Background

While Cognitive Behavioral Therapy (CBT) is recommended as first-line treatment for depression, a significant minority do not show an adequate treatment response. Despite evidence for the efficacy of Mindfulness-Based Therapies (MBT) both in treating current depression and preventing relapse, it remains unknown whether MBT and CBT are equivalent in the treatment of current depression.

Methods

Five databases were searched for randomized controlled trials (RCTs) directly comparing MBT with CBT and including depression as primary or secondary outcome.

Results

When pooling the results of 30 independent RCTs with a total of 2750 participants, MBT and CBT were statistically significantly equivalent at both post-intervention (Hedges's g = −0.009; p < .001) and follow-up (g = −0.033; p = .001). Supplementary Bayesian analyses provided further support for the alternative hypothesis of no difference between MBT and CBT. When exploring possible sources of heterogeneity, the differences at follow-up were smaller between CBT and mindfulness-based cognitive therapy (MBCT) than between CBT and mindfulness-based stress-reduction (MBSR) (Slope = 0.37;p = .022).

Conclusion

The currently available evidence suggests that that MBT and CBT are equally efficacious in treating current adult depression. It remains unclear whether the similar effects of the two intervention types are due to different mechanisms or common factors.

中文翻译：

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在头对头随机对照试验中比较基于正念的疗法和认知行为疗法对抑郁症的疗效：等效性的系统评价和荟萃分析

背景

虽然认知行为疗法 (CBT) 被推荐为抑郁症的一线治疗方法，但仍有少数人没有表现出足够的治疗反应。尽管有证据表明基于正念的疗法 (MBT) 在治疗当前抑郁症和预防复发方面均有效，但尚不清楚 MBT 和 CBT 在治疗当前抑郁症方面是否等效。

方法

在五个数据库中搜索了直接比较 MBT 与 CBT 并将抑郁症作为主要或次要结果的随机对照试验 (RCT)。

结果

当汇总 30 项独立 RCT 的结果时，共有 2750 名参与者，MBT 和 CBT 在干预后（Hedges 的g  = −0.009；p  < .001）和后续行动（g  = −0.033；p  =.001）。补充贝叶斯分析进一步支持了 MBT 和 CBT 之间没有差异的替代假设。在探索异质性的可能来源时，CBT 和基于正念的认知疗法 (MBCT) 之间的随访差异小于 CBT 和基于正念的减压 (MBSR) 之间的差异（斜率 = 0.37；p = .022 ）  。

结论

目前可用的证据表明，MBT 和 CBT 在治疗当前成人抑郁症方面同样有效。目前尚不清楚这两种干预类型的相似效果是由于不同的机制还是共同因素。