Data_Sheet_1_The Impact of Cognitive Behavioral Therapy on Peripheral Interleukin-6 Levels in Depression: A Systematic Review and Meta-Analysis.pdf

There is interest in the role of peripheral interleukin-6 (IL-6) in depression and the effect of treatment (e. g., pharmacologic, psychosocial, neurostimulation). However, the relationship between cognitive behavioral therapy (CBT), IL-6 and depression has not yet been established. We conducted a meta-analysis to explore the association between CBT and change of peripheral IL-6 levels in depressive symptoms or major depressive disorder (MDD). A systematic search of online databases (i.e., PubMed, Web of Science, Google Scholar, PsycINFO, and Cochrane Library) was completed from inception to May 2021. In total, 10 eligible papers with 940 participants reporting peripheral IL-6 levels before and after CBT were included in the analysis. The main result indicates that peripheral levels of IL-6 were significantly lower after CBT intervention in individuals with depression, with a small effect (SMD = 0.38, 95% CI: 0.07, 0.69, p = 0.02). The results of subgroup analyses demonstrate that (1) there was a significant decrease in IL-6 for studies that were equal to or <8 weeks in duration vs. more than 8 weeks in duration, and (2) IL-6 was significantly reduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis (i.e., DSM-IV, DSM-IV-TR, or DSM-V) of MDD, but not for the subgroup without DSM diagnosis. Publication year was identified as a potential contributor to heterogeneity of the results from our analysis. Taken together, our findings support the notion that CBT influences peripheral IL-6 in individuals with depression and represents a point of commonality with other antidepressant treatment modalities (e.g., antidepressants).
Systematic Review Registrationhttps://doi.org/10.17605/osf.io/tr9yh, identifier: 10.17605/osf.io/tr9yh.

学界对于外周白细胞介素-6（interleukin-6, IL-6）在抑郁症中的作用，以及各类治疗手段（如药物治疗、社会心理干预、神经刺激疗法）的疗效均存在研究兴趣。然而，认知行为疗法（cognitive behavioral therapy, CBT）、IL-6与抑郁症三者之间的关联尚未明确。本研究开展荟萃分析，旨在探讨认知行为疗法与抑郁症患者（含抑郁症状群体及重性抑郁障碍（major depressive disorder, MDD）患者）外周IL-6水平变化之间的关联。研究于2021年5月前，对各在线数据库自建库起至当日进行了系统检索，检索范围涵盖PubMed、Web of Science、Google Scholar、PsycINFO及Cochrane Library。最终共有10篇符合纳入标准的文献纳入本次分析，共涉及940名报告了认知行为疗法干预前后外周IL-6水平的受试者。核心结果显示，抑郁症患者在接受认知行为疗法干预后，其外周IL-6水平显著降低，效应量较小（标准化均数差（standardized mean difference, SMD）=0.38，95%置信区间（95% confidence interval, 95% CI）：0.07~0.69，P=0.02）。亚组分析结果显示：① 干预时长≤8周的研究亚组中，患者外周IL-6水平出现显著降低，而干预时长超过8周的亚组未观察到该效应；② 采用《精神障碍诊断与统计手册》（Diagnostic and Statistical Manual of Mental Disorders, DSM，包括DSM-IV、DSM-IV-TR及DSM-V）诊断重性抑郁障碍的亚组中，IL-6水平显著下降，但未采用DSM诊断的亚组未出现该变化。本研究分析表明，文献发表年份是导致研究结果存在异质性的潜在因素之一。综上，本研究结果支持以下观点：认知行为疗法可调节抑郁症患者的外周IL-6水平，且与其他抗抑郁治疗手段（如抗抑郁药物）具有共通的作用特征。系统评价注册信息：https://doi.org/10.17605/osf.io/tr9yh，识别码：10.17605/osf.io/tr9yh。