OBJECTIVE Evidence on the optimal "dose" of cognitive behavioral therapy (CBT) for treating major depressive disorder is sparse. This analysis aimed to evaluate the dose-response curve in CBT using a nonlinear approach, whereby "dose" was defined as number of treatment sessions. The dose-response curve of CBT was compared to other psychotherapies and pharmacological treatments for depression. METHOD A systematic review and metaregression analysis of randomized controlled trials (RCTs) examining the efficacy of CBT in adults with acute depression was conducted. Treatment arms examining other psychosocial or pharmacological interventions were also analyzed. Cubic spline metaregression techniques were used to model nonlinear dose-response curves. RESULTS Seventy-two studies and 7,377 participants were included. Modeling the dose-response curve between change of depression symptom severity and the number of CBT sessions resulted in a nonlinear curve characterized by a strong improvement in symptom severity from baseline within the first eight sessions. Symptom reduction continues in the further course of the treatment, but at a slower pace. A similar pattern of symptom development was found for other therapies as well, although the prominence of early improvement and overall effect sizes vary across treatment arms. CONCLUSION Results imply a general tendency for the strongest alleviation of depressive symptom severity in early stages of CBT treatment, thus, if aiming at symptom alleviation, speak for short CBT interventions. However, these findings have to be discussed in the light of the limited data regarding the sustainability of treatment effects in short-term therapies and effects beyond symptomatic changes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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抑郁症认知行为治疗的剂量反应关系：非线性元回归分析。


客观关于治疗重度抑郁症的认知行为疗法（CBT）的最佳“剂量”的证据很少。该分析旨在使用非线性方法评估 CBT 的剂量反应曲线，其中“剂量”被定义为治疗次数。将 CBT 的剂量反应曲线与其他抑郁症心理治疗和药物治疗进行比较。方法 对随机对照试验 (RCT) 进行系统评价和荟萃回归分析，研究 CBT 对成人急性抑郁症的疗效。还分析了检查其他心理社会或药物干预措施的治疗组。使用三次样条元回归技术来模拟非线性剂量反应曲线。结果 纳入 72 项研究和 7,377 名参与者。对抑郁症症状严重程度变化与 CBT 疗程次数之间的剂量反应曲线进行建模，得出了一条非线性曲线，其特征是前八个疗程内症状严重程度较基线有显着改善。在进一步的治疗过程中，症状会继续减轻，但速度会减慢。其他疗法也发现了类似的症状发展模式，尽管早期改善的显着性和总体效果大小因治疗组而异。结论 结果表明，在 CBT 治疗的早期阶段，抑郁症状严重程度的缓解有最强的趋势，因此，如果以缓解症状为目标，则应采用短期 CBT 干预。然而，这些发现必须根据有关短期治疗效果的可持续性和症状变化以外的效果的有限数据进行讨论。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。