Background

Non-responsiveness to treatment occurs in approximately one third of patients. Randomized clinical trials of psychotherapy options for these patients are scarce and systematic knowledge about whether psychotherapy is a viable option is lacking.

Objectives

This meta-analysis aimed to 1) determine the amount of evidence available for treatment non-response using psychotherapy relative to pharmacological procedures; 2) systematically review randomized controlled psychotherapy trials (RCTs) used to treat non-responders; and 3) examine whether some psychotherapies are more efficacious than others.

Data sources

Online databases were systematically examined and references of relevant systematic reviews were hand-searched.

Study eligibility criteria

RCTs that administered a psychotherapy new to non-responders were considered. All Mood and Anxiety Disorders were considered. No limitations were made with respect to type of treatment.

Review method

A meta-analytic review of the psychotherapy RCTs for treatment non-responders.

Results

Results showed that psychotherapy was successful in treating treatment non-responders with a medium to large effect size. Between-group comparisons did not reveal significant differences in treatment effects for any of the assessed disorder or treatment types. Effects were maintained at follow-up.

Conclusions

Psychotherapy is a viable treatment option for treatment non-responders. More attention to this group of patients is needed and more research with better quality studies is warranted. Recommendations are discussed.

中文翻译：

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治疗无反应者：一项随机对照心理治疗试验的荟萃分析。

背景

对治疗无反应的患者约占三分之一。对于这些患者的心理治疗选择的随机临床试验是稀缺的，并且缺乏关于心理治疗是否可行的系统性知识。

目标

这项荟萃分析旨在：1）确定相对于药理学方法，使用心理疗法可用于治疗无反应的证据数量；2）系统地审查用于治疗无反应者的随机对照心理治疗试验（RCT）；3）检查某些心理疗法是否比其他疗法更有效。

数据源

对在线数据库进行了系统地检查，并对相关系统评价的参考文献进行了手工搜索。

研究资格标准

考虑了对非应答者进行心理治疗的RCT。考虑了所有的情绪和焦虑症。对于治疗类型没有限制。

审查方法

对无反应者进行心理治疗的随机对照试验的荟萃分析综述。

结果

结果表明，心理疗法成功治疗了中度至大型效应的无反应者。组间比较未显示任何评估的疾病或治疗类型在治疗效果上的显着差异。在随访中保持效果。

结论

对于无反应者，心理疗法是一种可行的治疗选择。需要更多地关注这类患者，并且需要进行更多质量更好的研究。讨论了建议。