Intervention Review

Family therapy for depression

  1. Tamara Henken1,*,
  2. Marcus J.H. Huibers2,
  3. Rachel Churchill3,
  4. Kathleen K Restifo4,
  5. Jeffrey J Roelofs4

Editorial Group: Cochrane Depression, Anxiety and Neurosis Group

Published Online: 18 JUL 2007

Assessed as up-to-date: 22 MAY 2007

DOI: 10.1002/14651858.CD006728


How to Cite

Henken T, Huibers MJ, Churchill R, Restifo KK, Roelofs JJ. Family therapy for depression. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD006728. DOI: 10.1002/14651858.CD006728.

Author Information

  1. 1

    Primulastraat 3, Eindhoven, Netherlands

  2. 2

    Maastricht University, Department of Clinical Psychological Science , Maastricht, Netherlands

  3. 3

    University of Bristol, Academic Unit of Psychiatry, Community Based Medicine, Bristol, Avon, UK

  4. 4

    Maastricht University, Department of Medical, Clinical and Experimental Psychology, Maastricht, Netherlands

*Tamara Henken, Primulastraat 3, Eindhoven, 5644 LH , Netherlands. h.henken@student.unimaas.nl.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 JUL 2007

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

People with depression often experience interpersonal problems. Family therapy for depression is a widely used intervention, but it is unclear whether this is an effective therapy for the treatment of depression.

Objectives

To assess the efficacy of family therapy for depression.

Search methods

The following electronic databases were searched using a specific search strategy: CCDANCTR-Studies and CCDANCTR-References searched on 21/10/2005, The Cochrane Central Register of Controlled Trials, Medline (1966 to January 2005), EMBASE (1980 to January 2005), Psycinfo (1974 to January 2005). Reference lists of articles were also searched. Handsearches of relevant journals and bibliographies were conducted and first authors of included studies and experts in the field were contacted for further information.

Selection criteria

Included studies were randomised controlled and controlled clinical trials comparing family therapy with no intervention or an alternative intervention in which depression symptomatology was a main outcome measure.

Data collection and analysis

Methodological quality was independently assessed by two review authors using the Maastricht-Amsterdam Criteria List. The qualitative and quantitative characteristics of the selected trials were independently extracted by three review authors using a standardised data extraction form. Levels of evidence were used to determine the strength of the evidence available. It was not possible to perform meta-analyses because of the heterogeneity of the selected studies.

Main results

Three high-quality and three low-quality studies, involving 519 people with depression, were identified. The studies were very heterogeneous in terms of interventions, participants, and measuring instruments. Despite fairly good methodological quality and positive findings of some studies, evidence for the effectiveness of family therapy for depression did not exceed level 3 (limited or conflicting evidence), except for moderate evidence (level 2), based on the non-combined findings from three studies, indicating that family therapy is more effective than no treatment or waiting list condition on decreasing depression, and on increasing family functioning.

Authors' conclusions

The current evidence base is too heterogeneous and sparse to draw conclusions on the overall effectiveness of family therapy in the treatment of depression. At this point, use of psychological interventions for the treatment of depression for which there is already an evidence-base would seem to be preferable to family therapy. Further high quality trials examining the effectiveness and comparative effectiveness of explicitly defined forms of family therapy are required.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Family therapy for depression

This review looks at whether family therapy is an effective intervention in treating people of any age with depression. Family therapy for depression is widely used, especially in the United Kingdom and the United States. The small number of randomised controlled trials included in the review were very heterogeneous, and therefore difficult to synthesise. Family therapy seems more effective than no treatment or being placed on a waiting list, but it remains unclear how effective this intervention is in comparison to other interventions. Further randomised controlled trials are needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

憂鬱症的家族治療

憂鬱症患者通常會有人際上的問題,而家族治療常廣泛地使用在憂鬱症患者身上,不過還不清楚家族治療究竟是否是一種有效的治療方法。

目標

評估家族治療對於憂鬱症患者的有效性

搜尋策略

我們使用特定的搜尋策略來搜尋電子資料庫:搜尋到 21/10/2005的CCDANCTRStudies and CCDANCTRReferences,The Cochrane Central Register of Controlled Trials, Medline (1966 to January 2005), EMBASE (1980 to January 2005), Psycinfo (1974 to January 2005). 搜尋文章後的參考文獻,並手動搜尋相關期刊及書目,並且與納入研究的第一作者和這一個領域的專家接觸來獲得更進一步的資訊。

選擇標準

這篇文獻包含了隨機對照試驗和對照臨床試驗的研究,比較家族治療與無任何介入治療或其他替代治療方式的效果差異,而憂鬱症狀是主要的結果測量值。

資料收集與分析

由2位作者分別使用MaastrichtAmsterdam Criteria List來評估方法學上的品質。由3名的作者分別使用標準化的資料摘錄格式來紀錄這些研究的質與量的特徵,使用證據等級來標示證據的強弱。由於這些研究的異質性因此無法使用metaanalyses。

主要結論

確認出3篇高品質和3篇低品質的研究,包括了519名憂鬱症的患者。不論在處置上、在受試方面、在測量說明上這些研究是相當的異質性。儘管在一些研究有相當好的方法學的品質及正向的發現,但是對憂鬱症患者的家族治療的有效性並沒有超過等級3(限制或矛盾的證據)。除了中度證據等級(等級2),基於非將資料合併計算的基礎上,從3個研究顯示家族治療比沒有治療或者還在等候名單的憂鬱症患者來說更有效,也有更好的家庭功能

作者結論

家族治療對於憂鬱症患者的有效性因為現有資料證據的異質性太高、太少,因此很難形成結論。目前已經有證據基礎的心理治療模式用來治療憂鬱症患者似乎比家族治療更好。未來需要更多高品質的臨床研究來驗證家族治療的有效性

翻譯人

本摘要由彰化基督教醫院胡淑惠翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

使用家族治療治療憂鬱這篇的回顧文獻主要是看家族治療對於任何年齡層的憂鬱症患者是否是一個有效的治療方式。特別是在美國和英國,家族治療廣泛的運用在憂鬱症的患者。包含在這篇文獻內的少數的隨機對照試驗異質性較高,因此相當難整合。家族治療似乎比沒有給於任何治療或還在等候名單的還要有效。然而比起其他的處置方式來說,我們並不清楚這種治療是如何有效。未來需要更多的隨機對照試驗的研究來支持。