(第三波)成人广泛性焦虑障碍的认知行为疗法:系统回顾和贝叶斯网络荟萃分析

IF 3.7 2区 医学 Q1 PSYCHIATRY
Xu Dai, Zhongming Zhang, Linghan Sun, Shunshun Zhu, Yunchou Wu, Junwei Lian, Xia Deng
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引用次数: 0

摘要

广泛性焦虑障碍(GAD)给患者和社会带来了沉重的负担。对于广泛性焦虑症,认知行为疗法(CBT)是一种被广泛认可的心理治疗方法。此外,第三波cbt扩大了治疗选择,并有可能对患者的结果和偏好产生积极影响。然而,哪种CBT协议或第三波CBT是最有效和最适合用于初级保健环境的仍然不确定。本研究通过贝叶斯网络荟萃分析探讨了各种CBT方案和第三波CBT在降低广泛性焦虑症症状严重程度方面的短期和长期相对疗效。荟萃分析包括56项研究,涉及4388名参与者。结合初始分析和敏感性分析,结果表明,在CBT方案中,Dugas的CBT方案在降低GAD症状严重程度方面表现出较好的短期和长期疗效,该方案包括自我监控、不确定性耐受教育、担忧信念评估、问题导向改善和核心恐惧处理。在第三波cbt中,基于接受度的治疗对广泛性焦虑症的短期和长期疗效也很显著。贝叶斯元回归分析结果显示,与对照组相比,是否由临床医生指导治疗或方案显着调节了效应量。这些发现为未来的广泛性焦虑症治疗师选择合适的治疗方法和方案提供了有价值的见解,并为更新广泛性焦虑症治疗指南提供了参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
(Third-wave) cognitive behavioral therapy for generalized anxiety disorder in adults: A systematic review and Bayesian network meta-analysis
Generalized anxiety disorder (GAD) imposes a substantial burden on the patient and society. To manage GAD, cognitive behavioral therapy (CBT) is a widely recognized psychotherapeutic approach. Moreover, the third-wave CBTs expand the treatment options and have the potential to positively impact patient outcomes and preferences. However, which CBT protocols or third-wave CBTs are the most effective and appropriate for use in primary care settings remains uncertain. This study explored the short-and long-term relative efficacy of various CBT protocols and third-wave CBTs in reducing GAD symptom severity via a Bayesian network meta-analysis. The meta-analysis comprised 56 studies involving 4388 participants. Combining the initial analysis and sensitivity analysis, the results indicated that among the CBT protocols, Dugas's CBT protocol—which incorporates self-monitoring, education on uncertainty intolerance, assessment of worry beliefs, improvement of problem orientation, and dealing with core fears—demonstrated superior short- and long-term efficacy in reducing GAD symptom severity. Within the third-wave CBTs, the short- and long-term efficacy of acceptance-based therapy for GAD treatment is also notable. The Bayesian meta-regression analysis results showed that whether the therapies or protocols were guided by a clinician significantly moderated the effect size compared with the control group. These findings provide valuable insights for future GAD therapists in selecting appropriate therapies and protocols and a reference for updating GAD treatment guidelines.
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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