant moderation effect.Conclusion:The effectiveness of CBT combined with drugs for obsessive-compulsive disorder in China is better than drug therapy alone or cognitive behavioral therapy alone.

关 键 词：强迫症 认知行为疗法 调节作用 元分析 

分 类 号：R749.7[医药卫生—神经病学与精神病学]