Objective

Anxiety and depression in chronic disease are common and burdensome co-morbidities. There has been growing interest in cognitive and behavioral therapies (CBTs) for anxiety and depression in chronic disease, however their efficacy has not been well-established. This study examined the efficacy of CBTs for depression and/or anxiety symptoms within chronic disease and explored the moderating role of clinical and methodological characteristics.

Methods

Following prospective registration, electronic databases were searched up to 2023 for randomized controlled trials (RCTs) examining CBTs for depression and/or anxiety in any adult chronic disease population.

Results

We included 56 RCTs. The overall effect of CBTs was g = 0.61 (95% CI, 0.49, 0.72) for depression and g = 0.56 (95% CI, 0.42, 0.70) for anxiety. A range of methodological features significantly moderated the effect sizes obtained, including type of control group and the outcome measure used. Risk of Bias ratings indicated some concerns regarding RCT conduct and reporting.

Conclusions

CBTs lead to moderate improvements in both depression and anxiety symptoms among people with chronic disease. However, the efficacy of CBT should be interpreted considering certain study and sample characteristics. It is recommended that future studies make improvements to study methodology and reporting.

中文翻译：

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慢性病患者抑郁和焦虑的认知行为疗法：系统评价和荟萃分析

客观的

慢性疾病中的焦虑和抑郁是常见且令人负担的合并症。人们对慢性病焦虑和抑郁的认知和行为疗法（CBT）越来越感兴趣，但其疗效尚未得到充分证实。这项研究检验了 CBT 对慢性疾病中抑郁和/或焦虑症状的功效，并探讨了临床和方法学特征的调节作用。

方法

前瞻性注册后，我们在电子数据库中搜索了截至 2023 年的随机对照试验 (RCT)，以检查 CBT 对任何成人慢性病人群的抑郁和/或焦虑的影响。

结果

我们纳入了 56 项 RCT。CBT 对抑郁症的总体效果为 g = 0.61 (95% CI, 0.49, 0.72)，对焦虑症的总体效果为 g = 0.56 (95% CI, 0.42, 0.70)。一系列方法学特征显着调节了所获得的效应大小，包括对照组的类型和所使用的结果测量。偏差风险评级表明了对 RCT 实施和报告的一些担忧。

结论

CBT 可适度改善慢性病患者的抑郁和焦虑症状。然而，CBT 的疗效应考虑某些研究和样本特征来解释。建议未来的研究改进研究方法和报告。