成人创伤后应激障碍的心理干预：已发表的荟萃分析的系统回顾

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders Pub Date : 2025-04-08 DOI:10.1016/j.janxdis.2025.103017

Ahlke Kip , Linnea Ritter , Thole H. Hoppen , Davide Papola , Giovanni Ostuzzi , Corrado Barbui , Nexhmedin Morina

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引用次数: 0

摘要

目的：越来越多已发表的荟萃分析研究了心理干预对创伤后应激障碍（PTSD）的疗效。这些荟萃分析得出的疗效结论对临床实践有很大影响。本研究旨在对成人创伤后应激障碍心理干预的随机对照试验（RCTs）的荟萃分析进行全面回顾，重点关注其内容、方法和报告质量。方法于2024年3月使用MEDLINE、PsycInfo、PTSDpubs、Web of Science和Cochrane系统综述数据库进行系统检索。采用AMSTAR 2评估meta分析的质量。该系统评价已在PROSPERO注册（CRD42020151234）。结果共纳入55项荟萃分析，其中治疗终点荟萃分析比较93项，随访期荟萃分析比较28项。荟萃分析最一致地显示心理干预优于对照条件。然而，治疗后超过一个月的有益长期效果仅限于以创伤为重点的认知行为干预（TF-CBT）和眼动脱敏和再加工（EMDR）。主要随机对照试验存在大量重叠，表明meta分析之间存在冗余。此外，meta分析的质量差异很大。结论需要提高meta分析的方法学和报告质量，避免产生冗余的meta分析，开展更多高质量的大型随机对照试验，并进行长期评估。

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Psychological interventions for adult posttraumatic stress disorder: A systematic review of published meta-analyses

Objective

A large and growing number of published meta-analyses have examined the efficacy of psychological interventions for post-traumatic stress disorder (PTSD). Conclusions drawn from these meta-analyses on treatment efficacy greatly influence clinical practice. This study aimed to provide a comprehensive review of meta-analyses of randomized controlled trials (RCTs) on psychological interventions for adult PTSD, focusing on their content, methodology, and reporting quality.

Method

Systematic database searches were conducted in March 2024 using MEDLINE, PsycInfo, PTSDpubs, Web of Science, and the Cochrane Database of Systematic Reviews. The quality of meta-analyses was assessed using AMSTAR 2. The systematic review was registered on PROSPERO (CRD42020151234).

Results

Overall, 55 meta-analyses with 93 meta-analytic comparisons at treatment endpoint and 28 comparisons at follow-up were included. Meta-analyses most consistently showed superiority of psychological interventions over control conditions. However, beneficial long-term effects exceeding one-month post-treatment were limited to trauma-focused cognitive behavior interventions (TF-CBT) and eye movement desensitization and reprocessing (EMDR). There was a substantial overlap of primary RCTs, indicating redundancy between meta-analyses. Furthermore, the quality of meta-analyses varied substantially.

Conclusions

There is a need to enhance the methodological and reporting quality of meta-analyses, avoid the production of redundant meta-analyses, and conduct more high-quality, large RCTs with long-term assessments.

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来源期刊

Journal of Anxiety Disorders Multiple-

CiteScore

16.60

自引率

2.90%

发文量

期刊介绍： The Journal of Anxiety Disorders is an interdisciplinary journal that publishes research papers on all aspects of anxiety disorders for individuals of all age groups, including children, adolescents, adults, and the elderly. Manuscripts that focus on disorders previously classified as anxiety disorders such as obsessive-compulsive disorder and posttraumatic stress disorder, as well as the new category of illness anxiety disorder, are also within the scope of the journal. The research areas of focus include traditional, behavioral, cognitive, and biological assessment; diagnosis and classification; psychosocial and psychopharmacological treatment; genetics; epidemiology; and prevention. The journal welcomes theoretical and review articles that significantly contribute to current knowledge in the field. It is abstracted and indexed in various databases such as Elsevier, BIOBASE, PubMed/Medline, PsycINFO, BIOSIS Citation Index, BRS Data, Current Contents - Social & Behavioral Sciences, Pascal Francis, Scopus, and Google Scholar.