Engida Yisma, Sandra Walsh, Susan Hillier, Marianne Gillam, Richard Gray, Martin Jones
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引用次数: 0
摘要
研究背景先前的研究表明,行为激活疗法与认知行为疗法对一般抑郁症同样有效。目的:比较行为激活疗法与对照疗法在减少卒中后抑郁症患者抑郁症状方面的效果:本综述检索了自开始至2021年7月13日(更新至2023年9月15日)的五个数据库,以了解针对卒中后抑郁症的行为激活与任何对照条件的随机对照试验的比较情况。偏倚风险由 Cochrane 协作组织的 "偏倚风险 2 "工具进行评估。主要结果是卒中后抑郁症患者的抑郁症状得到改善。我们计算了随机效应、逆方差加权荟萃分析:在 922 项初步研究中,有五项随机对照试验符合纳入标准,共有 425 人参与。荟萃分析表明,在6个月的随访中,行为激活与中风后抑郁症患者抑郁症状的减少有关(Hedges' g -0.39; 95% CI -0.64至-0.14)。五项试验中有两项(40%)的偏倚风险较低,其余三项(60%)被评为偏倚风险较高。异质性较低,无不一致性迹象:本综述中的证据太少,无法证实行为激活疗法与对照组相比对卒中后抑郁症的治疗效果。要最终确定行为激活作为卒中后抑郁症治疗方法的有效性,还需要进一步的高质量研究。
Effect of behavioural activation for individuals with post-stroke depression: systematic review and meta-analysis.
Background: Previous research showed that behavioural activation is as effective as cognitive-behavioural therapy for general depression. However, it remains unclear if it leads to greater improvement in depressive symptoms when compared with standard treatment for post-stroke depression.
Aims: To compare the effectiveness of behavioural activation against control conditions in reducing depression symptoms in individuals with post-stroke depression.
Method: This review searched five databases from inception until 13 July 2021 (updated 15 September 2023) for randomised controlled trials comparing behavioural activation and any control conditions for post-stroke depression. Risk of bias was assessed with the Cochrane Collaboration's Risk-of-Bias 2 tool. The primary outcome was improvement in depressive symptoms in individuals with post-stroke depression. We calculated a random-effects, inverse variance weighting meta-analysis.
Results: Of 922 initial studies, five randomised controlled trials with 425 participants met the inclusion criteria. Meta-analysis showed that behavioural activation was associated with reduced depressive symptoms in individuals with post-stroke depression at 6-month follow-up (Hedges' g -0.39; 95% CI -0.64 to -0.14). The risk of bias was low for two (40%) of five trials, and the remaining three (60%) trials were rated as having a high risk of bias. Heterogeneity was low, with no indication of inconsistency.
Conclusions: Evidence from this review was too little to confirm the effectiveness of behavioural activation as a useful treatment for post-stroke depression when compared with control conditions. Further high-quality studies are needed to conclusively establish the efficacy of behavioural activation as a treatment option for post-stroke depression.
期刊介绍:
Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.