ABSTRACT
Objective: To facilitate personalized treatment for major depressive disorder (MDD) among adults, a systematic review was conducted to explore the moderators of treatment outcome between pharmacotherapy and psychotherapy. Methods: A systematic search of papers, published in English before April, 2017, was conducted in Pubmed, PsycINFO and EMbase. Totally 754 papers were screened in accordance with the predefined inclusive and exclusive criteria. Then the selected literatures were scored according to randomized controlled trial (RCT), statistical, and the sample-size quality criteria, and analyzed to find the moderators. Results: A total of 30 papers were included. Totally 11 got " + " in all four domains in RCT quality, 25 got the score of 4 in statistical quality, and 15 got 6 in sample-size quality. And the moderators were tested across 7 categories, namely, social demographic and contextual factors, symptom severity, preference, symptom subtype, comorbid personality traits or disorders, comorbid emotional disorders or emotional reactivity, and biological factors. Hypometabolism of the right anterior insula, positive summed functional connectivity, preference for psychotherapy, a greater number of events, married/co-habiting status, unemployment, therapy sites with better psychotherapists, more prior antidepressant exposures, and childhood trauma might be associated with better outcomes with psychotherapy, while preference for medicine, melancholic features, high levels of neuroticism, comorbid personality disorders, comorbid anxiety emotional disorders predicted better outcomes in pharmacotherapy than in psychotherapy. Conclusion: Patient characters have a moderation effect on outcomes between pharmacotherapy and psychotherapy, thus these characters should be considered in the selection of the two therapies. Due to the limited quantity of these reviewed papers, however, the results should be retested by future studies.
ABSTRACT
Objective To explore the posttraumatic stress disorder(PTSD) symptoms, coping styles and security sense of witnessed college students. Methods A cross-sectional survey was carried out among 800 freshmen and sophomores students from a medical university in Guangzhou. The participants were asked to fill posttraumatic stress disorder self-rating scale (PTSD-SS) ,simplified coping style questionnaire(SCSQ) and security questionnaire(SQ). Results 155 college students had witnessed injury and the ratio was 20.5% ( P ＜ 0.05 ).Compared to the students who hadn't witnessed experience, the witnessed college students had less security( 50.78± 5.63 vs 52.01 ± 5.19 ), less active coping styles ( 34.94 ± 5.42 vs 35.88 ± 5.45 ) and less sense of control (25.07 ±4.25 vs 26.11 ±3.71 ) ,and they had got a higher score in PTSD symptoms and negative coping styles.Apart from the interpersonal sense of security,the other differences were significant between the two groups ( P＜0.05 ); the scores of PTSD symptoms had significant correlation with the total and subscales of coping styles and sense of control (P ＜ 0.01 or P ＜ 0.05 ). Conclusion The witnessed college students have severer PTSD symptoms and less security,and tend to take negative coping styles.