丧失亲人后抑郁、焦虑和创伤后应激障碍的危险因素：一项系统回顾和荟萃分析

IF 13.7 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2025-05-03 DOI:10.1016/j.cpr.2025.102589

C. Buur , R. Zachariae , M.M. Marello , M. O'Connor

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引用次数: 0

摘要

丧亲之痛会导致复杂的悲伤反应，包括临床显著的抑郁、焦虑和创伤后应激（ptsd）。深入了解这些复杂的悲伤反应的具体和共同的风险因素可以帮助识别需要支持的个人。方法对失联后抑郁、焦虑和创伤后应激障碍的危险因素进行综合系统回顾和荟萃分析。检索PsycInfo、PubMed、Web of Science和CINAHL以确定纳入meta分析的风险因素。结果系统评价纳入144项研究。大多数危险因素都是小范围的。对于抑郁症，共分析了21个危险因素，其中6个调整后的危险因素分析具有统计学意义。失前期抑郁是最强的危险因素（ESr = 0.25, 95% CI[0.03,0.45]）。在分析的9个PTSS危险因素中，有4个具有统计学意义，其中近亲死亡的影响最大（ESr = 0.24, 95% CI[0.01,0.44]）。只有女性性别与焦虑有显著关系（ESr = 0.21, 95% CI[0.09,0.32]）。女性、伴侣死亡和暴力/非自然损失是跨诊断的风险因素。结论综述了三种复杂悲伤反应的危险因素及其预测强度。研究结果提供了对跨诊断风险因素的见解，并有助于早期识别有复杂悲伤反应风险的人。

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Risk factors for depression, anxiety, and PTSS after loss: A systematic review and meta-analysis

Background

Bereavement can lead to complicated grief reactions including clinically significant symptoms of depression, anxiety, and post-traumatic stress (PTSS) post-loss. Gaining insight into specific and shared risk factors for these complicated grief reactions can help identify individuals needing support.

Methods

A comprehensive systematic review and meta-analysis of risk factors for post-loss depression, anxiety, and PTSS. PsycInfo, PubMed, Web of Science, and CINAHL were searched to identify risk factors for inclusion in the meta-analysis.

Results

The systematic review included 144 studies. Most risk factors were of small magnitude. For depression, 21 risk factors were analyzed, with six analyses of adjusted risk factors reaching statistical significance. Pre-loss depression was the strongest risk factor (ESr = 0.25, 95 %CI [0.03,0.45]). Of nine analyzed risk factors for PTSS, four reached statistical significance, with the death of a close relative yielding the largest effect (ESr = 0.24, 95 %CI [0.01,0.44]). Only female gender significantly predicted anxiety (ESr = 0.21, 95 %CI [0.09,0.32]). Female gender, the death of a partner, and violent/unnatural losses were transdiagnostic risk factors.

Conclusions

An overview of risk factors for three complicated grief reactions, including their predictive strength, is presented. The results provide insights into transdiagnostic risk factors and can aid early identification of people at risk of complicated grief reactions.

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.